Subjective well-being's alterations as risk factors for major depressive disorder during the perimenopause onset: an analytical cross-sectional study amongst Mexican women residing in Guadalajara, Jalisco.

BACKGROUND: Subjective well-being (SWB) can be defined as a self-report evaluation that reflects the satisfaction, and emotional level, over several social and personal indicators. Alterations in these indicators could become risk factors (RF) for major depressive disorder (MDD), but this association has not been studied at women's life stages such as the perimenopause onset, despite its increasing prevalence for depressive symptomatology. Therefore, the aim of this study was to identify if SWB's alterations determine RF for MDD during the perimenopause. METHODS: An analytical cross-sectional study was realized in 252 Mexican women with perimenopause's age range (48 ± 1.7) and menopausal symptomatology, treated on Medical Units belonging to Jalisco's 13th Health-Region. We applied the INEGI's Basic Self-Reported Wellbeing Survey (BIARE) that measured 30 SWB's indicators. To identify MDD's presence, the Beck's Depression Inventory-II (BDI-II) was applied. The sample was studied with associative analysis, along with logistic regression models, to determine adjusted odds ratio (aOR) and corresponding 95% confidence interval (95% CI). RESULTS: Trough the BDI-II we identified 40.5% women with MDD. When compared with the undepressed group we found lower scores in all the SWB's indicators, along with significant associations for depressive symptomatology. However, the logistic regression allowed us to identify significant RF when the women specifically reported personal life-dissatisfaction (aOR 9.6, 95% CI 1.90-17.68), emotional imbalances between happiness/sadness (aOR 7.1, 95% CI 1.49-13.57) and concentration/boredom (aOR 6.7, 95% CI 1.43-13.48); free-time dissatisfaction (aOR 5.5, 95% CI 1.17-5.70), public security unconformity (aOR 5.4, 95% CI 2.20-11.3), and sense of purposelessness (aOR 4.2, 95% CI 1.07-19.41). CONCLUSION: The main objective of the study was to determine if SWB's alterations are RF for depressive symptomatology, finding that social indicators with low scores are associated with MDD by means of aOR -Which were higher when compared to international research studies. Considering this, we suggest that more studies should be implemented, in order to understand and correctly attend the women's social conditions during their perimenopause transition.

Riesgo para el desarrollo de trastorno depresivo mayor al existir alteraciones en la sintomatología menopaúsica en mujeres de Guadalajara, Jalisco / Risk for the development of major depressive disorder when there are alterations in menopausal symptoms in women from Guadalajara, Jalisco

RESUMEN Antecedentes: El Trastorno Depresivo Mayor (TDM) puede presentarse durante el inicio de la menopausia, variando su prevalencia de acuerdo a diferentes factores de riesgo clínicos y sociodemográficos; presentándose una mayor asociación al existir alteraciones en la sintomatología menopaúsica. Ante esto, se buscará determinar el riesgo para desarrollar TDM al presentar alteraciones en la sintomatología menopaúsica. Metodología: Es un diseño transversal analítico que incluyó a 252 mujeres iniciando su menopausia (48±1.7 años), atendidas en centros de salud de Guadalajara, Jalisco. Las variables analizadas fueron antecedentes sociodemográficos, utilizando el Inventario de Depresión de Beck para identificar el TDM y la Escala de Valoración de la Menopausia para determinar alteraciones en los principales dominios sintomatológicos de la menopausia. Se realizaron análisis descriptivos y de asociación por medio de Odds Ratio (OR), aplicando finalmente una regresión logística. Resultados: La prevalencia de TDM fue de 40.5%, teniendo asociación con el antecedente de uso de anticonceptivos y con el agravamiento en la sintomatología menopaúsica. El análisis ajustado determinó que hay más riesgo de presentar TDM cuando existen alteraciones en los dominios sintomatológicos, tales como en el somático (OR 3.96, IC95% 1.58-9.95), el urogenital (OR 4.29, IC95% 2.13-8.65) y el psicológico (OR 13.55, IC95% 3.97-46.30). Conclusión: La presencia de alteraciones en la sintomatología menopaúsica se encuentra asociado con un mayor riesgo de presentar TDM, sobre todo si el dominio psicológico está afectado, por lo cual es necesario que el personal de salud identifique estas alteraciones y brinde un manejo temprano en esta etapa de la vida.

ABSTRACT Background: Major Depressive Disorder (MDD) can occur during the onset of the menopause, varying its prevalence according to different clinical and sociodemographic risk factors; presenting a greater association with the existence of alterations in the menopausal symptomatology. Given this, we will seek to determine the risk to develop MDD by presenting alterations in the menopausal symptoms Methodology: It is an analytical cross-sectional design that included 252 women beginning their menopause (48±1.7 years old), and who were attended in health centers of Guadalajara, Jalisco. The analyzed variables were their sociodemographic background, using the Beck Depression Inventory to identify the MDD and the Menopause Rating Scale to determine alterations in the main symptomatological domains of the menopause. Descriptive and association analyzes were performed by means of Odds Ratio (OR), subsequently applying a logistic regression model. Results: The prevalence of MDD was 40.5%, with significant associations with the history of contraceptive use and the worsening of menopausal symptoms. The adjusted analysis allowed us to determine that there is more risk for developing MDD when there were alterations in the symptomatological domains, such as in the somatic (OR 3.96, 95% CI 1.58-9.95), the urogenital (OR 4.29, IC95% 2.13-8.65) and in the psychological (OR 13.55, IC95% 3.97-46.30). Conclusion: The presence of alterations in the menopausal symptomatology is associated with an increased risk of developing MDD, especially if the psychological domain is affected, which is why it is necessary for health personnel to identify these alterations and provide early management in this stage of live.