| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 100 === Abstract
Background: According to the findings of previous studies, women are at greater risk for developing depression than men throughout the life. Some studies supported the association between women and depression was caused by the change of hormone level throughout the life, for example: adolescence, pregnancy, post-partum, and menopause, whiles others have not. Many studies have investigated the relations among menopause and depression by questionnaire in the Taiwan and abroad. However, there is no one study using the Taiwan National Health Insurance Research Database (NHIRD) to confirm the relation among menopausal syndrome and depression. Therefore, we intend to evaluate the relationship by applying the Taiwan National Health Insurance Research Database (NHIRD) for a long-term follow-up study.
Objectives: The purpose of this study was to explore the association among menopausal syndrome, the duration of hormone replacement therapy (HRT) and depression. Then we could provide useful information to the physicians about treating depression during menopause period.
Methods: Study group was women aged 45-48 years in 2004 with the diagnosis of menopausal syndrome twice in that year but excluded the people with the diagnosis of depression in previous year using NHIRD. We ran the database of the study group for 2 years but excluded the population of expiration or no visit to OPD from 2005 to 2006. We also matched a control group as the study group so that we could obtain the data of depression from the different groups and compare the difference between them. We also could obtain the population of depression from the study group and calculate the accumulation case from the view of short-term, medium-term and long-term effect of hormone replacement therapy (HRT).
Results: The results of the logistic regression analysis showed that the risk of acquiring depression at age 45-48 years was higher in the group of menopausal syndrome than the group of no menopausal syndrome (odds ratio(OR)=2.302, p<0.001). The analysis also displayed that the risk of acquiring depression was higher in the group of menopausal syndrome treated with hormone replacement therapy (HRT) than the group of menopausal syndrome without treatment(OR=1.328, p<0.001). The risk of developing depression in the group of menopausal syndrome with treatment with short-term, medium-term and long-term of hormone replacement therapy (HRT) was higher than the group of menopausal syndrome without treatment (OR=1.302, p<0.001; OR=1.336, p<0.001; OR=1.483, p<0.001).
Conclusions: This study found that women with menopausal syndrome having higher risk of developing depression than those without menopausal syndrome. The hormone replacement therapy (HRT) for treatment of menopausal depression was not good enough. The combination of antidepressant with hormone replacement therapy (HRT) might offer the better treatment found in previous studies.
Keywords: menopausal syndrome, depression, hormone replacement therapy (HRT)
|
|---|
