Predictors of irritability symptoms in mildly depressed perimenopausal women

OBJECTIVE: Irritability is a highly burdensome complaint, commonly, but not universally, linked with depressive symptoms. While increased variability in estradiol has been associated with depressive symptoms during perimenopause, more insight is needed into reproductive hormone dynamics and other factors that predispose perimenopausal women to irritable mood. METHODS: Among 50 mildly depressed perimenopausal women (mean (SD) age 48.4 (3.9) years), severity of irritability symptoms (on Symptom Questionnaire Hostility subscale, range 0-23) was assessed weekly for eight weeks, concurrent with potential predictors. Associations between these were examined using generalized estimating equating models. RESULTS: Most women (82.0%) reported having moderate to severe irritability at least once. However, the severity of irritability was highly variable from week-to-week (between-subject mean coefficient of variation [CV] 72.9% and within-subject mean CV 63.7%). In multivariate analyses, less variable serum estradiol levels (standardized beta within-person CV -0.23 95%CI [-0.32, -0.14], p \u3c 0.001), greater depression severity (0.45 [0.35, 0.56], p \u3c 0.001), younger age (-0.23, [-0.28, -0.09], p \u3c 0.001), and more frequent vasomotor symptoms (0.14 [0.05, 0.23], p=0.002) were associated with more irritability. Depression severity explained the largest portion of the variance in irritability, but still not more than 20.3%. Neither crude values, weekly change in, or variability of progesterone or FSH levels were associated with irritability. CONCLUSIONS: Irritability was highly prevalent among mildly depressed perimenopausal women. In contrast to depressive symptoms, decreased rather than increased variability in estradiol levels was associated with more irritability. This highlights that irritable mood can be disentangled from depressive symptoms in perimenopausal women and might be linked with different estradiol dynamics

Reproductive Cycle-associated Mood Symptoms In Women With Major Depression And Bipolar Disorder

Background: We sought to determine the prevalence of, and association between, reproductive cycle-associated mood symptoms in women with affective disorders. We hypothesized that symptoms would correlate with each other across a woman's reproductive life span in both major depression (MDD) and bipolar I disorder (BP). Methods: 2412 women with, MDD or BP were asked standardized questions about mood symptoms prior to menstruation, within a month of childbirth and during perimenopause. Lifetime rates for each of these symptom types were determined and an odds ratio was calculated correlating each of the types with the others. Results: Of 2524 women with mood disorders, 67.7% reported premenstrual symptoms. Of those at risk, 20.9% reported postpartum symptoms and 26.4% reported perimenopausal symptoms. The rates did not differ between women with MDD and BP but were significantly different from women who were never ill. The symptoms were significantly correlated in women with MDD with odds ratios from 1.66 to 1.82, but were not in women with BP. Limitations: This is a secondary analysis of a sample that was collected for other purposes and is based upon retrospecitve reporting. Conclusions: Reproductive cycle-associated mood symptoms were commonly reported in women with mood disorders and did not differ based on diagnosis. In MDD, but not BP, the occurrence of these symptoms was trait-like as the presence of one predicted the occurrence of the others. Further prospective study is required to clarify the determinants of this trait

N-3 polyunsatured fatty acids in menopausal transition: A systematic review of depressive and cognitive disorders with accompanying vasomotor symptoms

Depression is one of the most important health problems worldwide. Women are 2.5 times more likely to experience major depression than men. Evidence suggests that some women might experience an increased risk for developing depression during \u201cwindows of vulnerability\u201d, i.e., when exposed to intense hormone fluctuations, such as the menopause transition. Indeed, this period is associated with different symptoms, including vasomotor, depressive, and cognitive symptoms, which have all been shown to worsen as women approach menopause. Even though hormonal therapy represents the most effective treatment, side effects have been reported by several studies. Therefore, an increased number of women might prefer the use of alternative medicine for treating menopausal symptoms. N-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs) are included among these alternative treatments. We here provide a review of studies investigating the effects of n-3 LCPUFAs on hot flashes and depressive and cognitive disorders in menopausal women. The reported results are scattered and heterogeneous. In conclusion, a beneficial role of n-3 LCPUFAs in hot flashes, and depressive and cognitive symptoms related to menopausal transition is still far from conclusive

