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Golenbock SW, Wise LA, Lambert-Messerlian GM, Eklund EE, Harlow BL. Association between a history of depression and anti-müllerian hormone among late-reproductive aged women: the Harvard study of moods and cycles. Womens Midlife Health 2020; 6:9. [PMID: 32884826 PMCID: PMC7461252 DOI: 10.1186/s40695-020-00056-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 07/20/2020] [Indexed: 11/21/2022] Open
Abstract
Background There is conflicting evidence regarding the association between a history of depression and risk of early menopause. In a cohort of premenopausal women, we investigated the association between depression history and ovarian reserve, as measured by anti-müllerian hormone (AMH). Methods The Harvard Study of Moods and Cycles (HSMC) was a prospective cohort study of women living in the Boston, MA metropolitan-area (1995–1999). Women aged 36–45 years at cohort entry (1995) were sampled from seven Boston metropolitan-area communities using census directories. We measured serum AMH in early-follicular phase venous blood specimens from 141 women with a Structured Clinical Interview for DSM-IV (SCID)-confirmed history of depression and 228 without such a history. We calculated prevalence ratios (PR) for the association between characteristics of depression history and low AMH (≤1.4 ng/mL), adjusting for several potential confounders. Results The prevalence of low AMH was similar among depressed (57.5%) and non-depressed (57.9%) women (Adjusted [Adj] PR = 0.90, 95% CI: 0.75, 1.08). Among depressed women, results were not appreciably different among those who had ever used antidepressants and those with comorbid anxiety. Modest inverse associations between depression and low AMH were seen among women aged 36–40 years (Adj PR = 0.75, 95% CI: 0.52, 1.09) and nulliparous women (Adj PR = 0.77, 95% CI: 0.59, 1.00). No dose-response association with greater duration or length of depressive symptoms was observed. Conclusions Overall, the prevalence of low AMH was similar for depressed and non-depressed women 36–45 years of age. Surprisingly, among younger and nulliparous women, those with a history of depression had a slightly reduced prevalence of low AMH relative to those without such a history. These results do not indicate reduced ovarian reserve among women with a history of depression.
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Affiliation(s)
- Samuel W Golenbock
- Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA 02118 USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA 02118 USA
| | - Geralyn M Lambert-Messerlian
- Department of Pathology and Laboratory Medicine, Alpert Medical School at Brown University, 222 Richmond St, Providence, RI 02903 USA.,Women and Infants Hospital, 101 Dudley Street, Providence, RI 02905 USA
| | - Elizabeth E Eklund
- Department of Pathology and Laboratory Medicine, Alpert Medical School at Brown University, 222 Richmond St, Providence, RI 02903 USA.,Women and Infants Hospital, 101 Dudley Street, Providence, RI 02905 USA
| | - Bernard L Harlow
- Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA 02118 USA
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Pasquali MA, Harlow BL, Soares CN, Otto MW, Cohen LS, Minuzzi L, Gelain DP, Moreira JCF, Frey BN. A longitudinal study of neurotrophic, oxidative, and inflammatory markers in first-onset depression in midlife women. Eur Arch Psychiatry Clin Neurosci 2018; 268:771-781. [PMID: 28550365 DOI: 10.1007/s00406-017-0812-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 05/19/2017] [Indexed: 12/15/2022]
Abstract
Prospective studies have shown during the years preceding and following menopause, also known as "menopause transition", that midlife women are at higher risk for developing first-onset major depressive disorder (MDD). The biological factors associated with risk and resilience in this population are, however, largely unknown. Considering the growing body of evidence suggesting that inflammation, oxidative stress, and brain-derived neurotrophic factor (BDNF) are associated with the pathophysiology of MDD, we investigated serum levels of protein carbonyl, lipid peroxidation (thiobarbituric acid reactive substances-TBARS), thiol group content, BDNF, 3-nitrotyrosine, and heat shock protein 70 (HSP70) in a longitudinal cohort of first-onset MDD. One hundred and forty-eight women from the Harvard Study of Moods and Cycles, a prospective study of midlife women monitored throughout the transition to menopause, were studied. Within- and between-groups analyses of these peripheral markers were conducted in 37 women who developed and 111 women that did not develop MDD during the 3-year follow-up period. In women who developed MDD, HSP70 and 3-nitrotyrosine were elevated at baseline, whereas TBARS were elevated 6 months prior to development of MDD, as compared to those who did not develop MDD. Within-group analyses showed that HSP70, 3-nitrotyrosine, and BDNF decreased over time, whereas protein carbonyl was elevated only at 12 months prior to development of MDD. In women who did not develop MDD, HSP70 and thiol decreased over time. The development of MDD in midlife women may be associated with a systemic cascade of pro-oxidative and pro-inflammatory events including increased HSP70, 3-nitrotyrosine, protein carbonyl, and lipid peroxidation and decreased BDNF.
