Symptomatic Menopausal Transition Increases the Risk of New-Onset Depressive Disorder in Later Life: A Nationwide Prospective Cohort Study in Taiwan |
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Authors: | Mu-Hong Chen Tung-Ping Su Cheng-Ta Li Wen-Han Chang Tzeng-Ji Chen Ya-Mei Bai |
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Institution: | 1. Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.; 2. Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.; 3. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.; 4. Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.; 5. Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.; University of Washington, United States of America, |
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Abstract: | IntroductionThe role of the menopausal transition and associated menopausal symptoms in the occurrence of depressive disorders has been discussed and debated for a long time. Most previous clinical studies had limited case samples, and did not control the attributable risk of medical comorbidities.MethodsPatients with a diagnosis of symptomatic menopausal transition and without a psychiatric history were enrolled in 2000 in Taiwan, and compared with age-matched controls (1∶4). These subjects were followed to the end of 2010 to investigate the association between symptomatic menopausal transition and new-onset depressive disorder; the effect of medical comorbidities was also assessed.ResultsA total of 5,837 women with symptomatic menopausal transition were identified, and compared with 23,348 age-matched controls in 2000. The follow-up showed that symptomatic menopausal transition was an independent risk factor for major depression (hazard ratioHR]: 2.18, 95%CI: 1.79∼2.65) and any depressive disorder (HR: 2.34, 95%CI: 2.08∼2.63) after adjusting age at enrollment, monthly income, residence location, level of urbanization, and comorbid medical diseases. In addition, medical comorbidities, including cerebrovascular disease (HR: 1.77, 95% CI: 1.52∼2.07), cardiovascular diseases (HR: 1.35, 95% CI: 1.15∼1.57), congestive heart failure (HR: 1.35, 95% CI: 1.04∼1.75), and liver diseases (HR: 1.19, 95% CI: 1.03∼1.36) increased the risk of developing any depressive disorder.ConclusionOur population cohort study, with the largest study sample and medical record diagnosis thus far, supports an association between symptomatic menopausal transition and depressive disorder in midlife women, and an increased risk of depressive disorder with medical comorbidities. |
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