Depressed mood during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study.

OBJECTIVE: To characterize patterns of depressed mood during the menopausal transition (MT) in relation to age and MT-related factors and to assess the contribution of factors related to depressed mood at earlier points in the life span. DESIGN: Women (N = 508) were recruited from 1990 to 1992 from multiethnic neighborhoods and followed annually through 2005: 302 met the eligibility criteria for analyses reported here. The Center for Epidemiologic Studies Depression scale (CES-D) and a menstrual calendar were completed annually throughout the study. A subset of women provided a first morning voided urine specimen from 1997 through 2005. Urine samples were assayed for estrone glucuronide, follicle-stimulating hormone, testosterone, and cortisol. Mixed effects modeling was used to identify changes in CES-D scores over time, including the relationship to age, MT-related factors, and factors related to depression at other points in the life span (postpartum depression/blues, life stress, or family history of clinical depression). RESULTS: Age was modestly and negatively related to CES-D scores, but MT stage alone was not, except that the late MT stage was significantly related to depressed mood. Hot flash activity, life stress, family history of depression, history of "postpartum blues," sexual abuse history, body mass index, and use of antidepressants were also individually related to depressed mood; the hormonal assays and age of entry into and duration of late MT stage were unrelated. CONCLUSIONS: Although women in the late MT stage are vulnerable to depressed mood, factors that account for depressed mood earlier in the life span continue to have an important influence and should be considered in studies of etiology and therapeutics.

Risks and protective factors associated with symptoms of depression in low-income African American and Caucasian women during pregnancy.

This article describes the risks and protective factors for symptoms of depression in pregnancy among low-income African American and Caucasian women. Data were collected from 130 women who were between 16 and 28 weeks' gestation and enrolled in an urban prenatal clinic. The questionnaires used in the face-to-face interviews consisted of sociodemographic items, the Beck Depression Inventory (BDI-II), the Prenatal Psychosocial Profile (PPP), 3 items from the Jarel Spiritual Well-Being Scale, the Spiritual Perspective Scale, and 4 items on health risk behaviors. Twenty-seven percent of the women reported depressive symptoms at levels indicating risk for clinical depression. However, there were no significant differences between African American and Caucasian women. Sociodemographic factors accounted for 13% of the variance (P < .01) in BDI-II scores. Psychosocial and behavioral risk factors accounted for an additional 19% of the BDI-II variance (P < .001), and psychosocial and spiritual resources accounted for 7% of the variance (P < .001), resulting in these variables accounting for 54% of the total variance in BDI-II scores. Higher levels of stress, lower levels of self-esteem and social support, and higher religiosity had a significant relationship with more symptoms of depression. This supports the need to routinely screen for and to assess factors associated with depressive symptoms in pregnant low-income women.

Patterns of depressed mood across the menopausal transition: approaches to studying patterns in longitudinal data.

To date many researchers have focused on depression as a discrete episode, attempting to relate its occurrence to a transition in menopausal stage or other factors that might account for its occurrence. Characterizing change over time requires consideration of pattern or trajectory, not merely discrete events. The purposes of this paper are to: 1) to explore methods for intraindividual and interindividual (group) analysis of patterns of depressed mood among midlife women 2) to identify challenges for analytic strategies for understanding depressed mood as it is experienced by midlife women, with special concern for its relationship to the menopausal transition. Data from the Seattle Midlife Women's Health Study were used to illustrate approaches to intraindividual and interindividual analysis of patterns of depressed mood. For most women, menopausal transition was not a time when there was a new episode of depression. Instead, a minority of women showed evidence of becoming depressed once the transition had begun. The most prevalent pattern was that of non-depressed mood across the years of the menopausal transition. Association of several factors with a pattern of depressed mood included life stressors, perceived poor health, and vasomotor symptoms.