Premenstrual symptoms and perimenopausal depression

OBJECTIVE: The role of ovarian steroids in both premenstrual dysphoria and perimenopausal depression has led to the suggestion that these conditions represent expressions of the same underlying disorder. Premenstrual mood symptoms were evaluated in women with perimenopause-related depression. METHOD: Self-reports and daily symptom ratings during one menstrual cycle were examined in 70 depressed perimenopausal women attending a menopause clinic and 35 nondepressed perimenopausal women. RESULTS: Twenty-six percent of the depressed and 9% of the nondepressed women reported premenstrual symptoms. Thirty-one percent of the depressed and 20% of the nondepressed women met criteria for significant menses-related symptom cyclicity (at least a 30% increase in the average ratings of at least two of four measured negative mood symptoms in the premenstrual versus the postmenstrual week); 5 of these depressed women and none of the comparison subjects described premenstrual symptoms on self-reports. Finally, 21% of the depressed and 3% of the nondepressed women met criteria for premenstrual dysphoria (symptom cyclicity and at least moderate severity, with symptoms exceeding a minimum luteal symptom severity threshold of 2.5). CONCLUSIONS: A higher-than-expected rate of menses-related symptom cyclicity and premenstrual dysphoria was observed in perimenopausal depressed women. However, neither menses-related symptom cyclicity nor premenstrual dysphoria was an invariant accompaniment of perimenopausal depression. Additionally, the rate of premenstrual dysphoria was not predicted by initial self-reports.     

Effects of Menopause on Seizures in Women with Epilepsy

Summary: Purpose: Although important associations between epilepsy and women's hormonal phases are described, the relation of menopause to epilepsy has received little attention. Methods: By using a structured interview, we studied menopausal women with epilepsy seen at the University of Maryland Epilepsy Center over a 1-year period from 1994 to 1995. We analyzed the characteristics and temporal relation of the seizures to menopause and compared the frequency and severity of the seizures with those in a similar group of premenopausal women. Results: We identified 61 menopausal women (46 who were postmenopausal and 15 perimenopausal) and compared them with 46 premenopausal women. No statistically significant differences were noted in either the frequency or the severity of seizures comparing all menopausal or only postmenopausal with premenopausal women. However, 12 (20%) of the 61 menopausal women noted that their seizures first began during or after menopause, with eight having no proven cause for their seizures. Many individual women described changes in their seizures with menopause. Among the 61 menopausal women, 49 had established epilepsy before the onset of menopause, and 20 (41%) reported worsening of their seizures with menopause, 13 (27%) noted improvement, and 16 (33%) described no changes. These observations were similar for peri- and post-menopausal women. Of the 15 menopausal women taking hormone replacement therapy, the six taking progestin were significantly less likely to report worsening of their seizures. Conclusions: These findings support the view that hormonal influences are important in women with seizures. Although, in aggregate, menopausal (combined perimenopausal and post-menopausal) and postmenopausal women's seizures were similar in frequency and severity to those of other women, menopause was associated with changes in seizures for some women. Moreover, menopause may be a previously unrecognized factor for some new-onset seizures. The relations between menopause and epilepsy deserve to be more fully investigated.     

Health and psychosocial correlates of disordered gambling in older adults.

OBJECTIVE: A number of regional prevalence studies suggest that disordered gambling is a clinically significant problem among older adults. However, little research has evaluated whether older adults with a gambling disorder experience increased health, psychiatric, substance use, and social problems as compared with older adults without a gambling disorder. METHODS: A group of 48 older-adult disordered gamblers and 48 older adult non/infrequent gamblers, matched by age, sex, race, and recruitment site, completed the Addiction Severity Index (ASI), Brief Symptom Inventory (BSI), and Short Form-36 Health Survey (SF-36). Multivariate general-linear models evaluated between-group differences on these indices. RESULTS: Compared with non/infrequent gamblers, disordered gamblers reported increased severity of medical, family/social, psychiatric, and alcohol problems on the ASI. They also scored higher on depression, anxiety, paranoid ideation, and psychoticism subscales of the BSI, and lower on vitality, physical functioning, role-physical, general health, and social functioning subscales of the SF-36. CONCLUSIONS: These results suggest that older adults with a gambling disorder experience increased severity of health and psychosocial problems, compared with older adult non/infrequent gamblers matched by age, sex, race, and recruitment site.     