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Affiliation(s)
- Matheus A Pasquali
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Centro de Estudos em Estresse Oxidativo, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bernard L Harlow
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Claudio N Soares
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
| | - Michael W Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, USA
| | - Lee S Cohen
- Center for Women's Mental Health, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Luciano Minuzzi
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada
| | - Daniel P Gelain
- Centro de Estudos em Estresse Oxidativo, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Jose Claudio F Moreira
- Centro de Estudos em Estresse Oxidativo, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Benicio N Frey
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada. .,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada. .,Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada.
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3
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Prenatal diethylstilbestrol exposure and reproductive hormones in premenopausal women. J Dev Orig Health Dis 2015; 6:208-16. [DOI: 10.1017/s2040174415000082] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women in the mid-1900s, is a potent endocrine disruptor. Prenatal DES exposure has been associated with reproductive disorders in women, but little is known about its effects on endogenous hormones. We assessed the association between prenatal DES exposure and reproductive hormones among participants from the Harvard Study of Moods and Cycles (HSMC), a longitudinal study of premenopausal women aged 36–45 years from Massachusetts (1995–1999). Prenatal DES exposure was reported at baseline (43 DES exposed and 782 unexposed). Early follicular-phase concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol were measured at baseline and every 6 months during 36 months of follow-up. Inhibin B concentrations were measured through 18 months. We used multivariable logistic and repeated-measures linear regression to estimate odds ratios (OR) and percent differences in mean hormone values (β), respectively, comparing DES exposed with unexposed women, adjusted for potential confounders. DES-exposed women had lower mean concentrations of estradiol (pg/ml) (β=−15.6%, 95% confidence interval (CI): −26.5%, −3.2%) and inhibin B (pg/ml) (β=−20.3%, CI: −35.1%, −2.3%), and higher mean concentrations of FSH (IU/I) (β=12.2%, CI: −1.5%, 27.9%) and LH (IU/I) (β=10.4%, CI: −7.2%, 31.3%), than unexposed women. ORs for the association of DES with maximum FSH>10 IU/I and minimum inhibin B<45 pg/ml – indicators of low ovarian reserve – were 1.90 (CI: 0.86, 4.22) and 4.00 (CI: 0.88–18.1), respectively. Prenatal DES exposure was associated with variation in concentrations of FSH, estradiol and inhibin B among women of late reproductive age.
