Depression in midlife women: what have we learned from longitudinal studies?

Abstract

As the world's population of midlife women grows, researchers and clinicians have increasingly focused their attention on women's health. The purpose of this paper is to review published longitudinal studies of depression in midlife women. Several longitudinal studies of midlife women have included measures of depression on more than one occasion. Three revealed an association between perimenopause and depression: the Massachusetts Women's Health study, the Melbourne Women's Health study, and the South-East England study. Results in two of these three suggested that vasomotor symptoms (hot flashes) were associated with higher depression scores. None of the other studies found a significant association between menopause transition and depression scores. Data from the Seattle Midlife Women's Health Study were used in a cluster analysis. The most prevalent patterns were low CES-D scores in a non-depressed range over all measurement points, with no particular pattern of change across the menopause transition. Menopause transition does not appear to be associated with depression in most longitudinal studies. The lack of association of depression with menopause suggests that the social environment in which women experience menopause might be more significant than the biological changes associated with cessation of menses.