11/4/2023 0 Comments Menopause moods and emotions![]() More recently, a questionnaire, Meno-D, developed by Kulkarni et al. Additionally, although anxiety disorders are the most common mental health disorders (2) and anxiety and affective disorders have a separate DSMIV/ICD10 criteria, these are not assessed separately, nor consistently, in studies looking at either depression or anxiety (6) in the menopause making menopausal depression an umbrella term. Validated tools exist to assess the severity of depressive symptoms (eg Patient Health Questionnaire-9) and menopause related quality of life questionnaires (eg Greene Climacteric Scale). ![]() However, a unique presentation at the menopause has not been shown in research, which is likely contributed to by a lack of menopause-specific screening tools to assess mood disturbance. Many symptoms overlap difficulties with sleep, concentration, energy and libido could be attributed to classic depressive symptoms or, equally, to mood disturbance related to the menopausal transition.įurthermore, it has been reported that women describe an “on-off” phenomenon with sadness or irritability which may last for minutes to hours and spontaneously resolve, similar to what can be seen with PMS (5), making it harder to establish a temporal association between the psychological and physical symptoms. The clinical presentation of depression/mood disturbance at the menopause transition may be unique, with less sadness, increased anger, irritability and paranoia which can fluctuate in severity compared to younger women. Risk factors for depressive symptoms/disorders are multiple and include VMS, previous mood disorders including prior MDD, reproductive related mood disturbance (severe premenstrual syndrome (PMS) or postpartum depression), other health factors, psychological and socioeconomic factors, and hormonal changes such as variability in FSH and oestradiol. Premature ovarian insufficiency is associated with a 20% higher prevalence of depression than the general population (4). Women with hysterectomy and ovarian preservation have a 20% higher risk and women with hysterectomy without ovarian conservation have a 44% higher risk of depression (3). The risk of a major depressive episode (MDE) is also higher in the peri-menopause compared to the pre-menopause in women with a history of Major Depressive Disorder (MDD) (2). Even women with no previous history of depression, particularly those with history of vasomotor symptoms (VMS) or adverse life events are at increased risk of depressive symptoms compared to premenopausal women (2). ![]() The menopausal transition is a time of increased risk of mood disturbance. Women have a higher prevalence of anxiety and depressive disorders (1). The most common illnesses are related to anxiety, then affective and substance use disorders. One in five Australians experience a mental illness in any year. In the 2007 National Survey of Mental Health and Wellbeing almost half of all respondents aged 18-65 had a mental health problem at some time in their lives.
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