TY - JOUR
T1 - Predictors of irritability symptoms in mildly depressed perimenopausal women
AU - de Wit, Anouk E.
AU - Giltay, Erik J.
AU - de Boer, Marrit K.
AU - Nathan, Margo
AU - Wiley, Aleta
AU - Crawford, Sybil
AU - Joffe, Hadine
N1 - Publisher Copyright: © 2021 The Authors
PY - 2021/4
Y1 - 2021/4
N2 - Objective: Irritability is a highly burdensome complaint, commonly, but not universally, linked with depressive symptoms. While increased variability in estradiol has been associated with depressive symptoms during perimenopause, more insight is needed into reproductive hormone dynamics and other factors that predispose perimenopausal women to irritable mood. Methods: Among 50 mildly depressed perimenopausal women (mean (SD) age 48.4 (3.9) years), severity of irritability symptoms (on Symptom Questionnaire Hostility subscale, range 0–23) was assessed weekly for eight weeks, concurrent with potential predictors. Associations between these were examined using generalized estimating equating models. Results: Most women (82.0%) reported having moderate to severe irritability at least once. However, the severity of irritability was highly variable from week-to-week (between-subject mean coefficient of variation [CV] 72.9% and within-subject mean CV 63.7%). In multivariate analyses, less variable serum estradiol levels (standardized β within-person CV −0.23 95%CI [−0.32, −0.14], p < 0.001), greater depression severity (0.45 [0.35, 0.56], p < 0.001), younger age (−0.23, [−0.28, −0.09], p < 0.001), and more frequent vasomotor symptoms (0.14 [0.05, 0.23], p = 0.002) were associated with more irritability. Depression severity explained the largest portion of the variance in irritability, but still not more than 17.6%. Neither crude values, weekly change in, or variability of progesterone or FSH levels were associated with irritability. Conclusions: Irritability was highly prevalent among mildly depressed perimenopausal women. In contrast to depressive symptoms, decreased rather than increased variability in estradiol levels was associated with more irritability. This highlights that irritable mood can be disentangled from depressive symptoms in perimenopausal women and might be linked with different estradiol dynamics.
AB - Objective: Irritability is a highly burdensome complaint, commonly, but not universally, linked with depressive symptoms. While increased variability in estradiol has been associated with depressive symptoms during perimenopause, more insight is needed into reproductive hormone dynamics and other factors that predispose perimenopausal women to irritable mood. Methods: Among 50 mildly depressed perimenopausal women (mean (SD) age 48.4 (3.9) years), severity of irritability symptoms (on Symptom Questionnaire Hostility subscale, range 0–23) was assessed weekly for eight weeks, concurrent with potential predictors. Associations between these were examined using generalized estimating equating models. Results: Most women (82.0%) reported having moderate to severe irritability at least once. However, the severity of irritability was highly variable from week-to-week (between-subject mean coefficient of variation [CV] 72.9% and within-subject mean CV 63.7%). In multivariate analyses, less variable serum estradiol levels (standardized β within-person CV −0.23 95%CI [−0.32, −0.14], p < 0.001), greater depression severity (0.45 [0.35, 0.56], p < 0.001), younger age (−0.23, [−0.28, −0.09], p < 0.001), and more frequent vasomotor symptoms (0.14 [0.05, 0.23], p = 0.002) were associated with more irritability. Depression severity explained the largest portion of the variance in irritability, but still not more than 17.6%. Neither crude values, weekly change in, or variability of progesterone or FSH levels were associated with irritability. Conclusions: Irritability was highly prevalent among mildly depressed perimenopausal women. In contrast to depressive symptoms, decreased rather than increased variability in estradiol levels was associated with more irritability. This highlights that irritable mood can be disentangled from depressive symptoms in perimenopausal women and might be linked with different estradiol dynamics.
KW - Depression
KW - Irritability
KW - Perimenopause
KW - Predictors
KW - Reproductive hormones
UR - http://www.scopus.com/inward/record.url?scp=85099626639&partnerID=8YFLogxK
U2 - 10.1016/j.psyneuen.2021.105128
DO - 10.1016/j.psyneuen.2021.105128
M3 - Article
C2 - 33493755
SN - 0306-4530
VL - 126
JO - Psychoneuroendocrinology
JF - Psychoneuroendocrinology
M1 - 105128
ER -