title: Suicidal ideation among postmenopausal women on hormone replacement therapy: The Korean National Health and Nutrition Examination Survey (KNHANES V) from 2010 to 2012.
abstract: BACKGROUND
  Suicide is a major public health problem around the world. Some studies have found that hormone replacement therapy (HRT) is associated with depression in postmenopausal women. Depression is a well-known risk factor for suicide; therefore, we investigated the relationship between HRT and suicidal ideation in postmenopausal Korean women.
  
  
  METHODS
  We included 2286 postmenopausal women with or without HRT from the Korean National Health and Nutrition Examination Survey 2010-2012. The use and duration of HRT and mental health status, including stress, depressive mood, and suicidal ideation and attempts, were assessed by self-report questionnaires.
  
  
  RESULTS
  The proportion of participants with depressive mood and suicidal ideation was higher in the HRT group than the non-HRT group (all p values<0.05). As the duration of HRT increased, the percentage of participants with suicidal ideation increased (p for trend=0.006). After adjusting for all covariates, the odds ratio (95% confidence intervals) for suicidal ideation was 1.742 (1.223-2.482) in the women with HRT, compared to women without HRT. HRT duration longer than 10 years was associated with suicidal ideation (odds ratio=2.089 and 95% confidence intervals=1.069-4.084).
  
  
  CONCLUSIONS
  The cross-sectional design, a possibility of incorrect answer about menopausal status, and no assessment of the type of HRT are the main limitations of this study.
  
  
  CONCLUSIONS
  Postmenopausal women receiving HRT, especially for more than 10 years, showed increased suicidal ideation compared with postmenopausal women without HRT. Physicians should pay attention to mood symptoms and suicidal ideation in postmenopausal women with HRT.
authors.affiliation: Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Ji-Yoon
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Medical Statistics, Catholic University College of Medicine, Seoul, South Korea.
authors.forename: Yong-Kyu
authors.initials: YK
authors.lastname: Park
authors.affiliation: Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Kyung-Hwan
authors.initials: KH
authors.lastname: Cho
authors.affiliation: Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Seon-Mee
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Youn-Seon
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Do-Hoon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Ga-Eun
authors.initials: GE
authors.lastname: Nam
authors.affiliation: Department of Medical Statistics, Catholic University College of Medicine, Seoul, South Korea.
authors.forename: Kyung-Do
authors.initials: KD
authors.lastname: Han
authors.affiliation: Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea. Electronic address: mrchir@naver.com.
authors.forename: Yang-Hyun
authors.initials: YH
authors.lastname: Kim
mesh_terms: D044466:Asian People / Q000523:psychology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000139:chemically induced / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D020249:Hormone Replacement Therapy / Q000009:adverse effects* / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000523:psychology*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D059020:Suicidal Ideation; D013997:Time Factors
keywords: Hormone replacement therapy; Korean National Health and Nutrition Examination Survey; Postmenopausal women; Suicidal ideation