Women with no history of mood disturbance may be at increased risk for first lifetime episode of depression as they enter menopause compared with premenopausal women of the same age, according to an article in the April issue of the Archives of General Psychiatry.

Lee S. Cohen, MD, from Massachusetts General Hospital, Boston, and colleagues from the Harvard Study of Moods and Cycles examined the association between menopausal transition and onset of first lifetime episode of depression among women with no history of mood disturbance.

The participants were 460 premenopausal women 36 to 45 years old with no lifetime diagnosis of major depression who lived in seven communities near one American city. The incidence of new-onset depression was based on structured clinical interviews, CES-D scores, and self-administered questionnaires.

“Premenopausal women with no lifetime history of major depression who entered the perimenopause were twice as likely to develop significant depressive symptoms as women who remained premenopausal after adjustment for age at study enrollment and history of negative life events,” the researchers wrote. “The increased risk for depression was somewhat greater in women with self-reported vasomotor symptoms.”

“The current study suggests that within a similarly aged population of women with no lifetime history of depression, those who enter the menopausal transition earlier have a significant risk for first onset of depression,” the authors concluded.

“In the United States only, approximately 1.5 million women may reach menopause each year. A spectrum of symptoms and syndromes has been extensively described in women during the menopausal transition including severe vasomotor symptoms, loss of bone density, sexual dysfunction, a decline in cognitive function, and a potential increased risk for cardiovascular disease. Thus, the comorbidity of these problems with perimenopause-associated depression could affect many aging women, leading to a compounded burden of illness.”