Abstract
Introduction: Perimenopausal depression is predominantly caused by hormone shock, but the underlying physical and psychological factors are still unclear.Objectives: To explore the constituent components of perimenopausal depression by dynamically depicting its influencing factors and interactive pathways from the perspective of embodied cognition.Methods: This is a randomized clinical controlled trial. In this study, electroacupuncture was compared with escitalopram. A total of 242 participants with mild to moderate perimenopausal depression were enrolled from 6 hospitals in China. Each participant had a 12-week intervention and a 12-week follow-up period. The primary outcome of this study is the Hamilton Depression Rating Scale (HAMD-17), and the secondary outcome is the menopause-specific quality of life scale (MENQOL), serum Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estrogen (E2) levels.Results: The structural equation model suggested that hormone levels were not directly associated with HAMD-17 (P = 0.852), while MENQOL was statistically correlated with HAMD-17 as an intermediary variable (P < 0.001). Electroacupuncture gradually showed positive impacts on MENQOL and HAMD-17 during the follow-up period (P < 0.05). Cognitive impairment is the dominant dimension of perimenopausal depression.Conclusions: Hormonal shock may affect clinical symptoms and poor quality of life to induce cognitive impairment leading perimenopausal depression, and this impact on cognition is embodied. Electroacupuncture has positive effect on perimenopausal depression and quality of life.
Highlights
Perimenopausal depression is predominantly caused by hormone shock, but the underlying physical and psychological factors are still unclear
follicle-stimulating hormone (FSH) (r = 0.218, P = 0.001) and luteinizing hormone (LH) (r = 0.217, P = 0.002) were all correlated with MENQOL scales, but estradiol had no significant correlation with MENQOL and HAMD-17
The equation was constructed with hormones (FSH and LH), MENQOL, and HAMD-17, where MENQOL showed a significant mediation variable (Figure 2)
Summary
Perimenopausal depression is predominantly caused by hormone shock, but the underlying physical and psychological factors are still unclear. Perimenopausal depression in women, a type of depression, is caused by substantial estrogen shock and provides an avenue to explore psychosomatic factors and their relationships [2]. It is generally believed that both physical and psychological changes can cause depression [3]. The psychological and physiological interactions of perimenopausal depression remain unclear. Perimenopause is usually considered a reproductive transition, its clinical symptoms can include measurable neurological symptoms, such as insomnia, depression, and memory impairments [4]. In perimenopausal women with cognitive impairment, one prior PET study showed glucose metabolic decline [13] in the hippocampus, parahippocampal gyrus, temporal lobe, medial prefrontal cortex, and posterior cingulate gyrus. Some studies have demonstrated that estrogen receptors are widely distributed in the hypothalamus, amygdala, hippocampus, and cingulate cortex [14]
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