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Levine SZ. Low birth-weight and risk for major depression: a community-based longitudinal study. Psychiatry Res 2014; 215:618-23. [PMID: 24485407 DOI: 10.1016/j.psychres.2014.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 11/13/2013] [Accepted: 01/01/2014] [Indexed: 01/21/2023]
Abstract
The current study examines the association between low birth weight and risk for major depression from early adolescence to early adulthood. It accounts for eight documented confounders, and depression within families. Data were analyzed from the National Longitudinal Survey of Youth 1979 on mothers and offspring. Major depression was assessed with the Center for Epidemiologic Studies Depression Scale Short-Form (CES-D-SF) among offspring (N=3398) biannually, from 2000 to 2010 (aged 14-25). Competing models were examined with survival analysis and Generalized Estimated Equations (GEE). CES-D-SF based major depression was reported by 33.46% (n=1137) of participants. Among persons with very low birth weight (<1500 g), 47.5% (n=19/40) were classified with CES-D-SF depression (OR=1.81, 95% CI=0.97, 3.39). Similar results were found with survival analysis (HR=1.97, 95% CI=0.97, 4.01). Among multiple offspring families, GEE modeling showed a similar trend. On aggregate (unadjusted OR=2.46, 95% CI=1.07, 5.63; adjusted OR=2.43, 95% CI=0.94, 6.23), and within families of mothers with CES-D-SF depression (unadjusted OR=2.54, 95% CI=0.55, 11.66; adjusted OR=1.79, 95% CI=0.28, 11.42). Compelling evidence is lacking in favor of an association between very low birth weight (<1500 g), and suspected major depression from early adolescence to early adulthood after accounting for documented confounders.
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Affiliation(s)
- Stephen Z Levine
- Department of Community Mental Health, University of Haifa, Haifa 3498838, Israel.
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Tompson MC, Pierre CB, Boger KD, McKowen JW, Chan PT, Freed RD. Maternal depression, maternal expressed emotion, and youth psychopathology. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2010; 38:105-17. [PMID: 19693663 DOI: 10.1007/s10802-009-9349-6] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Across development, maternal depression has been found to be a risk factor for youth psychopathology generally and youth depression specifically. Maternal Expressed Emotion (EE) has been examined as a predictor of outcome among youth with depression. The present study explored the associations between youth psychopathology and two predictors-maternal depression within the child's lifetime and maternal EE-in a study of children at risk for depression. One hundred and seventy-one youth, ages 8-12, and their mothers participated. To assess maternal and youth psychopathology, dyads were administered structured diagnostic assessments, and mothers and children completed self-report measures of their own depressive symptoms. In addition, mothers completed the Achenbach Child Behavior Checklist-Parent Report Version (CBCL) for their children. Maternal EE was assessed based on the Five Minute Speech Sample. History of maternal depression was associated with high maternal EE, and the combination of maternal depression history and maternal EE was associated with children's own reports of higher depressive symptoms. Current maternal depressive symptoms were associated with mothers' reports of children's Internalizing scores on the CBCL, and maternal depression history, current maternal depressive symptoms, and maternal EE were strongly associated with mothers' reports of children's Externalizing and Total Problem scores on the CBCL. History of maternal depression and a rating of high or borderline Critical EE (characterized by maternal critical comments and/or reports of a negative relationship) were independently associated with children's depression diagnoses.
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Affiliation(s)
- Martha C Tompson
- Department of Psychology, Boston University, Boston, MA 02215, USA.
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6
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Din MO, Noor NM. Prevalence and Factors Associated with Depressive Symptoms in Malay Women. Women Health 2010; 49:573-91. [DOI: 10.1080/03630240903495897] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Calkins AW, Otto MW, Cohen LS, Soares CN, Vitonis AF, Hearon BA, Harlow BL. Psychosocial predictors of the onset of anxiety disorders in women: results from a prospective 3-year longitudinal study. J Anxiety Disord 2009; 23:1165-9. [PMID: 19699609 PMCID: PMC2760601 DOI: 10.1016/j.janxdis.2009.07.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 07/22/2009] [Accepted: 07/23/2009] [Indexed: 11/26/2022]
Abstract
In a prospective, longitudinal, population-based study of 643 women participating in the Harvard Study of Moods and Cycles we examined whether psychosocial variables predicted a new or recurrent onset of an anxiety disorder. Presence of anxiety disorders was assessed every 6 months over 3 years via structured clinical interviews. Among individuals who had a new episode of anxiety, we confirmed previous findings that history of anxiety, increased anxiety sensitivity (the fear of anxiety related sensations), and increased neuroticism were significant predictors. We also found trend level support for assertiveness as a predictor of anxiety onset. However, of these variables, only history of anxiety and anxiety sensitivity provided unique prediction. We did not find evidence for negative life events as a predictor of onset of anxiety either alone or in interaction with other variables in a diathesis-stress model. These findings from a prospective longitudinal study are discussed in relation to the potential role of such predictors in primary or relapse prevention efforts.
