上海某妇科门诊围绝经期及绝经后期妇女抑郁症状检出率及相关因素  

Prevalence and risk factors of depressive symptoms in perimenopausal and early postmenopausal women at a gynecological clinic in Shanghai

作　　者：陶晶[1] 仇剑崟[1] 顾红亮[2] 杨慧琳[2] 陈静[1] 王祖承[1] 

机构地区：[1]上海交通大学医学院附属精神卫生中心,200030 [2]上海市浦东新区妇幼保健院,201206

出　　处：《上海精神医学》2011年第1期31-37,共7页Shanghai Archives of Psychiatry

基　　金：高等学校博士学科点专项科研基金(20050266006)

摘　　要：背景围绝经期的激素水平变化常常与躯体症状和心理症状相关,因而这一阶段的妇女发生抑郁症状的风险高。但是生物—心理—社会因素在绝经期抑郁症状发生中的复杂的相互作用尚未完全清楚。目的评估围绝经期和绝经后期妇女抑郁症状的发生比例,以及抑郁症状的危险因素。方法随机选取在上海某妇幼保健院就诊的 45 ～55 岁的围绝经期及绝经后期妇女 287 例。所有对象完成 3 个问卷: 一般社会人口学资料问卷、Beck 抑郁量表(Beck's Depression Inventory,BDI) 以及 Kupperman 绝经指数量表(Kupperman Menopausal Index,KMI) .结果根据 KMI 的结果,最常见的绝经症状为潮热出汗(84.0%) 、肌肉骨关节痛(83.3%) 、疲乏无力(81.5%) 以及心悸(74.9%) 。以 BDI 总分 5 分为界限,104 例(36.2%,95% CI = 30.6% ～ 41.8%) 入组的妇女存在抑郁症状(即 BDI≥5) .与非抑郁组相比,抑郁组中哺乳史的比例低,绝经期相关症状家族史的比例高,未婚、离异或丧偶的婚姻状况较多,平均居住面积小。排除 KMI 中与抑郁症状相关的 4 项条目后,抑郁症状组 KMI 剩余 7 项的调整后总分高于非抑郁症状组[分别为 14.7(6.5) 分,11.6(5.5) 分,t =4.11,P <0.001]。多因素 logistic 回归分析结果显示存在绝经期相关症状家族史(OR =2.43,95%CI =1.15 ～5.12) 、调整后的 KMI 总分高(2.79,1.49 ～5.26) 、未哺乳(2.64,1.47 ～4.75) 、非在婚(3.72,1.23 ～11.21) 是临床抑郁症状的独立相关因素。结论在专科医院妇科门诊的围绝经期及绝经后期妇女的抑郁症状检出率较高,上述妇女在该时期发生抑郁症状的独立危险因素如下: 绝经期相关症状家族史、绝经期症状严重、从未哺乳以及非在婚。Background：Hormonal fluctuations during the perimenopausal period are often associated with both physical and psychological symp-toms so women are at high risk of depression during this period.However,the complex interaction of biopsychosocial factors in the development of depression during the menopause are not,as yet,fully known.Objective：Assess the prevalence of depressive symptoms and the risk factors for depressive symptoms in perimenopausal and early postmenopausal women in Shanghai,China.Methods：287 perimenopausal and early postmenopausal women 45-55 years of age were randomly selected from a gynecological clinic at a women＇s hospital in Shanghai.Respondents completed three questionnaires：a demographic profile questionnaire,Beck＇s Depression Inventory（BDI）,and the Kupperman Menopausal Index（KMI）.Results：The most frequent menopausal symptoms reported in the KMI by these respondents were hot flashes（84.0%）,arthralgia and myalgia（83.3%）,fatigue（81.5%）and palpitations（74.9%）.Using the cutoff score of 5 on the BDI,104 of the subjects（36.2%;95%CI=30.6%-41.8%）had clinically significant depressive symptoms.Compared to those without significant depressive symptoms,those with depressive symptoms were significantly less likely to have had breast-feed their children;more likely to have a family history of menopausal symptoms;more likely to be unmarried,divorced or widowed;and had a smaller mean household living space.After excluding the 4 items about depression,the mean（SD）adjusted total score of the 7 remaining items on the KMI was significantly higher in the depressed group [14.7（6.5）vs 11.6（5.5）;t=4.11,P0.001].Four factors remained independently related to having clinically significant depressive symptom in the logistic regression analysis：family history of menopausal symptoms（OR=2.43,95%CI=1.15-5.12）,high adjusted total KMI score（2.79,1.49-5.26）,no prior breastfeeding（2.64,1.47-4.75）,and not currently married（3.72,1.23-11.21）.Conclusion：The

关 键 词：围绝经期 绝经后期 抑郁 检出率 相关因素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]