Depressive symptoms, menopausal status, and climacteric symptoms in women at midlife

OBJECTIVE: Previous studies have found increased rates of depression in women aged 45 to 54 years, but the factors that influence these rates are not understood. It was assessed whether higher rates of depressive symptoms were associated with menopausal status, climacteric symptoms, and use of hormone replacement therapy. DESIGN: Cross-sectional survey. SETTING: Community sample. METHODS: Data are from 581 women ages 45 to 54 years who were interviewed by telephone between October 1998 and February 1999. MEASURES: Depression was measured with the abbreviated CES-D, a depressive symptoms screening measure. Women's reported perception of menopausal stage, frequency of periods in the preceding 12 months, and history of oophorectomy were used to classify their menopausal status into four categories: (1) no indication of menopause; (2) close to menopause; (3) had begun menopause; and (4) had completed menopause. RESULTS: There were 168 women (28.9%) who reported a high level (> or = 10) of depressive symptoms when the abbreviated CES-D was used. In a logistic-regression analysis, significant factors associated with increased depressive symptoms included physical inactivity, inadequate income, use of estrogen/progesterone combination, and presence of climacteric symptoms (trouble sleeping, mood swings, or memory problems). Menopausal status was not associated with depressive symptoms. CONCLUSIONS: In this sample of women age 45 to 54 years, climacteric symptoms but not menopausal status were associated with higher rates of depressive symptoms.     

Depressive symptoms, cynical hostility, and weight change: A 3-year follow-up among middle-aged men and women

In this article we examine, in a 3-year follow-up, whether depressive symptoms and cynical hostility predict weight change. A cardiovascular risk factor survey was carried out for a stratified random sample of a population aged between 45 to 64 years in 1992. A follow-up survey was conducted three years later for 119 male and 166 female participants of the baseline survey. Using similar methodology, body mass index (BMI), depression (Beck depression inventory), cynical hostility (cynical distrust scale), and several health-related factors were measured in both surveys. Higher depression scores at the baseline predicted both weight gain (> 2 BMI units) and weight loss (> 1 BMI unit) during the follow-up. Cynical hostility did not predict weight change. An increase in depression scores predicted weight loss. Women with depressive symptoms in the least educated group lost weight, and women with depressive symptomsin the most educated group gained weight. These results emphasize the assessment of depressive symptoms in a normal population that is interested in losing weight or preventing obesity.     

Depressive symptoms and serum lipid levels in young adult women

Accumulating data suggest that depression is associated with risk factors for cardiovascular disease, but few studies have investigated potential behavioral mediators of such associations, particularly among women. In this study of healthy young adult women (n = 225), we examined associations among depressive symptoms, health behaviors, and serum lipid levels. Depressive symptoms were assessed with the 20-item Center for Epidemiologic Studies-Depression scale, and a fasting blood sample was obtained for serum lipid levels, including total cholesterol, high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C). Diet was measured using 24-h recalls, and other health behaviors (physical activity, smoking) were assessed via self-report questionnaire. Results indicated a modest negative association between depressive symptoms and LDL-C levels. Higher levels of depressive symptoms were also associated with lower total and insoluble dietary fiber intake, both of which were associated with HDL-C and LDL-C. Mediational analyses indicated a significant indirect effect of depressive symptoms on LDL-C via total and insoluble dietary fiber in unadjusted analyses, but not in adjusted analyses. The present findings suggest that depressive symptoms are inversely associated with serum LDL-C levels in young adult women, but that these associations are not likely mediated by adverse lifestyle behaviors.     

