Role of stressful life events and menopausal stage in wellbeing and health

Alexander, Jeanne Leventhal; Dennerstein, Lorraine; Woods, Nancy Fúgate; McEwen, Bruce S.; Halbreich, Uriel; Kotz, Krista; Richardson, Gregg

doi:10.1586/14737175.7.11s.s93

Cited by 40 publications

(31 citation statements)

References 176 publications

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“…Nesse contexto, a perimenopausa é um período de maior vulnerabilidade para os transtornos psíquicos 9 . Alguns autores acreditam que a perimenopausa esteja fortemente associada ao aparecimento de sintomas de ansiedade e depressão em mulheres sem história prévia de doença mental, quando presentes outros fatores de risco, como elevado índice de massa corpórea, antecedentes de Síndrome de tensão pré-menstrual (TPM), ondas de calor, distúrbios do sono, desemprego e estado marital 10,11 . Outros autores valorizam a presença de sintomas vasomotores (fogachos) que, interferindo no sono da mulher, determinariam, em longo prazo, o aparecimento dos quadros depressivos e ansiosos (Teoria Dominó) 12 .…”

Section: Introductionunclassified

Depressão e ansiedade em mulheres climatéricas: fatores associados

Polisseni¹,

Araújo²,

Polisseni³

et al. 2009

Rev. Bras. Ginecol. Obstet.

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OBJETIVO: determinar a prevalência de depressão e ansiedade em mulheres climatéricas e os prováveis fatores responsáveis por sua ocorrência. MÉTODOS: em estudo transversal, foram selecionadas 93 mulheres que frequentaram um ambulatório de climatério no período de maio de 2006 a agosto de 2007. Como critério de inclusão foram consideradas mulheres na faixa etária de 40 a 65 anos e que concordaram em participar do projeto. Os critérios de exclusão foram: pacientes em uso de terapia hormonal, hormonioterapia por implantes, DIUs e injetáveis de depósito nos últimos seis meses, endocrinopatias que levassem a irregularidades menstruais, hepatopatias, coagulopatias, uso de drogas que interferissem no ciclo menstrual, ansiolíticos e antidepressivos (pois o uso dessas drogas era indicativo de diagnóstico prévio de alterações do humor), histerectomizadas, ooforectomizadas, portadoras de câncer e de enfermidades psiquiátricas, pacientes que tivessem sido submetidas à radioterapia ou quimioterapia. Foram aplicados quatro questionários durante a entrevista: Anamnese, contendo dados sociodemográficos, clínicos e hábitos de vida; Índice Menopausal de Blatt-Kupperman, com o objetivo de diagnosticar as pacientes portadoras de síndrome climatérica; a subescala para Ansiedade, derivada da escala Hospitalar para Ansiedade e Depressão (HADS-A), com a finalidade de diagnosticar os casos de Ansiedade e o Inventário de Depressão de Beck, com o intuito de diagnosticar as mulheres portadoras de depressão. Foram realizadas as análises descritivas e de correlação entre as variáveis; o teste do χ 2 e de Hosmer-Lemeshow, usando o programa Software Statistica versão 6. RESULTADOS: a média de prevalência de depressão entre as pacientes avaliadas foi de 36,8% enquanto que da ansiedade foi de 53,7%. Não houve diferença significativa entre a prevalência de depressão e ansiedade e as três fases do climatério. Observou-se relação significativa entre a presença de sintomas climatéricos de intensidade moderada e o aparecimento dessas alterações do humor (p<0,001). A depressão foi mais frequente em mulheres portadoras de ansiedade (OR=4,2) e insônia (OR=4,9) sendo a atividade remunerada considerada fator de proteção (OR=0,2). Os fatores de risco relacionados à ansiedade foram a presença de depressão (OR=6,1) e os antecedentes de tensão pré-menstrual (OR=7,0). CONCLUSÕES: a prevalência de depressão e ansiedade é elevada no climatério, sendo possível detectar fatores de risco relacionados à sua ocorrência.Abstract PURPOSE: to determine the prevalence of depression and anxiety in climacteric women and the probable factors responsible for its occurrence. METHODS: a transversal study that has selected 93 women attended at a climacteric outpatient

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Section: Introductionunclassified

Depressão e ansiedade em mulheres climatéricas: fatores associados

Polisseni¹,

Araújo²,

Polisseni³

et al. 2009

Rev. Bras. Ginecol. Obstet.

