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Major depression during and after the menopausal transition: Study of Women's Health Across the Nation (SWAN)

Published online by Cambridge University Press:  09 February 2011

J. T. Bromberger ,
H. M. Kravitz ,
Y.-F. Chang ,
J. M. Cyranowski ,
C. Brown  and
K. A. Matthews
J. T. Bromberger*
Affiliation:
Departments of Epidemiology and Psychiatry, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
H. M. Kravitz
Affiliation:
Departments of Psychiatry and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
Y.-F. Chang
Affiliation:
Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
J. M. Cyranowski
Affiliation:
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
C. Brown
Affiliation:
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
K. A. Matthews
Affiliation:
Departments of Psychiatry, Epidemiology, and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
*
*Address for correspondence: Dr J. T. Bromberger, Ph.D., University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. (Email: [email protected])
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Abstract

Background

It is unclear whether risk for major depression during the menopausal transition or immediately thereafter is increased relative to pre-menopause. We aimed to examine whether the odds of experiencing major depression were greater when women were peri- or post-menopausal compared to when they were pre-menopausal, independent of a history of major depression at study entry and annual measures of vasomotor symptoms (VMS), serum levels of, or changes in, estradiol (E2), follicular stimulating hormone (FSH) or testosterone (T) and relevant confounders.

Method

Participants included the 221 African American and Caucasian women, aged 42–52 years, who were pre-menopausal at entry into the Pittsburgh site of a community-based study of menopause, the Study of Women's Health Across the Nation (SWAN). We conducted the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) to assess diagnoses of lifetime, annual and current major depression at baseline and at annual follow-ups. Psychosocial and health factors, and blood samples for assay of reproductive hormones, were obtained annually.

Results

Women were two to four times more likely to experience a major depressive episode (MDE) when they were peri-menopausal or early post-menopausal. Repeated-measures logistic regression analyses showed that the effect of menopausal status was independent of history of major depression and annually measured upsetting life events, psychotropic medication use, VMS and serum levels of or changes in reproductive hormones. History of major depression was a strong predictor of major depression throughout the study.

Conclusions

The risk of major depression is greater for women during and immediately after the menopausal transition than when they are pre-menopausal.

Keywords

Longitudinalmajor depressionmenopause
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 9 , September 2011 , pp. 1879 - 1888
Copyright
Copyright © Cambridge University Press 2011

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