The transition to menopause has typically been considered a time when women may be more vulnerable to mood changes. There have been inconclusive data, however, as to whether women with no lifetime history of depression transitioning to menopause are at increased risk for developing an episode of major depression.

In a recent study, Drs. Lee Cohen and Claudio Soares examined the association between the menopausal transition and first onset of major depression. This study was conducted as part of the Harvard Study of Moods and Cycles, a population-based prospective study of premenopausal women with and without a lifetime history of major depression. In this report, a cohort of premenopausal women (36-45 years of age) with no lifetime diagnosis of major depression (n = 460) was assessed. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to screen for depressive symptoms over a period of up to 6 years.

Premenopausal women with no history of depression who entered the perimenopause were twice as likely to develop significant depressive symptoms when compared with women who remained premenopausal during the period of observation. The risk for depression was somewhat greater in women who reported vasomotor symptoms and was also increased among women who experienced negative life events proximate to this transition.

These findings indicate that among women with no history of depression transition into the menopause significantly increases the risk for depression. Further studies will help to determine whether other factors such as the presence of vasomotor symptoms, use of hormone therapy, presence of sleep disturbance and the occurrence of adverse life events may also affect a woman’s risk for depression during the midlife.

Ruta Nonacs, MD PhD

Cohen L, Soares C, Vitonis A, Otto M, Harlow B. Risk for new onset of depression during the menopausal transition: The Harvard Study of Moods and Cycles. Arch Gen Psychiatry. 2006;63:385-390

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