绝经对抑郁焦虑症状的影响:北京市社区女性队列调查  

Effects of menopause on depressive and anxiety symptoms in community women in Beijing

作　　者：唐瑞怡[1] 罗敏[1] 范宇博 谢卓霖 黄菲玲 张多多 刘改芬[2] 王亚平[1] 林守清[1] 陈蓉[1] Tang Ruiyi;Luo Min;Fan Yubo;Xie Zhuolin;Huang Feiling;Zhang Duoduo;Liu Gaifen;Wang Yaping;Lin Shouqing;Chen Rong(Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,National Clinical Research Center for Obstetric and Gynecologic Diseases,Beijing 100730,China;Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院妇产科,国家妇产疾病临床医学研究中心,北京100730 [2]首都医科大学附属北京天坛医院神经内科,北京100070

出　　处：《中华妇产科杂志》2022年第6期419-425,共7页Chinese Journal of Obstetrics and Gynecology

基　　金：国家自然科学基金(81871141);中国医学科学院医学与健康科技创新工程(2020-I2M-C&T-B-040)。

摘　　要：目的评估绝经分期、年龄等相关因素对北京市社区女性抑郁和焦虑症状的影响。方法基于社区的前瞻性队列研究。选取"北京协和医院中年女性卵巢衰老队列"中完成2次及以上抑郁焦虑症状评价、已绝经、未使用激素治疗、35~64岁之间的受试者纳入本研究的资料分析。主要结局变量为受试者的抑郁焦虑症状,通过医院抑郁焦虑量表进行评价。统计学分析方法采用广义估计方程。结果经由2006至2014年的随访,最终纳入430例受试者、2533次随访资料。在生殖衰老分期的各分期阶段抑郁症状发生率均高于焦虑症状;抑郁和焦虑症状的发生率,与生育期晚期[分别为14.5%(19/131)和3.1%(4/131)]相比,在绝经过渡期及绝经后期均升高,+1c期最高[分别为20.6%(155/751)和8.8%(66/751)],但差异均无统计学意义(P均>0.05)。本研究未发现绝经分期与抑郁焦虑症状有统计学相关性(P均>0.05)。抑郁症状发生率在≥60~<65岁年龄段最高[20.8%(74/355)],焦虑症状发生率在≥50~<55岁年龄段达到最高[8.2%(62/754)],但年龄与抑郁焦虑症状也无关(P均>0.05)。多因素分析显示,体质指数高、低教育水平、健康状态差是抑郁症状的独立危险因素(P均<0.05);健康情况差、失眠、早醒是焦虑症状的独立危险因素(P均<0.01)。结论抑郁和焦虑症状在绝经过渡期和绝经后期比生育期晚期更常见,其中抑郁症状比焦虑症状更普遍。有必要对围绝经期女性筛查和评估抑郁焦虑问题。Objective To determine the effects of menopausal stage,age and other associated risk factors on symptoms of anxiety and depression among women in a community in Beijing.Methods This study was a community-based prospective cohort.Participants who had transitioned through natural menopause,completed two or more depressive and anxiety symptoms evaluations,aged 35 to 64 years,and did not use hormone therapy were selected from the Peking Union Medical College Hospital aging longitudinal cohort of women in midlife to this analysis.The primary outcome variables were depressive and anxiety symptoms,assessed by hospital anxiety and depression scale(HADS).The generalized estimation equation was used in the statistical analysis.Results Followed up from 2006 to 2014,430 women and 2533 HADS assessments were retained in the cohort.Depressive symptoms were more common than anxiety symptoms during all menopausal stages.The incidences of depressive and anxiety symptoms were 14.5%(19/191)and 3.1%(4/191)in the premenopausal-3 stage,respectively.The incidence increased in both menopausal transition and postmenopausal stage,with the highest incidence in the+1c stage[20.6%(155/751)and 8.8%(66/751),respectively].However,these differences were not statistically significant(all P>0.05).Depressive symptoms were highest in the≥60-<65 age group[20.8%(74/355)],and anxiety symptoms were highest in the≥50-<55 age group[8.2%(62/754)];but there were no statistical significances between different age groups and depressive and anxiety symptoms(all P>0.05).Multivariable analysis showed that high body mass index,low education status,and poor health status were independently associated with depressive symptoms(all P<0.05),and that poor health status,trouble falling asleep,and early awakening were independently associated with anxiety symptoms(all P<0.01).Conclusions Depressive and anxiety symptoms are more common during menopausal transition and postmenopausal stage compared with reproductive stage.Depressive symptoms are more common than anxiety

关 键 词：绝经期 抑郁 焦虑 队列研究 

分 类 号：R711.75[医药卫生—妇产科学] R749[医药卫生—临床医学]