First episode depression in women- a study of clinical characteristics through the female reproductive stages in a rural tertiary care center in Kerala

Abstract

Background: The lifetime prevalence of major depressive disorders is 10-25% for women and 5-12% for men. Women are more prone to develop depressive episode from the period of menarche to the perimenopausal period. Relatively little research has been done on this. Materials and methods: Female patients between the ages of 12 years to 55 years presenting in the outpatient department with first episode depressive symptoms are selected (ICD 10), and the number of patients presenting in different stages of the reproductive cycle-peri menarche, pregnancy, post-partum, post-abortion and perimenopausal are noted. Age at onset, severity of the illness, positive family history, presence of somatic and hypochondriac symptoms, and suicidal intent (Beck suicidal intent scale, Hamilton rating scale for depression) were noted. Results and Discussion: Out of the total 120 patients, 53 were in the perimenopause state, 23 in the peri menarche, 5 in pregnancy, 14 in the post-partum, and 7 as post-abortion. The mean age of onset of depressive disorders was 36.7 years (SD-13.67).The severity of the depressive episode is significantly higher towards the younger age group (<30years) (2 − 24.315, p-value.002) and the number of patients presenting with somatic symptoms are much higher towards the older age group (41-55years) (2-13.760 p value-.008). There is no significant difference in the presence of positive family history, hypochondriasis and suicidal intent among various age groups. Perimenopausal and peri menarche periods show a higher prevalence of depressive disorders during the female reproductive cycle. Conclusion: There is a high prevalence of depression during female reproductive phases. More studies based on female reproductive hormonal changes and mood disorders are needed to prove the association.