Concordant restoration of ovarian function and mood in perimenopausal depression

OBJECTIVE: Despite reports of estradiol's therapeutic efficacy in perimenopausal depression, the relationship between ovarian function and mood in perimenopausal depression remains unclear. The purpose of this study was to examine changes in mood and pituitary-ovarian axis function in women exhibiting perimenopausal depression. METHOD: Depression ratings (from the Center for Epidemiologic Studies-Depression Scale [CES-D Scale]) and follicle-stimulating hormone (FSH) plasma levels of depressed perimenopausal women (N=110) attending a menopause clinic were obtained at baseline and after a 6-week screening period. RESULTS: Eighteen women experienced an improvement in depression (50% decline in CES-D Scale scores) at week 6, which was associated with a significant decrease in FSH plasma levels (baseline: mean=73.3 IU/liter [SD=42.0]; week 6: mean=42.2 IU/liter [SD=28.6]). Similarly, those subjects experiencing a 50% drop in FSH plasma levels had significant decreases in CES-D Scale scores (baseline: mean=23.3 [SD=6.8]; week 6: mean=18.1 [SD=10.9]). However, between women with CES-D Scale scores > or = 15 and those with CES-D Scale scores <15, no significant differences in FSH levels were observed either at baseline (mean=65.5 IU/liter [SD=35.7] and 60.9 IU/liter [SD=34.9], respectively) or at week 6 (mean=56.2 IU/liter [SD=36.6] and 51.5 IU/liter [SD=34.2]). CONCLUSIONS: Mood variability in women with perimenopausal depression may reflect episodic alterations in ovarian function that are best detected by longitudinal study designs.     

The SCL-90 and SCL-90R versions validated by item response models in a Danish community sample

OBJECTIVE: To evaluate the internal validity of the subscales of the combined SCL-90 and SCL-90R, the SCL-92, by item response analyses as compared with several previously reported factor analyses of this questionnaire in the literature. METHOD: The SCL-92 questionnaire was mailed to an age- and gender-stratified random sample of Danish citizens. The sample comprised 2040 individuals. The internal structure of the nine factors of the SCL-92 questionnaire was evaluated by Mokken-Loevinger analysis and Rasch analysis. RESULTS: In total, 1153 persons or 58% returned the questionnaire fully completed. Mokken analysis found all scales apart from the psychoticism scale acceptable. The Rasch analysis found most of the subscales to be robust. Minor problems were seen for the scales of phobic anxiety, obsession-compulsion and depression. Analysis of the Global Severity Index showed that the Rasch model was rejected for the full 92-item scale, but not for a scale consisting of the 63 items from the non-psychotic subscales. Spearman correlations among the subscales were all positive (range 0.34-0.79) and so were correlations between each of the subscales and the Global Severity Index (range 0.55-0.91). CONCLUSION: In this sample from the Danish general population the non-psychotic subscales, i.e. the subscales covering psychological distress were observed to function well. In a general population sample, the 63 non-psychotic items primarily appear to reflect one broad dimension of distress.     

Increased depression and anxiety in infertile Japanese women resulting from lack of husband's support and feelings of stress

We report that infertile women in Japan as well as in the Western world have high levels of emotional distress, anxiety, and depression. The reasons for anxiety and depression in infertile women are easy to presume but remain unclear. We conducted the present study to assess the relationship between the anxiety and depression of infertile Japanese women and their thought processes and emotional well-being with regard to their infertility. A cross-sectional questionnaire was administered to 101 infertile Japanese women who visited the infertility clinic at Tokai University. Inventories included the Hospital Anxiety and Depression Scale (HADS) and our original infertility questionnaire, which is composed of 22 questions to assess attitudes and emotional status in facing the stigma of infertility. After factor analysis, comparison between the HADS and the infertility questionnaire was made with simultaneous multiple regression analyses. Anxiety and depression in childless Japanese women were significantly associated with lack of husband's support and feeling stress. Our findings should prove useful in designing and implementing psychological support programs for infertile Japanese women. Psychological interventions to relieve or diminish these conditions might have significant therapeutic benefits for women attending infertility clinics in Japan.     

