The effect of Tibolone treatment on depression, anxiety and mood in women: a meta-analysis and systematic review of randomized controlled trials.

IF 2.7 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health Pub Date : 2025-10-22 DOI:10.1007/s00737-025-01615-9

Li Dong, Yi Gang Wang, Ming Zhang, Mingxing Hu, Qi Yuan, Xi Cheng, Kousalya Prabahar, Guanghai Wang

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Abstract

Background and aim: Depression, anxiety, and mood disorders are common in women. Tibolone, acting as both estrogen and progestin, has shown conflicting effects in hormone therapy. This first meta-analysis of RCTs assesses Tibolone's impact on these conditions in women.

Methods: Two reviewers independently searched Scopus, PubMed/Medline, Web of Science, and Embase up to 22 May 2024. Using the DerSimonian and Laird random-effects model, weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated. Risk of bias was assessed using the Cochrane tool, and evidence certainty was rated using the GRADE approach.

Results: Eight articles were included in the meta-analysis. Tibolone significantly reduced depression scores (WMD = -5.335, 95% CI: -9.144 to -1.525, p = 0.006), with high heterogeneity (I² = 99.8%). Greater effects were observed in trials ≤6 months. Anxiety (WMD =-1.489, CI: -3.271 to 0.294, p = 0.102, I² = 99.1%) and mood (WMD = -0.719, CI:-1.805 to 0.366, p = 0.194, I² = 76.6%) scores showed non-significant reductions.

Conclusion: Tibolone significantly improved depressive symptoms in women, with non-significant trends in anxiety and mood. However, due to high heterogeneity, risk of bias in some studies, and limited number of trials for anxiety and mood outcomes, findings should be interpreted with caution.

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替博龙治疗对女性抑郁、焦虑和情绪的影响：随机对照试验的荟萃分析和系统回顾。

背景和目的：抑郁、焦虑和情绪障碍在女性中很常见。替博龙作为雌激素和黄体酮，在激素治疗中表现出相互矛盾的效果。这是对随机对照试验的首次荟萃分析，评估了替博龙对女性这些疾病的影响。方法：截至2024年5月22日，两位审稿人独立检索了Scopus、PubMed/Medline、Web of Science和Embase。采用DerSimonian和Laird随机效应模型，计算加权平均差（WMD）和95%置信区间（CI）。使用Cochrane工具评估偏倚风险，使用GRADE方法评估证据确定性。结果：8篇文章被纳入meta分析。替博龙显著降低抑郁评分（WMD = -5.335, 95% CI: -9.144 ~ -1.525, p = 0.006），异质性高（I²= 99.8%）。在≤6个月的试验中观察到更大的效果。焦虑（WMD =-1.489, CI: -3.271 ~ 0.294, p = 0.102, I²= 99.1%）和情绪（WMD = -0.719, CI:-1.805 ~ 0.366, p = 0.194, I²= 76.6%）得分均无显著降低。结论：替博龙可显著改善女性抑郁症状，但在焦虑和情绪方面无显著趋势。然而，由于高异质性，一些研究存在偏倚风险，以及针对焦虑和情绪结果的试验数量有限，研究结果应谨慎解释。

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

Archives of Women's Mental Health 医学-精神病学

CiteScore

8.00

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.