Perimenopause closely associated with increased mania and depression risk: Study

A new study published in the recent issue of Nature Mental Health journal found an increased risk of mania and major depressive disorder (MDD) in perimenopause. Over 945 million women worldwide are projected to exist, where close to 80% of persons have neuropsychiatric symptoms during perimenopause, which is the time period surrounding the final menstrual period (FMP). Hot flashes, cognitive impairment, sleep issues, and mood-related symptoms are the most frequent neuropsychiatric symptoms at this time.

The researches so far has mostly examined solely depressive symptoms, it has been hypothesized that the perimenopause is also a high-risk time for the emergence or worsening of mental illnesses, including major depressive disorder, schizophrenia spectrum disorders, and bipolar disorder. While there is much evidence linking perimenopause to mood changes, less is known about the risk of a wide range of mental problems linked to aging reproductive systems. In this study, Lisa Shitomi-Jones and colleagues evaluated whether perimenopause is connected with a higher risk of acquiring mental illnesses than the late reproductive period.

The data on the time of menopause and mental health history were gathered by online questionnaires and interviews conducted by nurses with 128,294 female participants in the UK Biobank. The reference premenopausal era (6-10 years before the FMP) and the perimenopause (4 years around the FMP) were used to compare the incidence rates of mental illnesses. Major depressive disorder, schizophrenia spectrum disorders, mania, and other diagnoses were computed rates.

A total of 128,294 individuals were included in this study, where 753 (0.59%) had their first mental illness during the late reproductive period and 1,133 (0.88%) during the perimenopause. Incidence rates of mental illnesses increased dramatically during the perimenopause when compared with the reference reproductive period, and then reduced back to the premenopausal period during the postmenopause. With an incidence RR of 1.30, higher incidence rates of MDD were the main cause of the impact. But, mania was found to have the most impact size during the perimenopause. There was no correlation discovered between the incidence rates of schizophrenia spectrum diseases and perimenopause. Overall, the findings emphasize the significance of diagnostic accuracy in the evaluation of mental disorders related to aging.

Reference:

Shitomi-Jones, L. M., Dolman, C., Jones, I., Kirov, G., Escott-Price, V., Legge, S. E., & Di Florio, A. (2024). Exploration of first onsets of mania, schizophrenia spectrum disorders and major depressive disorder in perimenopause. In Nature Mental Health. Springer Science and Business Media LLC. https://doi.org/10.1038/s44220-024-00292-4