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VIEIRA A. A THEORETICAL PROPOSAL FOR LATE LUTEAL PHASE BEHAVIOURAL CHANGES IN AN EVOLUTIONARY CONTEXT. PSYCHOLOGIA 2009. [DOI: 10.2117/psysoc.2009.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Phillips GS, Wise LA, Harlow BL. A prospective analysis of alcohol consumption and onset of perimenopause. Maturitas 2007; 56:263-72. [PMID: 17000063 DOI: 10.1016/j.maturitas.2006.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2006] [Revised: 08/22/2006] [Accepted: 08/25/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We prospectively assessed the association between alcohol consumption and onset of perimenopause in women of late reproductive age using data from the Harvard Study of Moods and Cycles. Specific types of alcoholic beverages - red wine, white wine, beer, and liquor - were evaluated. METHODS Among 502 women aged 36-45 years residing in seven Boston communities, we assessed self-reported perimenopausal symptoms over a 5-year period. The onset of perimenopause was defined using changes in menstrual characteristics. We administered a semiquantitative food frequency questionnaire at enrollment to measure regular alcohol consumption during the past year. Hazard ratios (HRs) and 95% confidence intervals were derived from Cox regression models. RESULTS No association was found between total alcohol consumption and time to perimenopause. Compared with women consuming <1 alcoholic drink per month, HRs for those drinking red wine in quantities of 1-3 glasses per month, 1 glass per week, or >or=2 glasses per week were all below 1.0, after accounting for other sources of alcohol. Among never smokers, the inverse association with red wine was stronger and a positive association was observed with liquor consumption although numbers were small. No associations were observed with white wine or beer. CONCLUSION While there was no association between total alcohol consumption and onset of perimenopause, there was some suggestion of an inverse association between red wine and risk of perimenopause, particularly among never smokers.
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Affiliation(s)
- Ghasi S Phillips
- Harvard School of Public Health, Epidemiology, Kresge Building, 9th Floor, 677 Huntington Avenue, Boston, MA 02115, USA.
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10
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Thurston RC, Joffe H, Soares CN, Harlow BL. Physical activity and risk of vasomotor symptoms in women with and without a history of depression: results from the Harvard Study of Moods and Cycles. Menopause 2006; 13:553-60. [PMID: 16837876 DOI: 10.1097/01.gme.0000227332.43243.00] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine whether physical activity was associated with decreased risk of vasomotor symptoms in a prospective study of women transitioning through menopause. DESIGN Hypotheses were evaluated in the Harvard Study of Moods and Cycles, a longitudinal study of women with and without a history of major depression (N = 523). Ordinal logistic regression models were utilized to assess the odds of vasomotor symptoms (none, mild, moderate/severe; Greene Climacteric Scale) associated with physical activity (quartiles of metabolic equivalent-hours per week) at study enrollment and over a 3- to 5-year follow-up period. RESULTS No significant associations between physical activity and vasomotor symptoms were observed for the sample as a whole. However, exploratory analyses stratified by depression history revealed that among the 157 women with a lifetime history of major depression, high (odds ratio [OR] = 0.28, 95% CI: 0.09-0.83) or moderately high (OR = 0.33, 95% CI: 0.11-0.99) physical activity proximal to the vasomotor assessment, as well as consistently high (OR = 0.27, 95% CI: 0.10-0.75) or increasing (OR = 0.33, 95% CI: 0.12-0.92) physical activity over the duration of the 3- to 5-year follow-up period was associated with decreased vasomotor symptoms relative to sedentary behavior. No significant associations were observed for women without a history of depression. CONCLUSIONS Physical activity may be associated with decreased risk of vasomotor symptoms among women with a history of major depression.