The Role Of Estrogen In Emotional And Cognitive Processes Integral To Major Depressive Disorder

Women have greater incidence and prevalence of Major Depressive Disorder (MDD) than men during the reproductive life phase when ovarian hormones fluctuate, suggesting that ovarian hormones have a significant role in MDD etiology in women. As the core symptoms of MDD are indicative of alterations in stress responding, emotional processing, and mood regulation, examining the effects of the estrogen on these processes in women may provide a better understanding of the role of estrogen in the sex difference in MDD rates. The general aim of this dissertation was to examine neural, emotional, and attentional processes related to stress response alterations and cognitive bias in MDD in women. To examine menstrual phase and estradiol level effects on the neural and mood response to psychosocial stress, healthy, normally cycling women were examined at either the high or low estradiol phase of the menstrual cycle. Participants were exposed to the Montreal Imaging Stress Task (MIST), with brain activity measured through functional magnetic resonance imaging (fMRI), and behavioral response assessed with subjective mood and stress measures. We found that women during the high estradiol phase showed significantly less hippocampal deactivation during psychosocial stress compared to women during the low estradiol phase. Additionally, women with higher estradiol levels also had less subjective distress in response to the MIST than women with lower estradiol levels. These results suggest that high estradiol may be protective against the shifts in brain system activity and negative mood responses associated with psychosocial stress. Periods of low estradiol may enhance the negative impact of psychosocial stress on neural activity and mood and thus contribute to MDD risk in vulnerable women. The relation of cognitive bias to depression history in women was examined in postmenopausal women with and without a history of major depression using an emotion dot probe task during fMRI. Women with remitted MDD showed greater attentional facilitation for negative images than women with no history of MDD that was directly correlated with amygdala activity for negative images and amygdala-hippocampal connectivity in a resting scan. These findings provide evidence that differences in activity and functional connectivity in emotional processing networks may provide a neurobiological basis for continued cognitive bias in remitted MDD. Preliminary data indicate that estradiol treatment reduces amygdala-hippocampal connectivity specifically in women with a history of MDD and has interactive effects with MDD history on the mood response to psychosocial stress following the MIST such that women with a history of MDD appear to benefit from estradiol treatment while women without such history do not. Women with a history of or vulnerability to MDD may be particularly sensitive to the positive effects of estradiol on brain systems important to regulating emotional responses to psychosocial stress. The findings presented in this dissertation suggest that estrogen fluctuations across the menstrual cycle and at other reproductive events may contribute to depression risk through effects on brain systems integral to emotional evaluation and response with potential cognitive consequences

Examining daily quantitative electroencephalographic (qEEG), psychophysical and antropometric measures over a one week period.

The consequences of concussive injuries have been considered reversible, trivial, or permanent depending upon the perspective of the professional and the precision of the measurement tool. Saturated (daily) quantitative electroencephalographic (qEEG) measurements for 7 days after a sports-related concussive injury and for 7 days about 8 months later revealed conspicuous changes in power measurements in specific frequency bands over the impact site as well as within specific, likely contrecoup, areas. The fluctuations with time may accommodate the contradiction of results for concussive-EEG effects within the medical and scientific literature. Normative qEEG profiles for 20 normal participants collected daily for 7 days indicated extraordinarily strong intra-individual consistencies in power metrics and suggest that variability from easily established normative quantifications of topographic EEG activity could differentially discern concussive effects. The concordance of shifts in mood states with the power for relevant frequencies over expected regions of the cerebrum classically associated with different moods supports the validity of the subjective experience-brain location coupling and the direct contribution of subtle alterations in EEG power within certain frequency bands and cerebral regions to the types of mood.Master of Science (MSc) in Human Developmen