OBJECTIVE The aim of this study was to examine how depressive symptoms change in midlife and across the menopause transition. METHODS We conducted a secondary analysis of data from a prospective population-based cohort, the Coronary Artery Risk Development in Young Adults study. We included women (n = 2,160) with ≥3 responses to the Center for Epidemiologic Studies Depression Scale (CES-D) beginning at examination year 5, at approximately 30 years of age, and again at years 10, 15, 20, 25, 30, and 35 (ages 35 through 60 years). We modeled trajectories of CES-D by chronologic age and compared these to trajectories of depressive symptoms by relation to age at menopause. RESULTS We identified three trajectories of depressive symptoms: women with minimal (n = 1,328, 61%, mean CES-D 8.1); intermediate (n = 675, 31%, mean CES-D 15.6); or persistent depressive symptoms (n = 157, 7%, mean CES-D 26.1). Trajectories were stable over time, among women who had undergone natural menopause (n = 1,153), Black race (odds ratio [OR], 1.85; 95% confidence interval [CI], 1.43 to 2.40), less than a high school education (OR, 1.83; 95% CI, 1.38 to 2.41), and low income (OR, 1.60; 95% CI, 1.18 to 2.18), along with tobacco use (OR, 1.35; 95% CI, 1.04 to 1.77), alcohol consumption (OR, 1.01; 95% CI, 1.004 to 1.02), estrogen use for vasomotor symptoms (OR, 1.71; 95% CI, 1.06 to 2.77), and higher body mass index (OR, 1.03; 95% CI, 1.01 to 1.05) that were also associated with persistent depressive symptoms. Hormonal contraceptive use at year 2 was associated with lower odds of persistent depressive symptoms (OR, 0.69; 95% CI, 0.51 to 0.93). Similar patterns were observed among women who underwent surgical menopause. CONCLUSIONS Depressive symptoms in the premenopause were similar to those in postmenopause, and risk factors could be identified early in reproductive life. Studies with more frequent assessments of depressive symptoms during the menopause transition are needed.

中文翻译：

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从育龄晚期到更年期过渡期的黑人和白人女性人群中抑郁症状的轨迹：30 年分析。


目的 本研究的目的是检查抑郁症状在中年和整个更年期过渡期如何变化。方法 我们对来自前瞻性人群队列的数据进行了二次分析，即年轻人冠状动脉风险发展研究。我们纳入了从检查第 5 年开始、大约 30 岁以及第 10、15、20、25、30 和 35 岁 （35 至 60 岁） 开始对流行病学研究中心抑郁量表 （CES-D） 有 ≥3 反应的女性 （n = 2,160）。我们按实际年龄对 CES-D 的轨迹进行建模，并将其与更年期年龄相关的抑郁症状轨迹进行比较。结果我们确定了抑郁症状的三种轨迹：轻微 （n = 1,328， 61%， 平均 CES-D 8.1）;中间 （n = 675， 31%， 平均 CES-D 15.6）;或持续性抑郁症状 （n = 157,7%，平均 CES-D 26.1）。随着时间的推移，在自然绝经 （n = 1,153）、黑人 （比值比 [OR]，1.85;95% 置信区间 [CI]，1.43 至 2.40）、高中教育程度较低 （OR，1.83;95% CI，1.38 至 2.41） 和低收入 （OR，1.60;95% CI，1.18 至 2.18） 以及烟草使用（OR，1.35;95% CI，1.35 - 2.18）以及烟草使用（OR，1.35;95% CI， 1.04 至 1.77）、饮酒 （OR， 1.01;95% CI， 1.004 至 1.02）、使用雌激素治疗血管舒缩症状 （OR， 1.71;95% CI， 1.06 至 2.77） 和较高的体重指数 （OR， 1.03;95% CI， 1.01 至 1.05） 也与持续性抑郁症状相关。第 2 年使用激素避孕药与持续抑郁症状的几率较低相关 （OR，0.69;95% CI，0.51 至 0.93）。在接受手术绝经的女性中也观察到类似的模式。 结论 绝经前的抑郁症状与绝经后相似，可在生育早期识别危险因素。需要对更年期过渡期间的抑郁症状进行更频繁评估的研究。