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Affiliation(s)
- Rebecca C Thurston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
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Lambert-Messerlian GM, Harlow BL. The influence of depression, body mass index, and smoking on serum inhibin B levels in late reproductive-aged women. J Clin Endocrinol Metab 2006; 91:1496-500. [PMID: 16449329 DOI: 10.1210/jc.2005-2515] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
CONTEXT Women experiencing depression have difficult psychosocial functioning, and recent data suggest an earlier onset of menopause. Understanding the biological mechanism for the impairment of reproductive function associated with depression is important. OBJECTIVE The objective of the study was to determine whether a lifetime history of depression is associated with reduced ovarian reserve as reflected in serum levels of the granulosa cell product, inhibin B. DESIGN Residual serum samples from a subset of patients in the Harvard Study of Cycles and Moods were collected. SETTING Patients were recruited from seven Boston-area communities. PATIENTS Women with or without a history of major depression, based on structured clinical interviews for Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were enrolled. A subset of patients who had provided an early follicular phase blood specimen at study enrollment and two or more other samples over the first 18-month period of follow-up were included. INTERVENTION There were no interventions. MAIN OUTCOME MEASURE Serum inhibin B levels were measured. RESULTS Serum FSH levels were higher in women with a history of depression, whereas inhibin B levels did not differ between groups. Body mass index and age were significantly and inversely related to serum inhibin B levels. Smoking history was noted, for the first time, to have a significant negative association with inhibin B levels. CONCLUSIONS Smoking has a direct negative effect on ovarian reserve, as suggested by decreased serum inhibin B levels. In contrast, effects of depression on the reproductive axis may occur at the level of the pituitary and/or hypothalamus rather than at the gonadal level, as suggested by increased serum FSH levels.
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Affiliation(s)
- G M Lambert-Messerlian
- Dept. of Pathology and Laboratory Medicine, Prenatal and Special Testing, Women and Infants Hospital, 70 Elm Street Suite 2, Providence, RI 02903, USA.
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Hasler G, Lissek S, Ajdacic V, Milos G, Gamma A, Eich D, Rössler W, Angst J. Major depression predicts an increase in long-term body weight variability in young adults. ACTA ACUST UNITED AC 2006; 13:1991-8. [PMID: 16339131 DOI: 10.1038/oby.2005.244] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To test the hypothesis that major depression predicts an increase in long-term body weight variability (BWV). RESEARCH METHODS AND PROCEDURES This was a prospective community-based single-age cohort study of young adults (N = 591) followed between the ages of 19 and 40. Following initial screening, information was derived from six subsequent semistructured diagnostic interviews conducted by mental health professionals. Major depression was diagnosed on the basis of DSM criteria. BWV was defined as the root mean square error of a regression line fitted to each individual's BMI values over time. Multiple regression analysis was used to test the association between major depression and BWV while controlling for potentially confounding variables including antidepressant treatment, eating disorder symptoms, and physical activity. We used random effects models to determine the temporal relationship between repeated measures of major depression and body weight change. RESULTS A highly significant positive association between major depression and BWV was found, whereas major depression was not associated with BMI level or BMI trend. Depression severity showed a dose-response-type relationship with the magnitude of BWV. After controlling for potentially confounding variables including antidepressant use, eating disorder symptoms, smoking, and physical activity, major depression remained a significant predictor of BWV (beta= 0.13, p < 0.001). Longitudinal analysis revealed a unidirectional association between major depression and a later increase in body weight change rate irrespective of antidepressant medication. DISCUSSION Results from this study implicate depression as an important risk factor for increased BWV. Given increasing evidence for a link between major depression and both diabetes and cardiovascular disease, current results encourage further research on depression, BWV, and negative health outcomes.
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Affiliation(s)
- Gregor Hasler
- Psychiatric University Hospital, Zurich, Switzerland.
