title: [Depression in perimenopausal period].
abstract: In the article are two frequently misused notions are defined: climiacterium and menopause. Menopause-related disorders can appear 2 to 6 years before and continue for 2 to 6 years after menopause, with their duration up to 20 years. An attempt of qualitative approach to menopausal ailments is the point scale by Kupperman. The diversity of the symptoms encountered in women in perimenopausal period is the reason to seek medical advice from experts in various disciplines: internal medicine, cardiology, gynaecology, neurology, rheumatology, and least frequently psychiatry, as it is fairly common for women to perceive life problems or mental stress as somatic disorder. In Poland, middle-aged women constitute 30% of all women. Medical approach to their health problems is focused on somatic diseases like myocardial infarction, cerebral stroke, and cancer, which are likely to contribute to shortening of life expectancy. Growing awareness of the problem of depression among doctors non-psychiatrists may contribute to desirable change in doctors' and patients' attitude to this disease. The average prevalence of depression is estimated to be about 17% of the total population. Depression is thrice more frequent among women than among men. The peak of incidence is seen among middle-aged patients. In this article clinical forms of affective disorders are discussed according to the current DSM IV classification, main symptoms suggesting depression are given, and masked depression, the most common and most difficult to detect form of the disease is discussed. Risk factors for depression are presented, and attention is paid to the dramatic fact that depression may not only decrease the quality of life, but may also stand behind the patient's loss of full functional capacity or even death. Suicidal thoughts are experienced by 60% of depressive patients, while as many as 15% of them do actually commit suicide. Collective analysis of the depression risk factors and concomitant somatic disorders in a given patient will surely increase the likelihood of correct diagnosis.
authors.affiliation: Klinika Chorób Wewnetrznych, Endokrynologii i Zaburzeń Hemostazy Instytutu Chorób Wewnetrznych Akademii Medycznej w Gdańsku.
authors.forename: Alicja
authors.initials: A
authors.lastname: Zalewska-Juzwa
authors.forename: Eugenia
authors.initials: E
authors.lastname: Czestochowska
mesh_terms: D002979:Climacteric / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008875:Middle Aged