Friday, June 29, 2018

Clinicians Develop New Rating Scale for Perimenopausal Depression

Key differences in depressive symptoms that arise during perimenopause (the period immediately before menopause) suggest that perimenopausal depression may be a distinct subtype of depression, but scales to measure or monitor symptoms of perimenopausal depression are lacking. A report published yesterday in Translational Psychiatry describes the development and validation of a questionnaire that clinicians or patients can use to rate the severity of perimenopausal depression symptoms.

“Having a reliable tool to aid in the diagnosis of perimenopausal depression is very important in research of this relatively neglected area of women’s health,” wrote Jayashiri Kulkarni, M.D., and colleagues at Monash University in Melbourne, Australia. “Clinically, it is very important to accurately detect and diagnose perimenopausal depression as early as possible to enable more specific treatments, such as hormone treatment strategies.”

Kulkarni and colleagues conducted an extensive literature review and relied on clinical observation and focus groups (including perimenopausal women and clinicians) to identify key perimenopausal depression symptom areas. From this research, they created a 12-item questionnaire, called the Meno-D, which asked patients to rate the severity of the following symptoms on a scale of 0 to 4: anxiety, concentration, energy, irritability, isolation, memory, paranoia, self-esteem, sexual interest, sleep, somatic symptoms, and weight changes.

The Meno-D was then administered to 93 women experiencing symptoms of perimenopausal depression, 82 of whom completed the questionnaire. While the women varied significantly in their total Meno-D scores, despite all having perimenopausal depression, they generally had above average scores related to somatic (somatic symptoms and weight), cognitive (memory and concentration), self (self-esteem, paranoia, isolation, and anxiety), sleep (sleep disturbances and irritability), and/or sexual (sexual interest and energy) symptoms.

“Previous studies have reported that women experiencing perimenopausal depression complain about physical symptoms more than cognitive ones, which are not typically included in previous scales assessing for major depressive disorder,” Kulkarni and colleagues wrote. “This may explain why perimenopausal depression is often overlooked or left undiagnosed.”

They concluded, “The Meno-D will support a growing research field, interfacing both psychiatry and endocrinology, which indicates that perimenopausal depression is a unique subtype of depression requiring a different management approach.”

To read more about this topic, see the Psychiatric News article “Discontinuing Hormone Therapy May Increase Risk of Depression in Some Women.”

(Image: iStock/monkeybusinessimages)


The content of Psychiatric News does not necessarily reflect the views of APA or the editors. Unless so stated, neither Psychiatric News nor APA guarantees, warrants, or endorses information or advertising in this newspaper. Clinical opinions are not peer reviewed and thus should be independently verified.