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“…These concepts on "allostasis" were proposed by B. S. McEwen, F. S. Dhabhar and their colleagues [38][39][40][41]. Stressful life events were reported to be related to such allostatic load [42,43].…”

Section: Discussionmentioning

confidence: 99%

Internal environment in cancer patients and proposal that carcinogenesis is adaptive response of glycolysis to overcome adverse internal conditions

Watanabe¹,

Miyajima²,

Matsui³

et al. 2010

Health

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In a series of our recent studies, stress was found to induce simultaneously hypothermia and hyperglycemia. These conditions are beneficial to obtain prompt force which depends on the glycolysis pathway and to escape emergency. Since we have noticed that such conditions resemble the internal environment seen in some cancer patients, it was investigated whether such conditions were accompanied with other patients. We selected patients with early and advanced cancer. Body temperature and other parameters including blood gas contents were examined. A difference was seen in body temperature, namely, many patients showed hypothermia, irrespective of cancer stages. Further characterization of other parameters showed that hypothermia and hyperglycemia existed in many patients. They had immunosuppressive state and anemia. Blood gas analysis showed that oxygen contents were low and carbon dioxide contents were high in patients. These results suggest a possibility that the internal environment seen in patients is responsible to induce onset of disease and to maintain their cell growth, because cancer cells have an energy system of predominant glycolysis. Although hypothermia, hypoxia and hyperglycemia are important to activate the glycolysis pathway and to escape from emergency, such responses suppress the mitochondrial pathway for long span and may result in carcinogenesis.

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“…Both acute (e.g., interpersonal relationships or daily hassles) and chronic stressors (e.g., history of child abuse or victimization) have been linked to adverse health outcomes, more menopausal symptoms, and poorer well-being in middle-aged women. Moreover, there is a reciprocal relationship between stress and the menopausal transition as stress may exacerbate menopausal symptoms and menopausal experiences may, in turn, influence the perception, experience of, and coping with stressful life events [2]. Women who experience longer MT and increased symptoms have higher stress, and were found to be at increased risk for depression [3].…”

Section: Introductionmentioning

confidence: 99%

Depressed mood but not fatigue mediate the relationship between physical activity and perceived stress in middle-aged women

Elavsky

Gold

2009

Maturitas

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Objective-To determine whether depressed mood and fatigue mediate the relationships between physical activity, body mass index, menopausal hot flashes, and perceived stress.Method-This study is a secondary analysis of data obtained from a sub-sample of peri-and postmenopausal women (N = 212) from the TREMIN Research Program on Women's Health. Results-The hypothesized mediational model was tested using path analysis within a structural equation modeling framework in Mplus Version 5.1. In unadjusted analysis, the relationships between physical activity, menopausal hot flashes, and perceived stress were mediated by depressed mood; fatigue mediated the relationships between hot flashes, body mass index, and perceived stress. When adjusting for age, insomnia, menopausal and hormone use status, the mediational effects of depressed mood on stress remained significant only for physical activity, and fatigue mediated the relationship between hot flashes and stress. The adjusted model explained 70% of variance in perceived stress, 82% of variance in depressed mood, and 81% of variance in fatigue.Conclusion-Depressed mood may partially explain the relationship between physical activity and perceived stress in middle-aged women, however further studies are needed to corroborate causality.

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Role of stressful life events and menopausal stage in wellbeing and health

Cited by 40 publications

References 176 publications

Depressão e ansiedade em mulheres climatéricas: fatores associados

Depressão e ansiedade em mulheres climatéricas: fatores associados

Internal environment in cancer patients and proposal that carcinogenesis is adaptive response of glycolysis to overcome adverse internal conditions

Depressed mood but not fatigue mediate the relationship between physical activity and perceived stress in middle-aged women

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