title: Perimenopause and incidence of depression in midlife women: a population-based study in Taiwan.
abstract: OBJECTIVE
  To examine the relationships between depressive symptoms, menopausal status, and menopausal symptoms in middle-aged women.
  
  
  METHODS
  This cross-sectional, population-based study involved patients in the Taiwanese community. Data were retrieved from the nationwide 2002 Health Promotion Knowledge, Attitude, and Performance Survey in Taiwan. We assessed depressive symptoms using the Taiwanese Depression Questionnaire with a cut-off point of 18 of 19. Self-reported perception of menopausal status, frequency of menstrual periods in the preceding 12 months, and a history of oophorectomy surgery were used to categorize the women's menopausal status into premenopause, perimenopause, postmenopause, and surgical menopause.
  
  
  RESULTS
  A total of 3359 women aged 40-55 years were selected. Among these patients, 145 women (4.7%) experienced higher levels of concurrent depressive symptoms. The increase in depressive symptoms was significantly associated with menopausal status and most of the menopausal symptoms. After controlling for age, marital status, education, income, smoking, hormone therapy, and menopause symptoms, multivariate logistic regression showed that perimenopause was still significantly associated with depression in midlife women (odds ratio 1.97; 95% confidence interval 1.24-3.14).
  
  
  CONCLUSIONS
  Independent of menopausal symptoms, perimenopausal status increases the risk of depression.
authors.affiliation: Chang Gung Memorial Hospital at Linko and Chang Gung University College of Medicine, Department of Psychiatry, Taoyuan, Taiwan.
authors.forename: H-L
authors.initials: HL
authors.lastname: Lin
authors.forename: M-C
authors.initials: MC
authors.lastname: Hsiao
authors.forename: Y-T
authors.initials: YT
authors.lastname: Liu
authors.forename: C-M
authors.initials: CM
authors.lastname: Chang
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007182:Income; D017533:Marital Status; D008593:Menopause; D008875:Middle Aged; D047648:Perimenopause / Q000523:psychology*; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology