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Page CE, Soreth B, Metcalf CA, Johnson RL, Duffy KA, Sammel MD, Loughead J, Epperson CN. Natural vs. Surgical Postmenopause and Psychological Symptoms Confound the Effect of Menopause on Executive Functioning Domains of Cognitive Experience. Focus (Am Psychiatr Publ) 2024; 22:97-108. [PMID: 38694151 PMCID: PMC11058919 DOI: 10.1176/appi.focus.23021034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
Objective The menopause transition is associated with difficulties in executive function. However, it is unclear whether these difficulties persist past perimenopause. This study investigated whether potential confounders, including natural vs. surgical postmenopause and menopause-related psychological symptoms, influence whether executive dysfunction persists into postmenopause. Study Design A cross-sectional sample of women aged 35-65 years (N = 1971) in one of four groups, premenopause, perimenopause, natural postmenopause, and surgical postmenopause, were surveyed. Participants self-reported executive functioning with the Brown Attention Deficit Disorder Scale (BADDS), anxiety symptom severity with the Generalized Anxiety Disorder Questionnaire (GAD-7), and depression symptom severity with the Center for Epidemiologic Studies Depression Scale (CES-D). Main Outcome Measures We analyzed the association between group and BADDS scores using linear regression models - first, by controlling for age, education, and self-reported attention deficit hyperactivity disorder (ADHD) diagnosis (Model #1) and, second, by further controlling for current difficulty sleeping, anxiety, and depression (Model #2). Results In both models, BADDS scores were significantly elevated (indicating more difficulties in executive function) among women in the perimenopausal and surgical postmenopausal groups compared with those in the premenopausal group. Likewise, the perimenopausal and surgical postmenopausal groups had the highest proportions of participants who reported difficulty sleeping and clinical levels of anxiety and depression. BADDS scores were significantly higher in natural postmenopausal vs. premenopausal women without controlling for difficulty sleeping, anxiety, and depression (Model #1), but not when adjusting for these variables (Model #2). Conclusions The type of menopause and psychological symptoms are important confounders of the relationship between the menopause transition and executive dysfunction, and help explain whether executive dysfunction persists or recovers in postmenopause.Reprinted from Maturitas 2023; 170:64-73, with permission from Elsevier. Copyright © 2023.
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Affiliation(s)
- Chloe E Page
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Page, Metcalf, Duffy, Sammel, Epperson); Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado School of Public Health, Aurora, CO, United States (Johnson, Sammel); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Soreth, Loughead); Department of Family Medicine, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Epperson)
| | - Brianna Soreth
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Page, Metcalf, Duffy, Sammel, Epperson); Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado School of Public Health, Aurora, CO, United States (Johnson, Sammel); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Soreth, Loughead); Department of Family Medicine, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Epperson)
| | - Christina A Metcalf
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Page, Metcalf, Duffy, Sammel, Epperson); Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado School of Public Health, Aurora, CO, United States (Johnson, Sammel); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Soreth, Loughead); Department of Family Medicine, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Epperson)
| | - Rachel L Johnson
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Page, Metcalf, Duffy, Sammel, Epperson); Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado School of Public Health, Aurora, CO, United States (Johnson, Sammel); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Soreth, Loughead); Department of Family Medicine, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Epperson)
| | - Korrina A Duffy
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Page, Metcalf, Duffy, Sammel, Epperson); Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado School of Public Health, Aurora, CO, United States (Johnson, Sammel); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Soreth, Loughead); Department of Family Medicine, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Epperson)
| | - Mary D Sammel
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Page, Metcalf, Duffy, Sammel, Epperson); Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado School of Public Health, Aurora, CO, United States (Johnson, Sammel); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Soreth, Loughead); Department of Family Medicine, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Epperson)
| | - James Loughead
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Page, Metcalf, Duffy, Sammel, Epperson); Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado School of Public Health, Aurora, CO, United States (Johnson, Sammel); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Soreth, Loughead); Department of Family Medicine, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Epperson)
| | - C Neill Epperson
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Page, Metcalf, Duffy, Sammel, Epperson); Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado School of Public Health, Aurora, CO, United States (Johnson, Sammel); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Soreth, Loughead); Department of Family Medicine, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States (Epperson)
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Page CE, Soreth B, Metcalf CA, Johnson RL, Duffy KA, Sammel MD, Loughead J, Epperson CN. Natural vs. surgical postmenopause and psychological symptoms confound the effect of menopause on executive functioning domains of cognitive experience. Maturitas 2023; 170:64-73. [PMID: 36806931 DOI: 10.1016/j.maturitas.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/23/2022] [Accepted: 01/06/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The menopause transition is associated with difficulties in executive function. However, it is unclear whether these difficulties persist past perimenopause. This study investigated whether potential confounders, including natural vs. surgical postmenopause and menopause-related psychological symptoms, influence whether executive dysfunction persists into postmenopause. STUDY DESIGN A cross-sectional sample of women aged 35-65 years (N = 1971) in one of four groups, premenopause, perimenopause, natural postmenopause, and surgical postmenopause, were surveyed. Participants self-reported executive functioning with the Brown Attention Deficit Disorder Scale (BADDS), anxiety symptom severity with the Generalized Anxiety Disorder Questionnaire (GAD-7), and depression symptom severity with the Center for Epidemiologic Studies Depression Scale (CESD). MAIN OUTCOME MEASURES We analyzed the association between group and BADDS scores using linear regression models - first, by controlling for age, education, and self-reported attention deficit hyperactivity disorder (ADHD) diagnosis (Model #1) and, second, by further controlling for current difficulty sleeping, anxiety, and depression (Model #2). RESULTS In both models, BADDS scores were significantly elevated (indicating more difficulties in executive function) among women in the perimenopausal and surgical postmenopausal groups compared with those in the premenopausal group. Likewise, the perimenopausal and surgical postmenopausal groups had the highest proportions of participants who reported difficulty sleeping and clinical levels of anxiety and depression. BADDS scores were significantly higher in natural postmenopausal vs. premenopausal women without controlling for difficulty sleeping, anxiety, and depression (Model #1), but not when adjusting for these variables (Model #2). CONCLUSIONS The type of menopause and psychological symptoms are important confounders of the relationship between the menopause transition and executive dysfunction, and help explain whether executive dysfunction persists or recovers in postmenopause.
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Affiliation(s)
- Chloe E Page
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States
| | - Brianna Soreth
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Christina A Metcalf
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado School of Public Health, Aurora, CO, United States
| | - Korrina A Duffy
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States
| | - Mary D Sammel
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States; Department of Biostatistics and Informatics, Anschutz Medical Campus, University of Colorado School of Public Health, Aurora, CO, United States
| | - James Loughead
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - C Neill Epperson
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States; Department of Family Medicine, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, United States.
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Durosini I, Triberti S, Savioni L, Sebri V, Pravettoni G. The Role of Emotion-Related Abilities in the Quality of Life of Breast Cancer Survivors: A Systematic Review. Int J Environ Res Public Health 2022; 19:ijerph191912704. [PMID: 36232004 PMCID: PMC9566755 DOI: 10.3390/ijerph191912704] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 05/29/2023]
Abstract
Breast cancer survivors have to deal with notable challenges even after successful treatment, such as body image issues, depression and anxiety, the stress related to changes in lifestyle, and the continual challenges inherent to health management. The literature suggests that emotional abilities, such as emotional intelligence, emotion management, mood repair, and coping play a fundamental role in such challenges. We performed a systematic review to systematize the evidence available on the role of emotional abilities in quality of life and health management in breast cancer survivors. The search was performed on three scientific databases (Pubmed, Scopus, and PsycINFO) and, after applying exclusion criteria, yielded 33 studies, mainly of a cross-sectional nature. The results clearly support the hypothesis that emotional abilities play multiple important roles in breast cancer survivors' quality of life. Specifically, the review highlighted that coping/emotional management plays multiple roles in breast cancer survivors' well-being and health management, affecting vitality and general adjustment to cancer positivity and promoting benefit findings related to the cancer experience; however, rare negative results exist in the literature. This review highlights the relevance of emotional abilities to promoting quality of life in breast cancer survivors. Future review efforts may explore other breast cancer survivors' emotional abilities, aiming at assessing available instruments and proposing tailored psychological interventions.
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Affiliation(s)
- Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Stefano Triberti
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
| | - Lucrezia Savioni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
| | - Valeria Sebri
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
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