title: Age at menarche predicts age at onset of major affective and anxiety disorders.
abstract: Menarche age has been associated inconsistently with the occurrence, timing or severity of major depressive disorder (MDD), but rarely studied in women with bipolar (BDs) or anxiety disorders.
  
  
  
  We investigated women patients at a Sardinian mood disorder center for associations of age at menarche with age at illness onset for major affective or anxiety disorders, year of birth, and other selected factors, using bivariate comparisons and multivariate regression modeling.
  
  
  
  Among women (n=1139) with DSM-IV MDD (n=557), BD-I (n=223), BD-II (n=178), or anxiety disorders (n=181), born in 1904-1998, of mean age 42.9 years, menarche age averaged 12.8 [CI: 12.7-12.9] years. Illness onset age averaged 30.9 [30.1-31.8] years, ranking: BD-I, 25.8; anxiety disorders, 28.0; BD-II, 30.3; MDD, 34.1 years. Menarche age declined secularly over birth years, and was associated with younger illness-onset, having no or fewer siblings, more psychiatrically ill first-degree relatives, living in rural environments, being suicidal, substance abuse, and being unemployed. Earlier menarche and earlier illness-onset were significantly associated for onset age groups of ≤ 20, 20-39, and > 40 years. Menarche age versus diagnosis ranked: BD-II<BD-I<anxiety disorders<MDD.
  
  
  
  Age at menarche in Sardinia, as elsewhere, has declined over the past decades. It was strongly associated with age at onset of bipolar and anxiety, as well as major depressive disorders across the age range, suggesting sustained effects of biological maturational factors.
authors.affiliation: International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Lucio Bini Mood Disorder Centers, Cagliari and Rome, Italy. Electronic address: leonardot@aol.com.
authors.forename: L
authors.initials: L
authors.lastname: Tondo
authors.affiliation: Lucio Bini Mood Disorder Centers, Cagliari and Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Pinna
authors.affiliation: International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; NESMOS Department of Psychiatry, Faculty of Medicine, University (Sapienza) of Rome, Rome, Italy; Child Neuropsychiatry Unit, Department of Neuroscience, IRCCS Children Hospital Bambino Gesù, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Serra
authors.affiliation: NESMOS Department of Psychiatry, Faculty of Medicine, University (Sapienza) of Rome, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: De Chiara
authors.affiliation: International Consortium for Psychotic & Mood Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Baldessarini
mesh_terms: D000328:Adult; D017668:Age of Onset; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D015984:Causality; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007558:Italy; D008572:Menarche; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D015995:Prevalence; D055815:Young Adult
keywords: Anxiety; Bipolar disorders; Major depression; Menarche; Onset age