First onset psychiatric disorders in the perimenopause

Shitomi-Jones, Lisa, Dolman, Clare, Jones, Ian ORCID: https://orcid.org/0000-0001-5821-5889, Kirov, George ORCID: https://orcid.org/0000-0002-3427-3950, Escott-Price, Valentina ORCID: https://orcid.org/0000-0003-1784-5483, Legge, Sophie and Di Florio, Arianna ORCID: https://orcid.org/0000-0003-0338-2748 2024. First onset psychiatric disorders in the perimenopause. nature mental health Item availability restricted.

PDF - Accepted Post-Print Version Restricted to Repository staff only until 13 November 2024 due to copyright restrictions. Download (528kB)

Abstract

Background: To our knowledge, no study has systematically investigated the risk of a broad spectrum of psychiatric disorders associated with reproductive aging. This cohort study investigated whether the perimenopause (i.e., the years around the final menstrual period) is associated with increased risk of developing psychiatric disorders compared to the late reproductive stage. Methods: Information on menopausal timing and psychiatric history was obtained from nurse-administered interviews and online questionnaires from 128 294 female participants within UK Biobank. Incidence rates of psychiatric disorders during the perimenopause (4 years surrounding the final menstrual period) were compared with the reference premenopausal period (6 to 10 years before the final menstrual period). Rates were calculated for major depressive disorder, mania, schizophrenia spectrum disorders, and other diagnoses. Findings: Overall, of 128 294 participants, 753 (0.59%) reported their first onset of a psychiatric disorder during the late reproductive stage (incidence rate 1.53 per 1000 person-years) and 1133 (0.88%) during the perimenopause (incidence rate 2.33 per 1000 person-years). Compared to the reference reproductive period, incidence rates of psychiatric disorders significantly increased during the perimenopause (incidence rate ratio (RR) 1.52, 95% confidence interval 1.39 to 1.67) and decreased back down to that observed in the premenopausal period in the postmenopause (RR=1.09 [95% CI 0.98-1.21]). The effect was primarily driven by increased incidence rates of major depressive disorder, with an incidence rate ratio of 1.30 (confidence interval 1.16 to 1.45). However, the largest effect size at perimenopause was observed for mania (incidence rate ratio 2.12, 95% confidence interval 1.30 to 3.52). No association was found between perimenopause and incidence rates of schizophrenia spectrum disorders (incidence rate ratio 0.95, confidence interval 0.48 to 1.88). Conclusions: Perimenopause was associated with an increased risk of developing major depressive disorder and mania. No association was found between perimenopause and first onsets of schizophrenia spectrum disorders. This is the largest and most comprehensive study investigating the relationship between perimenopause and psychiatric disorders to date, as well as the first known study to establish a relationship between perimenopause and first onsets of mania.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	National Centre for Mental Health (PNCMH) Medicine MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher:	Nature Research
ISSN:	2731-6076
Date of First Compliant Deposit:	20 June 2024
Date of Acceptance:	13 May 2024
Last Modified:	28 Jun 2024 02:37
URI:	https://orca.cardiff.ac.uk/id/eprint/170025

Actions (repository staff only)

Edit Item