Characterizing the spectrum of distress symptoms in midlife women with perimenopausal depression.

backgroundPerimenopausal onset depression (PO-MDD) is a common cause of distress and functional impairment, though efforts to describe its clinical symptomatology have been limited. We aimed to characterize affective and anxiety symptoms associated with PO-MDD, and to identify clinical correlates of distress, including anxiety, temperament and climacteric symptoms.

methodsBaseline data from unmedicated women, ages 44-55, with PO-MDD (n = 49) and without PO-MDD (controls; n = 37) in the late-perimenopause (STRAW -1 criteria) recruited for two studies examining estrogen's effect on brain activation were included. The Structured Clinical Interview for DSM-IV-TR (SCID) was used to confirm PO-MDD diagnosis. Depression and anxiety symptoms were characterized using the Inventory of Depression and Anxiety Scale (IDAS). Clinical correlates of distress were examined using the Schedule for Non-Adaptive and Adaptive Personality (SNAP) and Greene Climacteric Scale (GCS). ANCOVAs were conducted to describe group differences, controlling for race. Pearson correlations examined associations between affective, anxiety, and menopausal symptoms.

resultsPO-MDD reported more severe symptoms than controls on all IDAS scales other than traumatic intrusions and appetite gain (all ps < 0.05). PO-MDD participants reported more severe irritability and anxiety on the IDAS, higher negative temperament and lower positive temperament scores on the SNAP, and higher GCS scores compared with controls. LIMITATIONS: Limited sample and homogeneity in racial and ethnic distribution.

conclusionsFindings show a broad range of perimenopause-onset distress symptoms beyond depressed mood, including anxiety and differences in maladaptive temperament. Correlations between IDAS composite scores and anxiety scales highlight the importance of screening for anxiety related distress in this population. CLINICALTRIALS: gov: #NCT0225517 and NCT03740009.