Preventing weight gain through exercise and physical activity in the elderly: a systematic review

This review examines the role of exercise and physical activity for preventing weight gain in older people. A structured search using MeSH-vocabulary and Title/Abstract-searches was conducted in PubMed for January 2000 to June 2011, identifying weight gain and exercise or physical activity as study topics, and aged adults as target group. In study selection, all types of exercise and physical activity and any measure of weight change in aged adults (≥65 years) or postmenopausal women were considered. N=9 primary studies were identified. All were conducted in the US, with one study additionally including samples from Canada and the UK. Three studies focused on aged adults, while six concentrated specifically on postmenopausal women. Forms of exercise or physical activity comprised self-reported exercise history in four studies and low, moderate or high intensity exercise interventions in five studies. Four studies combined exercise with a hypocaloric diet and included comparison groups receiving either diet only, health education, stretching or a delayed intervention (one study each). Exercise was associated with weight loss (1.1-6 kg) in all intervention studies, all of which studied an overweight sample, and with weight maintenance in most observational studies, all of which studied a general population or otherwise overweight-unspecific sample. In sum, exercise and physical activity can effectively prevent weight gain in older adults and postmenopausal women either in terms of weight loss or maintenance. They can preserve lean body mass and thus are important for the balance between potentially positive and negative effects of weight reduction in later life. In addition, since all intervention studies were conducted with an overweight sample, it seems that primordial prevention (in terms of preventing the development of risk factors such as excess weight in the first place) might be a neglected issue in geriatric and postmenopausal prevention.     

Depressive symptoms and the incidence of adult-onset asthma in African American women

BackgroundSome evidence suggests that depression may increase the risk of adult-onset asthma. No data are available for African American women, in whom the prevalence of depression and asthma is high.ObjectiveTo conduct prospective analyses of the relation of depressive symptoms to asthma incidence in the Black Women's Health Study, a prospective cohort of US black women followed since 1995 with mailed biennial questionnaires.MethodsOf 31,848 participants followed from 1999 to 2011, 771 reported incident asthma. Depressive symptoms were ascertained on 1999 and 2005 follow-up questionnaires with the Center for Epidemiological Studies–Depression Scale (CES-D). Participants rated the frequency of 20 symptoms. A score was calculated by summing the responses to all questions. Cox regression models were used to derive incidence rate ratios and 95% confidence intervals for 4 categories of the CES-D score in relation to incident asthma, adjusted for body mass index, smoking, and other covariates.ResultsThe multivariable incidence rate ratio in the highest category of CES-D score (≥33) compared with the lowest (<16) was 2.08 (95% confidence interval 1.58–2.74), with a significant trend (P < .0001). The incidence rate ratio was higher in women who took antidepressants, were current or former smokers, were not obese, and were at least 40 years old, although there were no statistically significant interactions.ConclusionA positive association was observed between CES-D score and the incidence of adult-onset asthma. If the hypothesis is confirmed, depression could contribute substantially to the burden of asthma in adults.     

Maternal physical activity,birth weight and perinatal mortality

As a result of the acquisition of upright posture, adaptation to muscular exercise seems to be unique in man. It involves a redistribution of the cardiac output mediated by the sympathetic system towards priority organs which apparently do not include the pregnant uterus. This could explain the poor tolerance of the human fetus to maternal exercise. The hypothesis is supported by the independence of a detrimental effect of work from the effect of maternal nutrition and by an influence of maternal posture in late pregnancy on its out-come. Possible relations between maternal activity before and during late pregnancy and perinatal mortality are discussed in the context of this hypothesis.     

Stress,psychological distress,psychosocial factors,menopause symptoms and physical health in women

Objectives

Relatively few studies have evaluated relationships between stress, psychological distress, psychosocial factors and menopause symptoms, and none have evaluated emotional intelligence (EI) in relation to menopause. In this study, direct and indirect relationships were evaluated between stress, psychological distress, psychosocial factors (e.g. social support, coping, EI), menopause symptom severity and physical health in middle-aged women.

Methods

One hundred and sixteen women aged 45–55 years were recruited through women's health centres and community organizations. They completed a short questionnaire asking about stress, psychological distress (i.e. anxiety, depression), EI, attitude to menopause, menopause symptoms and physical health.

