Síndromes depressiva e ansiosa em mulheres climatéricas

Abstract

Psychological symptoms during the climacteric, mainly depression and anxiety, have been studied since the XIX century. Because life expectancy has increased, it is a fact that women can expect to live a third of their lives after menopause. Mental health and quality of life deserve special attention, so that women may lead a healthy life during the climacteric. This study aimed to investigate the interplay of depression and anxiety symptoms and the biopsychosocial context of women during the climacteric. The prevalence of depression and anxiety symptoms was determined, and putative risk factors sought. 93 women aged between 40 and 65 years, attending the climacteric outpatient unit of the University Hospital of the Federal University of Juiz de Fora, MG, Brazil (HU/UFJF), were studied during the period from May 2006 through August 2007. Exclusion criteria were: use of hormonal replacement therapy, hormone implants, intra-uterine devices and depot injectable hormones in the previous six months; endocrine disease leading to irregular menses; liver disease; coagulation disorders; drugs interfering with the menstrual cycle; use of drugs to treat anxiety or antidepressants; hysterectomy; oophorectomy; cancer; psychiatric disorders; radiotherapy or chemotherapy. Four questionnaires were applied: Interview, highlighting sociodemographic features, clinical information and life habits; the Blatt-Kupperman menopausal Index (BKMI); the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A); and the Beck inventory for depression. A descriptive analysis was performed, and the Statistica Software program (version 6) was used to investigate correlations between the variables, with the chi-square and Hosmer-Lemeshow tests. There was no correlation of depression (p=0.12) and anxiety (p=0.88) with the phases of the climacteric. The mean frequency of depression was 36.8% and of anxiety was 53.7%. There was significant relationship between moderate-intensity climacteric symptoms and anxiety/depression (p<0.001). Depression was more frequent in those with anxiety (OR=4.22) and insomnia (OR=4.99), having a paid job being found protective (OR=0.27). Risk factors for anxiety were present depression (OR=6.10) and previous premenstrual tension (OR=7.08). The frequency of depression and anxiety is high in the climacteric, risk factors for their development being recognizable. Diagnosis of depression and anxiety (through specific instruments) and their adequate management may improve the quality of life of women in the climacteric.