title: Impact of reproductive status and age on response of depressed women to cognitive therapy.
abstract: OBJECTIVE
  Previous research suggests that reproductive hormones are potential affective modulators in mood disorders and may influence response to antidepressant medications. To our knowledge, there are no data on relationships between hormonal status and response to psychotherapy for recurrent major depressive disorder (MDD).
  
  
  METHODS
  At two sites, female outpatients (n=353), aged 18-70, with recurrent MDD received 12-14 weeks of cognitive therapy (CT). Menopausal status and age were based on self-report. In the parent study, nonresponse to therapy was defined as persistence of a major depressive episode (MDE) as defined by the DSM-IV or a final Hamilton Rating Scale for Depression-17-Item (HRSD(17)) score of ≥ 12 or both. More traditional definitions of response (at least a 50% reduction in pretreatment HRSD(17)) and remission (a final HRSD(17) ≤ 6) were also examined.
  
  
  RESULTS
  Controlling for pretreatment HRSD(17) scores, there were no significant differences found in the rates of response to CT or symptom status among premenopausal, perimenopausal, and postmenopausal women.
  
  
  CONCLUSIONS
  We found no support for the hypotheses that response to CT or the rates of change in depressive symptoms are moderated by reproductive status. The findings, however, are limited by the absence of early follicular phase serum sampling/analysis to estimate hormone levels and the reliance on self-report to establish menopausal status. These data motivate a full investigation of the effects of reproductive status on response to psychosocial interventions.
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. anna_brandon@med.unc.edu
authors.forename: Anna R
authors.initials: AR
authors.lastname: Brandon
authors.forename: Abu
authors.initials: A
authors.lastname: Minhajuddin
authors.forename: Michael E
authors.initials: ME
authors.lastname: Thase
authors.forename: Robin B
authors.initials: RB
authors.lastname: Jarrett
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D016015:Logistic Models; D008423:Maternal Age; D008593:Menopause; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D017584:Reproductive History; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013781:Texas; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents