What happens after menopause? (WHAM): Impact of risk-reducing salpingo-oophorectomy on depressive and anxiety symptoms at 24 months

IF 4.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
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Abstract

Objective

For women with pathogenic variants in BRCA1 and BRCA2, risk-reducing salpingo-oophorectomy (RRSO) at the recommended age causes surgical menopause. We previously reported elevated depressive symptoms at 6 and 12 months and elevated anxiety symptoms at 6 months after RRSO. We now report these outcomes at 24 months, their baseline and 12-month predictors and the effect of Menopausal Hormone Therapy (MHT).

Methods

Prospective controlled study of 59 premenopausal women planning RRSO and 91 comparisons who retained their ovaries. Depressive (CESD) and anxiety symptoms (GAD-7) were measured at baseline (before RRSO) and at 12 and 24 months. We used ordinary and logistic multivariable regression to estimate differences between and within groups at 24 months, before and after conditioning on baseline and 12 month measures.

Results

Overall, depressive and anxiety symptoms were not elevated above baseline at 24 months and did not differ between RRSO and comparisons, before or after adjusting for previous measures (P > 0.05). Elevated depressive symptoms at 12 months (OR = 24, P < 0.001), and elevated anxiety symptoms at 12 months (OR = 13, P < 0.001), strongly predicted 24 month measures. Elevated depressive symptoms at baseline no longer predicted 24 month symptoms once 12 month symptoms were considered, but elevated baseline anxiety still predicted anxiety at 24 months, even when 12 month anxiety was considered. No association between MHT use and depressive or anxiety symptoms was observed.

Conclusions

Depressive and anxiety symptoms are not elevated 24 months after RRSO. However, depressive symptoms at 12 months after RRSO are likely to persist at 24 months.
更年期之后会发生什么?(WHAM):降低风险的输卵管切除术对抑郁和焦虑症状在 24 个月后的影响。
目的:对于 BRCA1 和 BRCA2 中存在致病变异的女性来说,在推荐年龄进行降低风险的输卵管切除术(RRSO)会导致手术绝经。我们曾报告过 RRSO 术后 6 个月和 12 个月抑郁症状升高以及 6 个月焦虑症状升高的情况。现在,我们报告了 24 个月后的这些结果、其基线和 12 个月的预测因素以及绝经激素疗法(MHT)的效果:方法:对 59 名计划进行 RRSO 的绝经前妇女和 91 名保留卵巢的对比者进行前瞻性对照研究。在基线(RRSO 前)、12 个月和 24 个月时测量抑郁症状(CESD)和焦虑症状(GAD-7)。我们使用普通回归和逻辑多变量回归估算了基线和 12 个月测量前后 24 个月组间和组内的差异:总体而言,在 24 个月时,抑郁症状和焦虑症状没有高于基线,而且在调整之前和之后,RRSO 和对比组之间也没有差异(P > 0.05)。12 个月时抑郁症状升高(OR = 24,P 结论:抑郁症状和焦虑症状没有升高:RRSO 24 个月后,抑郁症状和焦虑症状不会升高。然而,RRSO 后 12 个月时的抑郁症状可能会持续到 24 个月。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Gynecologic oncology
Gynecologic oncology 医学-妇产科学
CiteScore
8.60
自引率
6.40%
发文量
1062
审稿时长
37 days
期刊介绍: Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy
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