Global prevalence of depression in menopausal women: A systematic review and meta-analysis

Jia, Yu; Zhou, Zitong; Xiang, Feng; Hu, Wanqin; Cao, Xuehua

doi:10.1016/j.jad.2024.05.051

Cited by 5 publications

(2 citation statements)

References 55 publications

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“…While depression occurs in all age groups, its prevalence is notably higher in women during and after perimenopause [ 6 , 7 ]. A large meta-analysis showed that the global prevalence of depression was 33.9% in perimenopausal women and 34.9% in postmenopausal women [ 8 ]. This increase is often attributed to hormonal fluctuations in estrogen and progesterone, sleep disturbances, and heightened stress susceptibility [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of exercise on depression and anxiety in postmenopausal women: a pairwise and network meta-analysis of randomized controlled trials

Han,

Duan,

Zhang

et al. 2024

BMC Public Health

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Background Exercise has been identified as a promising non-pharmacological therapy for the management of depression, but there is still controversy over which type is most effective. We aimed to compare and rank the types of exercise that improve depression in postmenopausal women by quantifying information from randomized controlled trials (RCTs). Methods The PubMed, Web of Science, SPORTDiscus, CNKI, The Cochrane Library, PsycINFO, EMBASE, and CINAHL Plus databases were searched to identify articles published from inception to 1 March 2024 reporting RCTs that examined the effectiveness of exercise on depression in postmenopausal women. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for RCTs. The quality of the evidence for each comparison was graded using the online confidence in network meta-analysis tool (CINeMA). Standardized mean differences (SMDs) were calculated using the mean and standard deviation of pre-to-post intervention changes and then pooled using a random effects model in a pairwise meta-analysis using Review Manager 5.4. Then, a frequentist network meta-analysis was conducted using a random effects model was conducted to evaluate the efficacy of different exercise types using the network package of Stata 15. Results This study included 26 studies involving 2,170 participants. The pairwise meta-analysis revealed that exercise had a significant positive effect on depression in postmenopausal women (SMD = -0.71, 95% confidence interval [CI] = -0.94 to -0.48; I2 = 78%). The network meta-analysis revealed that mind-body exercise (SMD = -0.97, 95% CI = -1.28 to -0.67), aerobic exercise (SMD = -0.58, 95% CI = -0.88 to -0.27) and multicomponent exercise (SMD = -0.57, 95% CI = -1.15 to -0.002) significantly reduced depression compared to the control intervention. Mind-body exercise had the highest probability of being the most effective intervention. Exercise interventions also showed positive effects on anxiety. Most studies were judged to have some concerns regarding their risk of bias, and the confidence in evidence was often very low according to CINeMA. Conclusion For postmenopausal women, there is very low to moderate quality evidence that exercise interventions are an effective antidepressant therapy, with mind-body exercise most likely being the optimal type. Trial registration This meta-analysis was prospectively registered with PROSPERO (registration number: CRD42024505425).

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Section: Introductionmentioning

confidence: 99%

Effects of exercise on depression and anxiety in postmenopausal women: a pairwise and network meta-analysis of randomized controlled trials

Han,

Duan,

Zhang

et al. 2024

BMC Public Health

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“…Global studies have reported that prevalence of depression in menopause women is 35.6% (95% CI: 32.0–39.2%), ranging from 33.9% (95% CI: 27.8–40.0%) in perimenopausal women to 34.9% (95% CI: 30.7–39.1%) in postmenopausal women. These results come from studies with a high degree of heterogeneity, highlighting that higher rates of depression have been detected in the studies with poorer quality and smaller sample size, which is a limitation for interpretation of the findings ( 18 ). While multicentric cross-sectional studies have shown contradictory results regarding the relationship between menopausal status and higher rates of depression, longitudinal studies in women aged 40-55 years old have identified relationships between the naturally occurring endocrine changes in the menopausal transition with mood disturbances.…”

Section: Introductionmentioning

confidence: 99%

The intersection between menopause and depression: overview of research using animal models

Herrera-Pérez,

Hernández-Hernández,

Flores-Ramos

et al. 2024

Front. Psychiatry

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Menopausal women may experience symptoms of depression, sometimes even progressing clinical depression requiring treatment to improve quality of life. While varying levels of estrogen in perimenopause may contribute to an increased biological vulnerability to mood disturbances, the effectiveness of estrogen replacement therapy (ERT) in the relief of depressive symptoms remains controversial. Menopausal depression has a complex, multifactorial etiology, that has limited the identification of optimal treatment strategies for the management of this psychiatric complaint. Nevertheless, clinical evidence increasingly supports the notion that estrogen exerts neuroprotective effects on brain structures related to mood regulation. Indeed, research using preclinical animal models continues to improve our understanding of menopause and the effectiveness of ERT and other substances at treating depression-like behaviors. However, questions regarding the efficacy of ERT in perimenopause have been raised. These questions may be answered by further investigation using specific animal models of reduced ovarian function. This review compares and discusses the advantages and pitfalls of different models emulating the menopausal stages and their relationship with the onset of depressive-like signs, as well as the efficacy and mechanisms of conventional and novel ERTs in treating depressive-like behavior. Ovariectomized young rats, middle-to-old aged intact rats, and females treated with reprotoxics have all been used as models of menopause, with stages ranging from surgical menopause to perimenopause. Additionally, this manuscript discusses the impact of organistic and therapeutic variables that may improve or reduce the antidepressant response of females to ERT. Findings from these models have revealed the complexity of the dynamic changes occurring in brain function during menopausal transition, reinforcing the idea that the best approach is timely intervention considering the opportunity window, in addition to the careful selection of treatment according to the presence or absence of reproductive tissue. Additionally, data from animal models has yielded evidence to support new promising estrogens that could be considered as ERTs with antidepressant properties and actions in endocrine situations in which traditional ERTs are not effective.

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Prevalence of poor sleep quality during menopause: a meta-analysis

Jia,

Zhou,

Cao

2024

Sleep Breath

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Global prevalence of depression in menopausal women: A systematic review and meta-analysis

Cited by 5 publications

References 55 publications

Effects of exercise on depression and anxiety in postmenopausal women: a pairwise and network meta-analysis of randomized controlled trials

Effects of exercise on depression and anxiety in postmenopausal women: a pairwise and network meta-analysis of randomized controlled trials

The intersection between menopause and depression: overview of research using animal models

Prevalence of poor sleep quality during menopause: a meta-analysis

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