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Abenhaim HA, Harlow BL. Live births, cesarean sections and the development of menstrual abnormalities. Int J Gynaecol Obstet 2005; 92:111-6. [PMID: 16376346 DOI: 10.1016/j.ijgo.2005.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2005] [Revised: 10/14/2005] [Accepted: 10/14/2005] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To examine the relationship between number of livebirths and cesarean sections on the development of menstrual abnormalities. METHODS The effect of number of livebirths and cesarean sections on menstrual abnormalities in the late reproductive period was evaluated using data from the Harvard Study of Moods and Cycles. RESULTS There were 298 women with no livebirths and 606 women with livebirths of which 184 had a history of cesarean section. Among all women, increasing number of livebirths was associated with an increasing trend in reported heavy menses, prolonged flow >6 days, and a decreasing trend in reported dysmenorrhea. This effect was amplified among women with a history of cesarean section. CONCLUSIONS Increasing number of livebirths is associated with heavy and prolonged menstrual flow during the late reproductive period. This association is particularly stronger in women with a history of cesarean section.
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Affiliation(s)
- H A Abenhaim
- School of Public Health, Harvard University, Boston, MA, USA
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Abstract
STUDY OBJECTIVE To determine the association between childhood abuse and becoming a smoker. DESIGN Retrospective cohort study. SETTING Boston, Massachusetts. PARTICIPANTS 722 women aged 36-45 years who completed the baseline questionnaire for the Harvard study of moods and cycles and the survey of interpersonal relationships. MAIN RESULTS Women who experienced either physical or sexual abuse as a child were 40% more likely to begin smoking compared with women with no history of abuse (95% CI 1.0 to 2.0). Virtually all of this association was confined to sexual abuse (OR = 2.2, 95% CI 1.1 to 4.3) as compared with physical abuse (OR = 0.7, 95% CI 0.7 to 1.6). However, the joint effect of experiencing both physical and sexual abuse as a child led to a 3.5-fold increase in the likelihood of becoming a smoker (95% CI 1.3 to 9.4) compared with women who did not experience any childhood abuse after adjustment for religion, social class, and poverty. CONCLUSIONS Women who experience childhood abuse, even in the absence of depression, are at increased risk of becoming cigarette smokers.
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Affiliation(s)
- H B Nichols
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
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Harlow BL, Cohen LS, Otto MW, Spiegelman D, Cramer DW. Early life menstrual characteristics and pregnancy experiences among women with and without major depression: the Harvard study of moods and cycles. J Affect Disord 2004; 79:167-76. [PMID: 15023491 DOI: 10.1016/s0165-0327(02)00459-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2002] [Accepted: 10/29/2002] [Indexed: 10/27/2022]
Abstract
BACKGROUND Other than premenstrual dysphoria, few studies have examined the extent to which basic characteristics of the menstrual cycle and the occurrence of other reproductive landmarks impact on the risk of major depression. METHODS From a population-based sample of 4161 premenopausal women 36-45 years of age, we identified 332 women who met DSM criteria for past or current major depression and a sample of 644 women with no such history. In person interviews included a detailed assessment of menstrual cycle characteristics from age at menarche through study enrollment as well as other reproductive landmarks. RESULTS Risk of depression increased significantly with decreasing age at menarche (P<0.001). The risk of depression was also higher in women with heavier menstrual flow and cycle irregularity during the first 5 years of menstruation. Women with a history of multiple abortions were 2-3-times more likely to develop major depression (95% CI 1.6-4.1). Increasing months of breastfeeding was associated with a decreased risk of depression after adjustment for education, marital status, and number of livebirths (P-value, test of trend=0.012). This association was largely confined to depression during the postpartum period. LIMITATIONS Menstrual and pregnancy history exposures were self-reported and retrospectively assessed. However, women with and without a HISTORY of depression were subject to similar recall requirements that likely resulted in an underestimate of most risk estimates. CONCLUSIONS Clinicians involved in routine obstetrical and gynecological care of women need to recognize that menstrual and pregnancy history events may serve as potential markers for subsequent psychiatric sequelae.