The associations between menopausal syndrome and depression during pre-, peri-, and postmenopausal period among Taiwanese female aborigines

Aim:  The aim of the study was to evaluate the association between physiological menopausal symptoms and depression during the pre-, peri-, and postmenopausal period among female Taiwanese aborigines.
Methods:  A total of 672 Taiwanese aboriginal women, aged 40–60 years, were recruited in the interviewing study and classified as pre-, peri-, and postmenopausal according to menstrual bleeding patterns in the previous 12 months. Then, the postmenopausal symptoms, depression, self-perceived health, family support, and associated demographic variables were assessed by questionnaire based on the results of interviewing by research assistants.
Results:  The results revealed that perimenopausal statuses are associated with depression and women with a perimenopausal status had a higher prevalence of depression than those with a premenopausal status. A higher score on physiological postmenopausal symptoms was found to be significantly associated with depression. Furthermore, somatic symptoms were associated with depression for pre-, peri-, and postmenopausal statuses. Moreover, sexual dysfunction and vasomotor symptoms were associated with depression only in the premenopausal status and postmenopausal status, respectively.
Conclusion:  Depression should be routinely evaluated for female Taiwanese aborigines consulting with physicians for menopause symptoms, especially for somatic symptoms. Furthermore, attention should be provided to premenopausal women with sexual dysfunction and postmenopausal women with vasomotor symptoms for depression.     

Headaches in Middle-Aged Women during Menopausal Transition: A Headache Clinic-Based Study

Middle-aged women are frequent visitors in headache clinics. We investigated the differences in headache characteristics of middle-aged women (aged 40-54 years) according to their menopausal status. In total, 229 women were divided into the following three groups: premenopausal (n = 78), perimenopausal (n = 69), and postmenopausal (n = 82). The prevalence of tension-type headaches was higher in the peri- and postmenopausal groups than in the premenopausal group (p < 0.05), whereas the prevalence of migraines was similar across the three groups. The proportion of patients with a short duration of headache history (<6 months) was significantly higher in the perimenopausal group (40.6%) than in the premenopausal (12.8%) or postmenopausal (17.1%) groups (p < 0.01). Analysis of headaches in perimenopausal patients who did not receive exogenous hormone treatment (n = 61) showed that current headaches were reported as new-onset headaches by 47.5% of subjects, as aggravations of prior headaches by 34.4% of subjects, or as unchanged from prior headaches in 18.0% of subjects. This study shows that the prevalence of tension-type headaches is different between menopausal periods, whereas the prevalence of migraines is not changed. Perimenopausal women tended to experience relatively more tension-type headaches and visited the hospital mainly due to new-onset headaches or aggravated headaches.     

Prevalence of insomnia and its relationship to menopausal status in middle-aged Korean women

Although the prevalence of insomnia and the association of insomnia with menopause have been well reported, not much work has been conducted in population-based research on insomnia and menopause in Korea. The purpose of the present report was to determine overall and different prevalence of insomnia by menopausal status, and the relationship between insomnia and menopause in a population-based sample of middle-aged Korean women. A total of 96.1% of 2497 randomly selected middle-aged Korean women participated. Insomnia was defined as occurring three times a week or more in the previous month. Subjects were categorized into three groups: premenopause, perimenopause, and postmenopause. The overall prevalence of insomnia in middle-aged Korean women was 14.3%. The most common symptom of insomnia was difficulty maintaining sleep (9.7%), followed by difficulty initiating sleep (7.9%), and early morning awakening (7.5%). Multiple logistic regression analysis revealed that menopause was independently associated with insomnia after adjusting for confounding factors such as age, income, and depression. Perimenopause was significantly associated with a dramatic increase in the risk of insomnia, but there was no significant association for postmenopause. The major finding is that insomnia is significantly associated with the menopausal transition. The prevalence of insomnia increases significantly by the transition from premenopause to perimenopause, but not to postmenopause. A further prospective study is needed to investigate the influence of menopause on insomnia.     

The relationship between psychiatric symptoms and glycemic status in a Chinese population

With the exception of depression and anxiety, there has been no study designed to evaluate the association between other psychiatric symptoms and Type 2 diabetes. The aim of this study was to investigate the relationship between different psychiatric symptoms and diabetes as well as pre-diabetes (Pre-DM) in a Chinese population. Totally, 9561 participants without a history of diabetes, depression, psychosis, use of hypnotics, and abnormal thyroid function were enrolled. Psychiatric symptoms were measured by Brief Symptoms Rating Scale questionnaire, which consists of three global indices [General Severity Index (GSI), Total Number of Positive Symptoms (PST), and Positive Symptom Distress Index (PSDI)] and ten subscales, including somatization, obsession, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid ideation, psychoticism and additional symptoms. Different glycemic statuses included normal glucose tolerance (NGT), Pre-DM, and newly-diagnosed diabetes (NDD) group. GSI, somatization, hostility, phobia, psychoticism, and additional symptoms were the factors positively associated with NDD as well as pre-DM in an age-adjusted model. After adjustments for age, gender, body mass index, educational level, hypertension, plasma triglycerides and creatinine, smoking, alcohol use, regular exercise, marital status, and family history of diabetes mellitus, the following psychiatric symptoms were independently related to both NDD and pre-DM: GSI, PST, somatization, obsession, interpersonal sensitivity, depression, anxiety, hostility, phobia, psychoticism, and additional symptoms. In addition to depression and anxiety, global indices of psychiatric symptoms and other subscales, including somatization, obsession, interpersonal sensitivity, hostility, phobia, psychoticism and additional symptoms, may have an impact on both diabetes and Pre-DM.     

