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Does childhood maltreatment or current stress contribute to increased risk for major depression during the menopause transition?

Published online by Cambridge University Press:  10 December 2020

Joyce T Bromberger ,
Yuefang Chang ,
Alicia B Colvin ,
Howard M Kravitz  and
Karen A Matthews
Joyce T Bromberger*
Affiliation:
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
Yuefang Chang
Affiliation:
Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
Alicia B Colvin
Affiliation:
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
Howard M Kravitz
Affiliation:
Departments of Psychiatry and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
Karen A Matthews
Affiliation:
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
*
Author for correspondence: Joyce T Bromberger, E-mail: brombergerjt@upmc.edu
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Abstract

Background

The menopausal transition (MT) poses an increased risk for major depression (MD), but not for all women. Current and past stress are toxic risk factors for depression throughout life. The MT may be a time of increased sensitivity to stress, especially among women with a lifetime history of major depressive disorder (MDD). We evaluated whether women who experienced childhood maltreatment (CM) or current stressful events or ongoing problems were at increased risk for MD during the MT.

Methods

At the Pittsburgh site of the Study of Women's Health Across the Nation, 333 midlife women were interviewed approximately annually over 15 years with the Structured Clinical Interview for the Diagnosis of DSM-IV Axis I Disorders and provided health and psychosocial data including the Childhood Trauma Questionnaire. Repeated measures logistic regression analyses were conducted separately for women with and without lifetime MDD at study entry.

Results

Among women with lifetime MDD, CM, but not current stress, interacted with menopausal status to increase the risk for MD during postmenopause (ORs ranged from 2.71 to 8.04). All stressors were associated with increased odds of MD. Among women without lifetime MDD, current stress was related to risk for MD, but the effect did not vary by menopausal status.

Conclusions

Women with MDD prior to midlife and who experienced CM were at greatest risk for MD after the MT. Women without prior MDD were at increased risk for MD during peri- and postmenopause. Healthcare providers should monitor women at risk for MD even after the MT.

Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 13 , October 2022 , pp. 2570 - 2577
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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