Clinical phenotypes of female depression and age at menarche: Analysis of data from NHANES 2005–2020

Abstract

Background

Depression exhibits a high prevalence among females, with its heterogeneity contributing to various phenotypes. Reproductive status is a pivotal determinant in the etiology and progression of female depression. However, the characteristics of depression associated with female reproductive have been insufficiently explored.

Methods

A cohort of 15,602 adult females, derived from the National Health and Nutrition Examination Survey spanning 2005 to 2020, was subjected to analysis following data screening. This study utilized data encompassing reproductive status, Patient Health Questionnaire (PHQ) scores, cognitive function assessments, estrogen levels and thyroid profiles. Latent class analysis was employed to identify the clinical subtypes of female depression.

Results

Females in the early menarche group exhibited higher depressed scores compared to those in non-early menarche group (P < 0.001). A final model with three latent classes was determined to be optimal. Key distinguishing characteristics across identified classes included the menarche age, symptom severity, cognitive function, and levels of thyroxine hormones. Women in Class 3 had the most severe symptoms, and they experienced menarche at the earliest age, poorest cognitive performance and lowest free thyroxine and higher thyroglobulin (all P < 0.05, Bonferroni correction).

Conclusions

Female depression appears to encompass a range of distinct phenotypes. The menarche age may serve as a significant marker for future sex-specific biological and genetic studies pertaining to female depression subtype. To comprehensively decipher the biomarker profiles associated with depression subtypes, further investigation into reproductive-related factors is essential.