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Affiliation(s)
- Bernard L Harlow
- Obstetrics and Gynecology Epidemiology Center at Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Abstract
OBJECTIVE Assessing lay beliefs about causes of depressive behaviour and analysing the influence of labelling and demographic factors on causal attributions. METHOD In Switzerland we conducted a representative telephone survey with 873 interviewees. A vignette depicting a man with depression satisfying the Diagnostic and Statistical Manual (DSM)-III-R criteria was presented. Content analysis of up to three answers about assumed causes was conducted. RESULTS For more than half the respondents (56.6%) difficulties within the family or the partnership are causal for depression. Occupational stress is the second most-mentioned cause (32.7%), whereas unspecified further stress is in third place (19.9%). Traumatic events (17.9%), depressive disorder (14.1%) and further unspecified illnesses (11.6%) follow. Few correlations were found between causal attributions, labelling and demographic factors. CONCLUSION The respective causal attributions are mainly independent of demographic factors, thus generalizable for the population. The attributions are shaped primarily by psychosocial ideas about aetiology. Nevertheless, one-third of the interviewees holds biological or disease-related beliefs about causes of depression. The respective illness models cannot be neglected in the therapeutic relationship.
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Affiliation(s)
- C Lauber
- Institution Psychiatric University Hospital, Zurich, Switzerland
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Joffe H, Cohen LS, Harlow BL. Impact of oral contraceptive pill use on premenstrual mood: Predictors of improvement and deterioration. Am J Obstet Gynecol 2003; 189:1523-30. [PMID: 14710055 DOI: 10.1016/s0002-9378(03)00927-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The purpose of this study was to estimate risk factors for the deterioration and improvement of premenstrual mood disturbance with oral contraceptive pill use. STUDY DESIGN Predictors of the deleterious and beneficial effects of oral contraceptive pill use on premenstrual mood were analyzed with the use of logistic regression in a nested case-control study within a community-based cohort of 976 premenopausal women in Massachusetts. RESULTS Of 658 women who were using oral contraceptive pills, 16.3% of the women reported oral contraceptive pill-related premenstrual mood deterioration, and 12.3% of the women reported premenstrual mood improvement. In adjusted models, previous depression was the only significant predictor of mood deterioration (odds ratio, 2.0; 95% CI, 1.1-3.8); early-onset premenstrual mood disturbance and dysmenorrhea were significant predictors of oral contraceptive pill-related mood improvement (odds ratio, 3.1 [95% CI, 1.9-5.2] and odds ratio, 2.3 [95% CI, 1.4-3.9], respectively). CONCLUSION Oral contraceptive pills do not influence premenstrual mood in most women. Premenstrual mood is most likely to deteriorate in women with a history of depression and to improve in women with early-onset premenstrual mood disturbance or dysmenorrhea.
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Affiliation(s)
- Hadine Joffe
- Perinatal and Reproductive Psychiatry Clinical Research Program, Massachusetts General Hospital, 15 Parkman Street, WACC, Boston, MA 02114, USA.
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Wise LA, Krieger N, Zierler S, Harlow BL. Lifetime socioeconomic position in relation to onset of perimenopause. J Epidemiol Community Health 2002; 56:851-60. [PMID: 12388578 PMCID: PMC1732042 DOI: 10.1136/jech.56.11.851] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
STUDY OBJECTIVE To assess the association between lifetime socioeconomic position and onset of perimenopause. DESIGN Prospective cohort study. SETTING Boston, Massachusetts. PARTICIPANTS 603 premenopausal women aged 36-45 years at baseline who completed a cross sectional survey on childhood and adult socioeconomic position. MAIN OUTCOME MEASURES Time to perimenopause, defined as time in months from baseline interview to a woman's report of (1) an absolute change of at least seven days in menstrual cycle length from baseline or subjective report of menstrual irregularity; (2) a change in menstrual flow amount or duration; or (3) cessation of periods for at least three months, whichever came first. MAIN RESULTS Incidence of perimenopause was 1.75 times higher (95%CI 1.10 to 2.79) and median age at onset was 1.2 years younger (44.7 v 45.9 years) for women reporting childhood and adult economic distress compared with women reporting no lifetime economic distress. After adjustment for age, race/ethnicity, age at menarche, parity, oral contraceptive use, family history of early menopause, depression, smoking, and body mass index, the association weakened (incidence rate ratio (IRR)=1.59; 95%CI 0.97 to 2.61). Inverse associations were observed for most, but not all, measures of educational level. Measures of current household income were not associated with risk of perimenopause. CONCLUSIONS This study suggests that adverse socioeconomic conditions across the lifespan, when measured in terms of economic hardship and low educational attainment, may be associated with an increased rate of entry into perimenopause.