The Brief Symptom Inventory (BSI) as a screening tool for psychological disorders in patients with epilepsy and mild intellectual disabilities in residential care

This study examines the usefulness of the Brief Symptom Inventory (BSI) as a screening tool for psychological disorders in patients with epilepsy and mild intellectual disabilities. Participants were 91 residents of the Bethel Institute, Bielefeld, Germany. Cronbach's alpha was revealed to be sufficient for the composite score Global Severity Index (GSI) (0.95) and for most of the subscales (0.64-0.80). Compared with normative data, residents with epilepsy scored slightly higher on all BSI scales. Only the subscale Paranoid Ideation was especially elevated, a finding of heuristic value. Subgroups of residents with past psychiatric morbidity, on current psychotropic medication, with poor seizure control, and more epilepsy-related problems either tended toward or demonstrated higher GSI scores. These results indicate the validity of the questionnaire with the GSI as a global indicator of possible psychopathology. BSI subscales seemed to reflect predominantly the amount of emotional distress, but their potential to identify specific clinical syndromes remained unclear.     

Menopause-related quality of life in chronically mentally ill women

OBJECTIVE: Menopause is an important life event that has not yet been well characterized among women with severe mental illness. Our goal was to evaluate menopause-related quality of life among severely mentally ill women. METHOD: We conducted a cross-sectional assessment of perimenopausal and postmenopausal women, ages 45-55, diagnosed with schizophrenia/schizoaffective disorder, bipolar disorder, or major depression, who were receiving inpatient or outpatient psychiatric care. Women were compared regarding menopausal symptoms and quality of life using the Menopause Specific Quality of Life Scale (MENQOL). RESULTS: Women with severe mental illnesses who were peri- and post-menopausal experienced considerable vasomotor, physical, sexual, and psychosocial symptoms related to menopause. On seven of 29 MENQOL items, women with major depression reported problems significantly more often than women with other serious mental illnesses. CONCLUSIONS: This preliminary study indicates that psychiatrists and other physicians should consider the frequency and overlap of menopausal and psychiatric symptoms among women with serious mental illness in this age group.     

Musculo-skeletal pain, psychological distress, and hormones during the menopausal transition

OBJECTIVE: To investigate the relationship between sex hormones (estradiol, testosterone, androstendione, DHEA-S) and prolactin on one hand and musculo-skeletal pain and psychological distress on the other during the menopausal transition. METHOD: Fifty-seven regularly menstruating women, who were studied over five consecutive years, who reached menopause before the fifth assessment, and did not use hormone replacement therapy were included in the study. Hormones were sampled and a questionnaire including questions on psychological distress and musculo-skeletal pain were administered at the five points of assessment. Data on last year before menopause (T1), first (T2) and second (T3) year after menopause are reported. RESULTS: DHEA-S, but neither testosterone nor androstendione, was inversely related to distress and pain. Pain contributed to the variance of DHEA-S over the menopausal transition, whereas DHEA-S levels did not predict pain or distress when baseline levels were controlled for. Prolactin was at T1 and T2 positively associated with distress and at T2 positively associated with musculo-skeletal pain. Musculo-skeletal pain pre-menopause was significantly related to estradiol. CONCLUSION: DHEA-S was negatively associated, and prolactin positively associated with musculo-skeletal pain and psychological distress. Whereas post-menopause DHEA-S levels were influenced by pain scores, no significant effect of pre-menopause hormones on post-menopause pain and distress was found.     

