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Adverse childhood experiences increase risk for depression in menopause
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Adverse childhood experiences, particularly those that occurred during the prepubertal phase, increased risk for incident menopause major depressive disorder.
“Our results show that women who experience at least two adverse events during their formative years — whether it be abuse, neglect, or some type of family dysfunction — are more than twice as likely to experience depression during perimenopause and menopause as women who either experienced those stressors earlier in life, or not at all,” C. Neill Epperson, MD, of the University of Pennsylvania, said in a press release. “This suggests that not only does early life stress have significant and long-lasting effects on the development and function of the regions of the brain responsible for emotions, mood, and memory, but the timing of when the event occurs may be equally as important.”
To determine associations between adverse childhood experiences and risk for first-episode major depressive disorder during menopause, researchers evaluated women from the Penn Ovarian Aging Study cohort who completed behavioral, cognitive and endocrine evaluations annually from 1996 to 2012. Participants completed the Adverse Childhood Experiences Questionnaire at study end (n = 243). Adverse events that occurred 2 or more years before menarche were defined as prepubertal. Menopause MDD was defined as first observed onset of MDD in perimenopause to postmenopause transition.
Overall, 100 women experienced lifetime MDD and of these, 48% experienced incident menopause MDD.
Women who reported at least two adverse childhood events had significantly higher risk for lifetime MDD (adjusted OR = 2.05; P = .034) and incident menopause MDD (aOR = 2.58; P = .03), compared with women who reported no adverse childhood events.
When controlling for race, smoking, BMI and employment, women who reported at least two prepubertal adverse childhood events were 2.3 times more likely to experience incident menopause MDD (P = .024)
Experiencing one adverse childhood event in postpuberty was associated with lower risk for lifetime and incident menopause MDD.
“There’s clearly a strong link between childhood adversity and risk of depression, throughout a woman's life, but particularly during the transition to menopause,” study researcher Ellen W. Freeman, PhD, of the University of Pennsylvania, said in the release. “Our study points to the need for more research examining the long-term brain effects of childhood adversity, particularly around the time of puberty.” – by Amanda Oldt
Disclosure: Epperson reports serving as a consultant to Umecrine Mood, Sage therapeutics and Asarina; investing in Pfizer, Johnson and Johnson, Merck, Abbott and Abbvie; and receiving support for nonrelated research from SAGE and Shire. Please see the study for a full list of relevant financial disclosures.