From Reuters Health Information

Primary Ovarian Insufficiency and Depression Linked

David Douglas

Physician Rating:

..

NEW YORK (Reuters Health) November 29, 2010 — Women with spontaneous 46, xx primary ovarian insufficiency (POI) are at increased risk of depression, but the relationship between the conditions is unclear, researchers report in a November 3rd online paper in the Journal of Clinical Endocrinology & Metabolism.

However, "both women with POI and their care-givers need to know that POI is associated with an increased risk for depression," Dr. Peter J. Schmidt of the National Institute of Mental Health, Bethesda, Maryland, told Reuters Health by email.

Dr. Schmidt and colleagues note that some studies suggest that depression and its treatment may in fact prompt POI. To learn more, they studied 174 women with POI, evaluating them using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (4th edition).

These women had a significantly higher lifetime prevalence of major depression compared to 100 women with Turner's syndrome (54.5% versus 36.6%), and also compared to community-based samples of women.

In all, 95 of the POI patients reported at least one major depression episode, and 22 of the remainder (12.6%) reported at least one episode of minor depression.

In 68.4% women reporting major depression, its onset came before the POI diagnosis. There were similar findings in the minor depression group.

But depression occurred as often before the onset of menstrual cycle insufficiency -- a proxy for the early stages of ovarian insufficiency -- as afterward. Thus, the authors say, "depression is not likely to cause POI."

In fact, the team speculates that it's "possible that estrogen-based treatments could potentially be an effective therapeutic alternative to traditional antidepressants in depressed women with POI."

The researchers also point out the prevalence of POI (1%) is small compared with the lifetime rates of depression in women (20%). This suggests that ovarian insufficiency isn't the cause of depression in most women.

Nevertheless, the investigators conclude that "the high rates of depression accompanying the diagnosis of POI strongly suggest that attention to the possible presence of depression in these women should be part of the evaluation and management of all women who present with POI."

Dr Schmidt added that "a substantial number of depressive episodes clustered during the transition from normal menstrual cycle function to ovarian failure. We see the same pattern in older women who are transitioning to menopause."

"We need to identify the nature of the risk in this subgroup of young women and how we can intervene preemptively on an individual basis. Ultimately, understanding the connection between the menopause transition (both in POI and normally-timed) and depression may also tell us about the cause of depressions that occur in women at other times in their lives."

SOURCE: http://link.reuters.com/zed67q

J Clin Endocrinol Metab. Published online November 3, 2010.

# posted by roodbont @ 6:01 AM