title: Vasomotor symptoms are associated with depression in perimenopausal women seeking primary care.
abstract: OBJECTIVE
  To compare the relationship between vasomotor symptoms (hot flushes and night sweats) and depression in perimenopausal women with that in postmenopausal and older premenopausal women.
  
  
  METHODS
  Questionnaire data assessing current depressive symptoms (Center for Epidemiologic Studies Depression Scale), hot flushes, night sweats, menopausal status, depression history, hormonal therapy use, and demographic characteristics were collected from women aged 40 to 60 years seeking primary care. Multivariable logistic regression models were used to examine the relationship between vasomotor symptoms and depression.
  
  
  RESULTS
  Depression (defined by a Center for Epidemiologic Studies Depression Scale score >/= 25) was observed in 14.9% of 141 perimenopausal women, 13.9% of 151 postmenopausal women, and 7.6% of 184 older premenopausal women. Recent vasomotor symptoms were reported by 53.9% of perimenopausal women, 43.7% of postmenopausal women, and 20.7% of older premenopausal women. Perimenopausal women with vasomotor symptoms were 4.39 times more likely to be depressed than those without vasomotor symptoms (95% CI, 1.40-13.83), an association that did not change after controlling for depression history. In contrast with perimenopausal women, postmenopausal and older premenopausal women with vasomotor symptoms did not have a significantly greater risk for depression than women of the same menopausal status without vasomotor symptoms (adjusted odds ratios, 1.28 and 1.77; 95% CI, 0.47-3.46 and 0.53-5.89, respectively).
  
  
  CONCLUSIONS
  Hot flushes and night sweats are associated with depression in perimenopausal women. Further investigation is warranted to elucidate the mechanism by which hot flushes may be associated with depression in perimenopausal women and not in postmenopausal or older premenopausal women.
authors.affiliation: Perinatal and Reproductive Psychiatry Program, Reproductive Endocrine Unit, and Medical Service, Massachusetts General Hospital, Boston, MA, USA. hjoffe@partners.org
authors.forename: Hadine
authors.initials: H
authors.lastname: Joffe
authors.forename: Janet E
authors.initials: JE
authors.lastname: Hall
authors.forename: Claudio N
authors.initials: CN
authors.lastname: Soares
authors.forename: John
authors.initials: J
authors.lastname: Hennen
authors.forename: Caragh J
authors.initials: CJ
authors.lastname: Reilly
authors.forename: Karen
authors.initials: K
authors.lastname: Carlson
authors.forename: Lee S
authors.initials: LS
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000367:Age Factors; D002979:Climacteric / Q000502:physiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis*; D005260:Female; D019584:Hot Flashes / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D017698:Postmenopause / Q000502:physiology / Q000523:psychology; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D013546:Sweating / Q000502:physiology; D014666:Vasomotor System / Q000503:physiopathology*