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Yıl:2013; Cilt: 26; Sayı: 2>> Özet
TAM METİN
Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2013;26(2):171-176
Menopoz dönemindeki kadınlarda hormon profilinin depresif belirtiler ile ilişkis
N Alpay, ZE Kıvanç, C Ulaşoğlu
Bakırköy Ruh ve Sinir Hastalıkları Hastanesi,İstanbul
Amaç: Ortalama ömrün uzaması ve menopoz dönemi yaşayan kadın popülasyonunun artmasıyla menopoza bağlı yakınmaların tedavisi önem kazanmıştır. Çalışmamızda, menopozda hormonal parametrelerle depresif belirtilerin şiddeti arasındaki ilişkinin değerlendirilmesini amaçladık. Yöntem: Çalışmaya, Ocak-Ağustos 2009 tarihleri arasında Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği Menopoz Polikliniği’ne başvuran, en az 12 aydır adet göremeyen ve hormonal olarak menopozun doğrulandığı 171 gönüllü hasta dahil edilmiş ve kendilerine sosyodemografik bilgileri içeren ve menopoz belirtilerini sorgulayan anketler, Hamilton Depresyon Ölçeği ve Hamilton Anksiyete Ölçeği uygulanmıştır. Cerrahi menopoz olguları, farklı bir kategori olduğu düşünülerek, çalışma dışı bırakılmıştır. Veriler NCSS programı ile analiz edilmiştir. Bulgular: Olguların %49.7’sinde hafif derecede depresyon, %18.7’sinde orta derecede depresyon görülmüş; %65.5’inde minör anksiyete, %23’ünde majör anksiyete saptanmıştır. Folikül Stimulan Horman (FSH) düzeyine göre depresyon oranları arasında anlamlı bir ilişki bulunmazken, FSH ile anksiyete görülme oranı arasında anlamlı bir ilişki bulunmuştur. Östradiol (E2) düzeyine göre değerlendirildiğinde, depresyon ve anksiyetenin görülme oranları arasında istatistiksel olarak anlamlı bir ilişki bulunmuştur. Vajinal atrofi görülen olgularda depresyon oranı hafif derecede yüksek bulunmuştur. Sonuç: Menopozal olgularda, serum FSH ve E2 seviyeleri ile anksiyete ve depresyon mevcudiyeti arasında anlamlı bir birliktelik olduğu görülmüştür. Bu bulgular, menopoz tek başına depresif semptomların majör sebebi olarak kabul edilmese de jinekolog, aile hekimi ve psikiyatristlerin premenopozal, perimenopozal ve postmenopozal evrelerde psikosomatik ve psikososyal faktörleri bir bütün halinde değerlendirerek, multidisipliner biçimde yaklaşmaları gerektiğini göstermektedir. Anahtar kelimeler: Menopoz, depresyon, anksiyete
The relationship between hormonal profile and depressive symptoms in menopausal women
Objective: As the average life expectancy gets longer and the menopausal women population increases, the notion of curing menopausal complaints becomes increasingly more important. The aim of this study is to evaluate the relationship between hormonal parameters and the severity of depressive symptoms. Methods: In this study, 171 voluntary women referred to Bakirköy Dr. Sadi Konuk Training and Research Hospital, Gynecology and Obstetrics Department, Menopausal Clinic, from January 2009 to August 2009 and who had not had menstrual periods for at least 12 months were enrolled and questionnaires for sociodemographic data and menopausal symptoms, Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale were applied. Since surgical menopausal cases were considered as a different category, they were not included. The data were analyzed using NCSS. Results: Mild depression was found in 49.7% of the cases. 18.7% of the cases had moderate depression, 65.5% had minor anxiety and 23% had major anxiety. We found no significant relation between Follicule Stimulating Hormone (FSH) levels and depression rate whereas there was a significant relation between FSH levels and the anxiety rate. There was also significant relation between estradiol (E2) levels and depression along with anxiety. Mild depression was found higher in our cases who had atrophic vulvovajinitis. Conclusion: Levels of blood FSH and E2 are significantly related with the existence of depression and anxiety. Results suggest that although menopause itself cannot be accepted as the only reason for depressive symptoms, a multidisciplinary approach, including gynecologists, family doctors and physiciatrists, should be adopted to evaluate psychosocial and psychosomatic factors as a whole in premenopausal, perimenopaual and postmenopausal stages. Key words: Menopause, depression, anxiety

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