Results

Low emotional intelligence was found to be related to worse menopause symptoms and physical health, and these associations were partly mediated by high stress, anxiety and depression, a negative attitude to menopause and low proactive coping.

Conclusions

Women with high EI appear to hold more positive attitudes to menopause and experience less severe stress, psychological distress and menopause symptoms and better physical health. These results suggest that women who expect menopause to be a negative experience or are highly stressed or distressed may be more likely to experience a more negative menopause.     

湖北省农村贫困地区妇女的抑郁症状及相关因素

目的:了解湖北省农村贫困地区妇女的抑郁症状流行现状及相关因素,为农村贫困地区妇女抑郁的三级预防提供理论依据和指导。方法:采用随机整群抽样法在湖北省7个贫困县市的8个村调查1345名妇女(年龄18～64岁),采用简版流调中心用抑郁自评量表(CES-D₁₀)评估抑郁症状。结果:CES-D₁₀平均得分为(5.8±4.5)分,中位数为5.0分。具有抑郁倾向的检出率为19.8%。多因素回归分析结果显示,睡眠质量越差、经济状况差、年龄越大、丧偶以及有异常孕产史妇女的CES-D₁₀得分越高(β=0.40、0.24、0.07、0.06、0.05,P<0.05);经常锻炼身体妇女的CES-D₁₀得分越低(β=-0.06,P<0.05)。结论:本研究发现,经济困难、睡眠质量差、年龄增长、丧偶、异常孕产史和锻炼身体是湖北省农村贫困妇女抑郁症状的相关因素。     

Depressive symptoms increase risk of HIV disease progression and mortality among women in Tanzania

The effect of depression on HIV disease progression was examined among 996 HIV-positive Tanzanian women participating in a trial on micronutrients and pregnancy outcomes, vertical transmission, and disease progression. Depression and social support were measured 2 months after HIV screening and every 6 to 12 months thereafter. Depression measures from pregnancy and more than 12 months postpartum were included in this analysis. Participants' clinical condition and access to supportive individual or group counseling was assessed throughout the 6 to 8 years of follow-up. Cox proportional hazard models were used to estimate the time-varying effect of depression on progression to HIV clinical stage III/IV (World Health Organization) and all-cause mortality. Participation in group or individual counseling and baseline social support were also examined. More than half (57%) of the study sample had symptoms comparable with depression at least once during the follow-up period. Controlling for sociodemographic variables, psychosocial support, and clinical condition at enrollment, depression was associated with an increased risk of disease progression (HIV clinical stage III/IV [hazard ratio (HR) = 1.61, 95% confidence interval (CI): 1.28 to 2.03] and mortality [HR = 2.65, 95% CI: 1.89 to 3.71]). Depression is common among HIV-infected Tanzanian women and increases the risk of disease progression. Screening for depression and providing psychosocial interventions should be considered part of comprehensive HIV care.     

Depressive symptoms in bulimic, depressed, and non-psychiatric control subjects

Depressive symptoms and syndromes occur commonly in bulimia--an observation which has prompted some investigators to hypothesize an association between bulimia and major affective disorder. However, it has also been suggested that the character of the depressive symptoms in bulimic patients differs from that found in patients with major depression--arguing against an association between the two disorders. To test this possibility, we compared item scores on the Hamilton Rating Scale for Depression among 45 bulimic patients, 21 patients in treatment for major depression, and 27 non-psychiatric control subjects. The bulimic and depressed patients proved indistinguishable on virtually all items, whereas both groups were readily distinguishable from non-psychiatric control subjects.     

