Depressive symptoms during the menopausal transition: the Study of Women's Health Across the Nation (SWAN).
BACKGROUND
The influence of menopausal status on depressive symptoms is unclear in diverse ethnic groups. This study examined the longitudinal relationship between changes in menopausal status and the risk of clinically relevant depressive symptoms and whether the relationship differed according to initial depressive symptom level.


METHODS
3302 African American, Chinese, Hispanic, Japanese, and White women, aged 42-52 years at entry into the Study of Women's Health Across the Nation (SWAN), a community-based, multisite longitudinal observational study, were evaluated annually from 1995 through 2002. Random effects multiple logistic regression analyses were used to determine the relationship between menopausal status and prevalence of low and high depressive symptom scores (CES-D <16 or > or =16) over 5 years.


RESULTS
At baseline, 23% of the sample had elevated CES-D scores. A woman was more likely to report CES-D > or =16 when she was early peri-, late peri-, postmenopausal or currently/formerly using hormone therapy (HT), relative to when she was premenopausal (OR range 1.30 to 1.71). Effects were somewhat stronger for women with low CES-D scores at baseline. Health and psychosocial factors increased the odds of having a high CES-D and in some cases, were more important than menopausal status.


CONCLUSIONS
We used a measure of current depressive symptoms rather than a diagnosis of clinical depression. Thus, we can only make conclusions about symptoms current at annual assessments.


CONCLUSIONS
Most midlife women do not experience high depressive symptoms. Those that do are more likely to experience high depressive symptom levels when perimenopausal or postmenopausal than when premenopausal, independent of factors such as difficulty paying for basics, negative attitudes, poor perceived health, and stressful events.
Bromberger
Joyce T
JT
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States. brombergerjt@upmc.edu
Matthews
Karen A
KA
Schott
Laura L
LL
Brockwell
Sarah
S
Avis
Nancy E
NE
Kravitz
Howard M
HM
Everson-Rose
Susan A
SA
Gold
Ellen B
EB
Sowers
MaryFran
M
Randolph
John F
JF
D000328:Adult; D002979:Climacteric / Q000187:drug effects / Q000523:psychology*; D003431:Cross-Cultural Comparison; D003863:Depression / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D020249:Hormone Replacement Therapy; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010555:Personality Inventory; D014481:United States