title: Hormone-related factors and post-menopausal onset depression: results from KNHANES (2010-2012).
abstract: BACKGROUND
  Although hypotheses have been proposed regarding the biological mechanisms of hormonal fluctuations in mood disorders, few epidemiological studies have addressed this issue. The aim of this study was to examine the association between hormone-related life events and postmenopausal depression.
  
  
  METHODS
  Of 13,918 women who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) V, a total of 4869 post-menopausal women who had completed information on depression onset age and additional reproductive factors were included in the analysis. A multivariate logistic regression was applied to calculate the odds ratios between reproductive factors and post-menopausal onset depression.
  
  
  RESULTS
  A total of 276 women (5.7%) were diagnosed with depression after menopause. Longer reproductive years were associated with a reduced risk of depression (for more than 35 reproductive years: OR=0.41, 95% CI: 0.27-0.62, P-trend<0.001). Similarly, a later age of menopause (52 years and older) corresponded to a decreased risk of depression (OR=0.35, 95% CI: 0.22-0.55) compared to the women with a menopausal age younger than 46 years. Greater numbers of pregnancies and exogenous hormone use were also associated with increased risk of depression.
  
  
  CONCLUSIONS
  All data were collected from interviews using questionnaires. There may be some inaccuracies in recall of lifetime reproductive events, but women generally recalled their hormonal events correctly.
  
  
  CONCLUSIONS
  Early menopause and the use of exogenous hormones were associated with the risk of post-menopausal depression. Clinicians should closely monitor and consider further screening for depressed women who undergo early menopause or those with exogenous hormone use.
authors.affiliation: Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sun Jae
authors.initials: SJ
authors.lastname: Jung
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Aesun
authors.initials: A
authors.lastname: Shin
authors.affiliation: Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: dhkang@snu.ac.kr.
authors.forename: Daehee
authors.initials: D
authors.lastname: Kang
mesh_terms: D017668:Age of Onset; D000368:Aged; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D017698:Postmenopause; D017584:Reproductive History; D012306:Risk; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Depression; Hormonal life event; Hormone replacement therapy; Menopause; Oral contraceptive