Menopause in multiple sclerosis: therapeutic considerations

While the onset of multiple sclerosis (MS) typically occurs during the childbearing years, many women living with MS are of perimenopausal age. There is frequent overlap between menopausal and MS-related symptoms and co-morbidities (e.g. sexual dysfunction, mood disorders and bladder function). Furthermore, some MS symptoms may be exacerbated by perimenopausal changes such as hot flashes or sleep disturbance. The MS neurologist may frequently be the first to become aware of these symptoms and to play a role in monitoring and managing them. In this review, we describe immunological and neurologic changes at menopause as they may impact MS. We then review common symptoms, including fatigue, depression, sexual function, pain and insomnia, and provide both behavioral and pharmacological suggestions for their management. Next, we discuss the need for osteoporosis and cancer screening in perimenopausal women with MS. Finally, we highlight important research gaps, including what effect, if any, the menopausal transition may play on MS disease course as well as the potential modulatory role of hormone replacement therapies.     

Fluctuations in mood and psychological distress during the menstrual cycle

This paper examines fluctuations in mood and symptoms associated with psychological distress during the phases of the menstrual cycle in two samples of university women. The first (Study I) sample of women (N = 162) was randomly selected from the University population. The second sample (Study II) was women (N = 138) who attended a psychiatric clinic. The subjects completed a questionnaire which included measures of depression, anxiety and general psychological distress. Information about the menstrual cycle and contraceptive pills was elicited from the subjects who were unaware that affect during the menstrual cycle was being studied. In study I there were no significant differences in depression, anxiety or psychological distress between phases of the cycle. The results of study II indicated that even in a group of women with emotional problems, it was not possible to demonstrate an increase in the average severity of mood disturbance or psychological distress during any phase of the menstrual cycle. It was concluded that in general, university women between the ages of 18-30 who are mostly single, nulliparous, with or without significant psychopathology, seeking or not seeking psychiatric help do not experience significant or disruptive fluctuations in mood and symptoms of psychological distress during the phases of the menstrual cycle. Women who are afflicted with distressing and incapacitating cyclical fluctuations are best studied as a vulnerable subgroup.     

The Effect of Menopause and Perimenopause on the Course of Epilepsy

PURPOSE: The purpose of this study was to obtain preliminary information about the effect of menopause and perimenopause on the course of epilepsy, and to determine whether seizure type, use of hormone-replacement therapy (HRT), or a history of catamenial seizure pattern would influence this course. METHODS: We performed a questionnaire study of women with epilepsy currently in menopause and perimenopause, requesting information regarding the course of their epilepsy and treatment. Statistical analysis was performed by using Pearson chi2 with 95% confidence limits. RESULTS: Forty-two menopausal women (ages 41-86 years) responded. Twelve subjects reported no change in seizures at menopause, 17 reported a decrease in seizure frequency, and 13 reported an increase. Sixteen (38%) took synthetic HRT. Sixteen (38%) additional subjects (having some overlap with the HRT group) reported having a catamenial seizure pattern before menopause. HRT was significantly associated with an increase in seizures during perimenopause (p = 0.001). A history of catamenial seizure pattern was significantly associated with a decrease in seizures at menopause (p = 0.013). Thirty-nine perimenopausal women (ages 38-55 years) responded. Nine subjects reported no change in seizures at perimenopause, five reported a decrease in seizure frequency, and 25 reported an increase. Eight (15%) subjects took synthetic HRT, and 28 (72%) reported having a catamenial seizure pattern before menopause. HRT had no significant effect on seizures; however, a history of catamenial seizure pattern was significantly associated with an increase in seizures at perimenopause (p = 0.02). CONCLUSIONS: These pilot data suggest that synthetic HRT may be associated with an increase in seizure frequency in menopausal women with epilepsy. A catamenial seizure pattern may be associated with seizure decrease during menopause but with an increase during perimenopause.     

Psychosomatic medicine. Side effects of oral contraceptive medication: a psychosomatic problem

To determine which side effects of oral contraceptives are biologic and which are psychologic in origin, 70 women were interviewed for several hours. The women were private patients of a gynecologist or attending a family planning clinic and were proven fertile, without gynecologic illness or psychiatric history, and were taking various combined or sequential pills. When the women were classified into emotionally well-adjusted and maladjusted, the maladjusted group had more severe and numerous psychological side effects. Onset of side effects was associated with fear of cancer, pregnancy despite the pill, and fear of damage to the procreative system. Most common side effects were nausea, vomiting, breast swelling, weight gain, mood changes, anxiety, irritability and nervousness. Side effects, assumed to be psychologic because they occurred in the maladjusted group, included depression (45% of total), loss of libido, breast swelling. Weight gain was not associated with maladjustment.     

