Risk of Psychiatric Disorders Following Symptomatic Menopausal Transition

Abstract

Menopausal transition is highly symptomatic in at least 20% of women. A higher prevalence of psychiatric symptoms, including depression, anxiety, and sleep disturbance, has been shown in women with symptomatic menopausal transition. However, a clear correlation between symptomatic menopausal transition and psychiatric disorders has not been established.We explored the association between symptomatic menopausal transition and subsequent newly diagnosed psychiatric disorders, including schizophrenia as well as bipolar, depressive, anxiety, and sleep disorders.We investigated women who were diagnosed with symptomatic menopausal transition by an obstetrician-gynecologist according to the data in the Taiwan National Health Insurance Research Database. A comparison cohort comprised age-matched women without symptomatic menopausal transition. The incidence rate and the hazard ratios of subsequent newly diagnosed psychiatric disorders were evaluated in both cohorts, based on the diagnoses of psychiatrists.The symptomatic menopausal transition and control cohorts each consisted of 19,028 women. The incidences of bipolar disorders (hazard ratio [HR] = 1.69, 95% confidence interval [CI] = 1.01–2.80), depressive disorders (HR = 2.17, 95% CI = 1.93–2.45), anxiety disorders (HR = 2.11, 95% CI = 1.84–2.41), and sleep disorders (HR = 2.01, 95% CI = 1.73–2.34) were higher among the symptomatic menopausal transition women than in the comparison cohort. After stratifying for follow-up duration, the incidence of newly diagnosed bipolar disorders, depressive disorders, anxiety disorders, and sleep disorders following a diagnosis of symptomatic menopausal transition remained significantly increased in the longer follow-up groups (1–5 and ≥ 5 years).Symptomatic menopausal transition might increase the risk of subsequent newly onset bipolar disorders, depressive disorders, anxiety disorders, and sleep disorders. A prospective study is necessary to confirm these findings.

Increased illness burden in women with comorbid bipolar and premenstrual dysphoric disorder: data from 1 099 women from STEP‐BD study

“…The course of bipolar disorder (BD) in women is characterized by increased risk of mood instability during female‐reproductive life events such as the premenstrual, perinatal, and perimenopausal periods . The onset of BD in women peaks between 15–23 years of age, with depressive episodes typically preceding manic episodes .…”

Menopause and illness course in bipolar disorder: A systematic review

“…One study using a large database of a national health insurance program in Taiwan examined the rate of new diagnoses across several psychiatric disorders that occurred during symptomatic menopause transition . Symptomatic menopause transition was defined as ICD‐9‐CM code 627.2 from the national database and as diagnosed by an obstetrician/gynaecologist.…”

“…Symptomatic menopause transition was defined as ICD‐9‐CM code 627.2 from the national database and as diagnosed by an obstetrician/gynaecologist. The authors noted that women had a slightly but significantly increased odds ratio (OR) for developing/being diagnosed with BD (OR 1.68; confidence interval [CI]=1.01‐2.79) over a follow‐up period of 10 years . The type of episode or the nature of the symptoms that were experienced that led to the diagnosis being made was not reported.…”

“…22 One study using a large database of a national health insurance program in Taiwan examined the rate of new diagnoses across several psychiatric disorders that occurred during symptomatic menopause transition. 23 Symptomatic menopause transition was defined as ICD-9-CM code 627.2 from the national database and as diagnosed by an obstetrician/gynaecologist. The authors noted that women had a slightly but significantly increased odds ratio (OR) for developing/being diagnosed with BD (OR 1.68; confidence interval [CI]=1.01-2.79) over a follow-up period of 10 years.…”

“…The authors noted that women had a slightly but significantly increased odds ratio (OR) for developing/being diagnosed with BD (OR 1.68; confidence interval [CI]=1.01-2.79) over a follow-up period of 10 years. 23 The type of episode or the nature of the symptoms that were experienced that led to the diagnosis being made was not reported. Symptoms or relapse rates of women who had an existing diagnosis of BD were not reported.…”