Using self-determination theory to promote physical activity and weight control: a randomized controlled trial in women

Behavior change interventions are effective to the extent that they affect appropriately-measured outcomes, especially in experimental controlled trials. The primary goal of this study was to analyze the impact of a 1-year weight management intervention based on self-determination theory (SDT) on theory-based psychosocial mediators, physical activity/exercise, and body weight and composition. Participants were 239 women (37.6 ± 7.1 years; 31.5 ± 4.1 kg/m²) who received either an intervention focused on promoting autonomous forms of exercise regulation and intrinsic motivation, or a general health education program (controls). At 12 months, the intervention group showed increased weight loss (−7.29%,) and higher levels of physical activity/exercise (+138 ± 26 min/day of moderate plus vigorous exercise; +2,049 ± 571 steps/day), compared to controls (P < 0.001). Main intervention targets such as more autonomous self-regulation (for treatment and for exercise) and a more autonomous perceived treatment climate revealed large effect sizes (between 0.80 and .96), favoring intervention (P < 0.001). Results suggest that interventions grounded in SDT can be successfully implemented in the context of weight management, enhancing the internalization of more autonomous forms of behavioral regulation, and facilitating exercise adherence, while producing clinically-significant weight reduction, when compared to a control condition. Findings are fully consistent with previous studies conducted within this theoretical framework in other areas of health behavior change.     

Depressive symptoms in rape victims

Thirty-four recent rape victims were assessed for depressive symptomatology using a well-validated self-report instrument in combination with formal psychiatric evaluation. Fifteen subjects were found to be moderately or severely depressed when measured on the self-report questionnaire. A closer examination of these 15 subjects revealed that 8 were suffering from a major depressive disorder. The authors emphasize that all clinicians working with rape victims should be alert to the emergence of depression in this population.     

Vasomotor symptoms and quality of life in previously sedentary postmenopausal women randomised to physical activity or estrogen therapy

OBJECTIVE: To assess if regular physical exercise or oral oestradiol therapy decreased vasomotor symptoms and increased quality of life in previously sedentary postmenopausal women. SETTING: A prospective, randomised trial at a University Hospital. METHODS: 75 postmenopausal, sedentary women with vasomotor symptoms were randomised to: exercise three-times weekly over 12 weeks (15 women), oral oestradiol therapy for 12 weeks (15 women) and 45 women to three other treatment arms. Results from the exercise and oestradiol groups are presented here. The effects on vasomotor symptoms and wellbeing were assessed with logbooks and validated questionnaires. RESULTS: Ten women fulfilled 12 weeks of exercise. The number of flushes was rather unchanged in five women and decreased to 28% (range 18-42%) of baseline in the other five women. Five of the ten women continued to exercise another 24 weeks, thus in all 36 weeks. The mean number of flushes decreased by about 50% in these five women (from 6.2/24 to 3.2 flushes/24 h at 36 weeks). In the same group a score made as the product of reduction in number and severity of flushes decreased by 92% at 12 weeks, 75% at 24 weeks and 72% at 36 weeks compared with baseline. In the estrogen group flushes decreased from 8.4 to 0.8 (P<0.001) after 12 weeks of therapy and remained at this level after 36 weeks. Well-being according to different measurements improved significantly in both groups, albeit more markedly in the estrogen group. CONCLUSIONS: Apart from many other health benefits regular physical exercise may decrease vasomotor symptoms and increase quality of life in postmenopausal women, but this has to be further evaluated scientifically. Exercise should be introduced gradually to ensure compliance.     

Interrelationships among activity,food intake and weight gain in genetically obese and lean Zucker rats

In Experiment 1, food deprivation resulting in a 30% reduction in body weight produced significant increases in wheel running in both obese and lean female Zucker rats. In Experiment 2, a new technique, food contingent activity (FR, VI), dramatically increased wheel running in both obese and lean female Zucker rats. This increase in activity was achieved primarily during the dark period. Regardless of changes in activity levels, food intake and body weight gain remained similar to controls. When food was again available ad lib, activity levels rapidly decreased for obese but not lean rats. These results indicate that behavioral interventions alone are not sufficient to correct the obesity of the genetically obese rat.