The relationship between locus of control, tinnitus severity, and emotional distress in a group of tinnitus sufferers

One hundred and nine tinnitus sufferers attending a specialist out-patient clinic completed questionnaires assessing the following: locus of control of behaviour, anxiety (STAI), depression (BDI) and tinnitus severity. Anxiety and depression were found to be correlated with tinnitus severity, as was locus of control, with “internals” reporting their tinnitus to be less severe than “externals.” Partial correlations indicated that locus of control did not directly affect tinnitus severity, but rather, this effect was mediated by the effect of locus of control on anxiety and depression.     

Depression in premenopausal women: gonadal hormones and serotonergic system assessed by D-fenfluramine challenge test

PURPOSE: The aim of the study was to compare the activity of gonadal hormones and serotonergic system in premenopausal women with or without depression in relation to clinical and hormonal indices of menopause. METHODS: The sample included 60 women with single or recurrent major depressive episode with disease onset after 38 year of age (mean age 43 years) and 30 healthy control women (mean age 41 years). Psychometric assessment was done by means of 17-item Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI). The presence of menopausal symptoms was assessed by Kupperman Menopause Index (KMI). Activity of gonadal axis was measured by estimating estradiol and follicle-stimulating hormone (FSH) levels. For the assessment of central serotonergic activity, the D-fenfluramine test was used. RESULTS: Depressed women had higher intensity of menopausal symptoms, significantly lower concentration of estradiol, and higher of FSH than control women. Severity of depression correlated with both the intensity of menopausal symptoms and the concentration of FSH. Baseline levels of prolactin were not different in both groups. Following D-fenfluramine administration, there was a significant increase in prolactin concentration in healthy women and a transient decrease in depressed ones. Baseline cortisol level was significantly higher in depressed women and correlated with the severity of depression. D-Fenfluramine challenge caused a significant increase of cortisol secretion in healthy women and a significant decrease in depressed ones. A relationship was observed between baseline estradiol, FSH, and cortisol level and the magnitude of prolactin and cortisol response to D-fenfluramine. CONCLUSIONS: In premenopausal women, a high degree of interconnections was demonstrated between symptoms of depression and symptoms of menopause on both clinical and hormonal level. The results confirm the association between depressive and menopausal symptoms as well as an involvement of gonadal hormones, cortisol, and serotonin deficiency in this process.     

上海某妇科门诊围绝经期及绝经后期妇女抑郁症状检出率及相关因素

背景围绝经期的激素水平变化常常与躯体症状和心理症状相关,因而这一阶段的妇女发生抑郁症状的风险高。但是生物—心理—社会因素在绝经期抑郁症状发生中的复杂的相互作用尚未完全清楚。目的评估围绝经期和绝经后期妇女抑郁症状的发生比例,以及抑郁症状的危险因素。方法随机选取在上海某妇幼保健院就诊的 45 ～55 岁的围绝经期及绝经后期妇女 287 例。所有对象完成 3 个问卷： 一般社会人口学资料问卷、Beck 抑郁量表（Beck＇s Depression Inventory,BDI） 以及 Kupperman 绝经指数量表（Kupperman Menopausal Index,KMI） .结果根据 KMI 的结果,最常见的绝经症状为潮热出汗（84.0%） 、肌肉骨关节痛（83.3%） 、疲乏无力（81.5%） 以及心悸（74.9%） 。以 BDI 总分 5 分为界限,104 例（36.2%,95% CI = 30.6% ～ 41.8%） 入组的妇女存在抑郁症状（即 BDI≥5） .与非抑郁组相比,抑郁组中哺乳史的比例低,绝经期相关症状家族史的比例高,未婚、离异或丧偶的婚姻状况较多,平均居住面积小。排除 KMI 中与抑郁症状相关的 4 项条目后,抑郁症状组 KMI 剩余 7 项的调整后总分高于非抑郁症状组[分别为 14.7（6.5） 分,11.6（5.5） 分,t =4.11,P 〈0.001]。多因素 logistic 回归分析结果显示存在绝经期相关症状家族史（OR =2.43,95%CI =1.15 ～5.12） 、调整后的 KMI 总分高（2.79,1.49 ～5.26） 、未哺乳（2.64,1.47 ～4.75） 、非在婚（3.72,1.23 ～11.21） 是临床抑郁症状的独立相关因素。结论在专科医院妇科门诊的围绝经期及绝经后期妇女的抑郁症状检出率较高,上述妇女在该时期发生抑郁症状的独立危险因素如下： 绝经期相关症状家族史、绝经期症状严重、从未哺乳以及非在婚。