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Affiliation(s)
- L A Wise
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital/Harvard Medical School, Boston, USA.
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Cohen LS, Soares CN, Otto MW, Sweeney BH, Liberman RF, Harlow BL. Prevalence and predictors of premenstrual dysphoric disorder (PMDD) in older premenopausal women. The Harvard Study of Moods and Cycles. J Affect Disord 2002; 70:125-32. [PMID: 12117624 DOI: 10.1016/s0165-0327(01)00458-x] [Citation(s) in RCA: 147] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Consistent data on the prevalence and predictors of premenstrual dysphoric disorder (PMDD) in the general population are lacking. METHODS Premenstrual symptoms of 4164 women (aged 36-44 years) were retrospectively assessed by the Moos Premenstrual Inventory. From this original sample, 976 subjects were further interviewed at which time demographic and lifestyle characteristics, gynecologic history, and medical conditions were examined. The Structured Clinical Interview for DSM-IV Axis I disorders (SCID) was used to assess past and current psychiatric morbidity. Additionally, 513 of these women completed a prospective evaluation of premenstrual symptoms by using the Daily Rating of Severity of Problems Form (DRSP). RESULTS The diagnosis of PMDD was confirmed in 33 of 513 women (6.4%) who completed the prospective evaluation with daily records. Fourteen subjects (2.7%) met criteria for PMDD without a previous history of depression. PMDD was associated with lower education (odds ratio [OR]=2.3, confidence interval [CI]=1.1-4.9), a history of major depression (OR=3.6, CI=1.7-7.4), and current cigarette smoking (OR=4.1, CI=1.5-11.1). In addition, women not working outside the home were significantly less likely to meet criteria for PMDD (OR=0.2, CI=0.1-0.9). LIMITATIONS Only 513 of 976 women agreed to have their symptoms documented prospectively. Symptoms were assessed over the course of one menstrual cycle. CONCLUSIONS This study indicates a significant prevalence of PMDD in a large community-based sample. Given the associated impairment in social and occupational functioning seen in PMDD, these prevalence data provide a strong rationale for enhanced recognition and treatment of the disorder.
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Harlow BL, Missmer SA, Cramer DW, Barbieri RL. Does tubal sterilization influence the subsequent risk of menorrhagia or dysmenorrhea? Fertil Steril 2002; 77:754-60. [PMID: 11937129 DOI: 10.1016/s0015-0282(01)03253-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the relation between tubal ligation, change in menstrual cycle characteristics, and early follicular phase hormones. DESIGN Cross-sectional analysis of women 36-44 years of age. SETTING The greater Boston area. PATIENT(S) Nine hundred seventy-six premenopausal women with intact uteri. INTERVENTION(S) A comparison of women with and without a history of tubal ligation. MAIN OUTCOME MEASURE(S) Menstrual and reproductive histories were self-reported. Early follicular phase blood samples were obtained to assess FSH, LH, and E(2). We compared menstrual cycle changes from the first 5 years after menarche with completion of the baseline questionnaire in women with and without a prior history of tubal ligation. RESULT(S) Cycle length, cycle regularity, menses length, flow volume, dysmenorrhea, and hormone levels were similar in women with and without a history of tubal ligation. However, among parous women with a history of cesarean section, those with a tubal ligation >5 years ago experienced a marginal increase in volume of menstrual flow compared with women with no tubal ligation history. CONCLUSION(S) We found no significant change in menstrual cycle characteristics or hormone levels in women with or without a history of tubal ligation. However, tubal ligation may have a modest effect on the change in menstrual flow volume over time among parous women with a history of cesarean section.
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Affiliation(s)
- Bernard L Harlow
- Department of Obstetrics and Gynecology, the Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
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