Female psychopathologic profile during menopausal transition: a preliminary study.

OBJECTIVES: To evaluate the psychopathological profile and the incidence of major depressive disorders in consecutive women attending a Menopause Clinic. METHODS: Women attending outpatient menopause clinic at Filippo del Ponte Hospital in Varese (Italy), referring to the centre from 1 March to 30 April 2005, were invited to fill up a specific questionnaire while waiting for the visit. The questionnaire included demographics and history (e.g. current or past use of antidepressant drugs); symptoms check list (SCL-90-R); Beck depression inventory (BDI). RESULTS: Sixty-four women were enrolled to the study. On the SCL-90-R, "somatic" symptoms cluster was the most frequent. Patients diagnosed as depressed using the Beck depression inventory (BDI) were 18 (28.1%). Thirteen (70%) of currently depressed women presented a positive history of depressive disorders. The analysis of depressed women according to previous depressive disorders revealed higher scores for women with positive history in both scales. Depressed patients have a significantly lower mean age compared to non-depressed patients (53.3+/-6.2 years versus 57.33+/-4.9 years, p=0.023). CONCLUSIONS: Our preliminary data show a high correlation between a history of depressive disorder and recurrence of depression in the menopausal period. Perimenopause seems to be a higher risk period for the development of a depressive disease compared to menopausal status. The somatization cluster warrants further investigation.

Effects of dehydroepiandrosterone (DHEA) supplementation on hormonal, metabolic and behavioral status in patients with hypoadrenalism.

Oral DHEA administration to patients with hypoadrenalism, in addition to glucocorticoid and mineralcorticoid replacement, may improve both well-being and hormonal/metabolic parameters. Twenty patients (13 men, 7 women, 26-76 yr, 11 with Addison's disease, 9 with central hypoadrenalism) were recruited in a placebo-controlled, randomized study. Hormone levels, carbohydrate and lipid parameters, bone metabolism, body composition and psychological parameters were evaluated at baseline and after treatment with DHEA 50 mg/day or placebo for 4 months. After 4 months of DHEA administration, serum DHEAS levels raised both in men (from 0.71+/-0.18 to 8.28+/-1.66 micropmol/l, p<0.005) and in women (from 0.25+/-0.07 to 5.65+/-1.93 micromol/l, p<0.05). Only in hypoadrenal women an increase in testosterone (T; from 0.4+/-0.1 to 1.45+/-0.26 nmol/l, p<0.05) and androstenedione (A; from 0.86+/-0.34 to 2.05+/-0.29 nmol/l, p<0.05) levels was observed. In men no significant modifications in T and 17-hydroxyprogesterone (17-OHP) levels were found, whereas serum SHBG significantly decreased. As far as the metabolic parameters are concerned, only in patients with Addison's disease a significant decrease in total cholesterol and in low-density lipoproteins after 4 months of DHEA administration was found. No changes in glucose metabolism and insulin sensitivity were observed. In basal conditions, mean serum osteocalcin (OC) was normal and significantly decreased after DHEA treatment. A significant reduction in body fat mass percentage (BF%) after DHEA administration was observed. As far as well-being is concerned, DHEA replacement did not cause any relevant variation of subjective health scales and sexuality in both sexes. Our study confirms that DHEA may be beneficial for female patients with hypoadrenalism, mainly in restoring androgen levels. Concerning the health status, more sensitive and specific instruments to measure the effects of DHEA treatment could be necessary.