Reducing depression during the menopausal transition with health coaching: Results from the healthy menopausal transition randomised controlled trial.
OBJECTIVE
To determine if health coaching (HC) decreases the incidence of depression, reduces the severity of symptoms, and increases quality of life during the menopausal transition (MT).


METHODS
Parallel, single-blinded, randomised controlled trial of 6 sessions of phone-delivered HC compared with usual care. Participants were 351 community-dwelling women free of major depression going through the MT, of whom 180 were assigned the intervention and 171 usual care. The primary outcome of interest was the incidence of clinically significant depressive symptoms over 52 weeks. Other study measures included the Hospital Anxiety and Depression Scale, quality of life (SF-12), the Menopause Rating Scale (MRS), diet, body mass index, alcohol use, smoking and physical activity. We considered that women with Patient Health Questionnaire (PHQ-9) scores between 5 and 14 (inclusive) had sub-threshold depressive symptoms.


RESULTS
Nine women developed clinically significant symptoms of depression during the study-2 had been assigned HC (odds ratio, OR=0.26, 95%CI=0.05, 1.29; p=0.099). Intention-to-treat showed that, compared with usual care, the intervention led to a greater decline in depressive scores, most markedly for participants with sub-threshold depressive symptoms. Similar, but less pronounced, benefits were noticed for anxiety scores and the mental component summary of the SF-12. The intervention led to a decline in MRS scores by week 26 and subtle improvements in body mass, consumption of vegetables and smoking.


CONCLUSIONS
HC addressing relevant risk factors for depression during the MT improves mental health measures. Our findings indicate that women with sub-threshold depressive symptoms may benefit the most from such interventions, and suggest that HC could play a useful role in minimizing mental health disturbance for women going through the MT.
Western Australian Centre for Health & Ageing (M573), Centre for Medical Research of the Perkins Institute for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Australia; Department of Psychiatry, Royal Perth Hospital, Australia. Electronic address: osvaldo.almeida@uwa.edu.au.
Osvaldo P
OP
Almeida
Western Australian Centre for Health & Ageing (M573), Centre for Medical Research of the Perkins Institute for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Australia.
Kylie
K
Marsh
Western Australian Centre for Health & Ageing (M573), Centre for Medical Research of the Perkins Institute for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Australia.
Karen
K
Murray
Department of Obstetrics & Gynaecology, University of Melbourne and Royal Women's Hospital, Parkville, VIC 3052, Australia.
Martha
M
Hickey
School of Medical Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
Moira
M
Sim
Western Australian Centre for Health & Ageing (M573), Centre for Medical Research of the Perkins Institute for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Australia; Department of Psychiatry, Royal Perth Hospital, Australia.
Andrew
A
Ford
Western Australian Centre for Health & Ageing (M573), Centre for Medical Research of the Perkins Institute for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; School of Medicine and Pharmacology, University of Western Australia, Australia; Department of Geriatric Medicine, Royal Perth Hospital, Australia.
Leon
L
Flicker
D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008593:Menopause / Q000523:psychology*; D000071252:Mentoring; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
Depression; Depressive disorder; Health coaching; Major depression; Menopausal transition; Perimenopause; Randomised controlled trial