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March 29, 2017

Penn study finds teen trauma raises depression risk in menopause

Women who experience multiple traumatic events and chronic stress during their teenage years face a higher risk of depression during menopause than those who don't—even without a history of depression, according to researchers at the University of Pennsylvania.

In a study conducted by the Perelman School of Medicine, the first of its kind to focus on the role of childhood adversity in the onset of major depressive disorder (MDD) during menopause, researchers concluded that hormonal changes in menopause might expose a previously hidden risk in women.

“Our results show that women who experience at least two adverse events during their formative years – whether it be abuse, neglect, or some type of family dysfunction– are more than twice as likely to experience depression during perimenopause and menopause as women who either experienced those stressors earlier in life, or not at all,” said lead author C. Neill Epperson, who serves as director of the Penn Center for Women's Behavioral Wellness.

The research team enrolled 243 women between 35 and 47 years old, all deemed premenopausal with normal hormonal cycles, for behavioral, cognitive and endocrine evaluations at intervals over a 16-year period from 1996-2012. They each received approximately 12 assessments for cognition and mood in addition to providing blood samples to measure hormone levels. In the final years of the study, the women gave phone interviews to assess menopause status and determine any adverse childhood experiences that might reveal a potential link to health outcomes.

Among women who reported adverse childhood events include in the questionnaire, the most commonly reported experiences were emotional abuse, parental separation or divorce and living with someone with alcohol or substance abuse. Women who reported two or more adverse childhood experiences after the onset of puberty were 2.3 times more likely to have their first experience of MDD during perimenopause, or the years leading into menopause, than those without such experiences—though they were not more likely to be diagnosed with depression at earlier stages of life.

“This suggests that not only does early life stress have significant and long-lasting effects on the development and function of the regions of the brain responsible for emotions, mood, and memory, but the timing of when the event occurs may be equally as important," Epperson said.

The researchers say further investigation is needed to determine how the frequency and severity of adverse childhood events impact women's risk for depression later in life, as well as the possible role hormone therapy could play in depression risk during menopause.

Results from the study were published in The Journal of Clinical Psychiatry.