Depressive symptoms during the menopausal transition: The Study of Women's Health Across the Nation (SWAN)

Joyce T. Bromberger, Karen A. Matthews, Laura L. Schott, Sarah Brockwell, Nancy E. Avis, Howard M. Kravitz, Susan A. Everson-Rose, Ellen B Gold, MaryFran Sowers, John F. Randolph

Research output: Contribution to journalArticlepeer-review

313 Scopus citations


Background: The influence of menopausal status on depressive symptoms is unclear in diverse ethnic groups. This study examined the longitudinal relationship between changes in menopausal status and the risk of clinically relevant depressive symptoms and whether the relationship differed according to initial depressive symptom level. Methods: 3302 African American, Chinese, Hispanic, Japanese, and White women, aged 42-52 years at entry into the Study of Women's Health Across the Nation (SWAN), a community-based, multisite longitudinal observational study, were evaluated annually from 1995 through 2002. Random effects multiple logistic regression analyses were used to determine the relationship between menopausal status and prevalence of low and high depressive symptom scores (CES-D < 16 or ≥ 16) over 5 years. Results: At baseline, 23% of the sample had elevated CES-D scores. A woman was more likely to report CES-D ≥ 16 when she was early peri-, late peri-, postmenopausal or currently/formerly using hormone therapy (HT), relative to when she was premenopausal (OR range 1.30 to 1.71). Effects were somewhat stronger for women with low CES-D scores at baseline. Health and psychosocial factors increased the odds of having a high CES-D and in some cases, were more important than menopausal status. Limitations: We used a measure of current depressive symptoms rather than a diagnosis of clinical depression. Thus, we can only make conclusions about symptoms current at annual assessments. Conclusion: Most midlife women do not experience high depressive symptoms. Those that do are more likely to experience high depressive symptom levels when perimenopausal or postmenopausal than when premenopausal, independent of factors such as difficulty paying for basics, negative attitudes, poor perceived health, and stressful events.

Original languageEnglish (US)
Pages (from-to)267-272
Number of pages6
JournalJournal of Affective Disorders
Issue number1-3
StatePublished - Nov 2007


  • CES-D
  • Depressive symptoms
  • Longitudinal
  • Menopause

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Behavioral Neuroscience
  • Biological Psychiatry
  • Neurology
  • Psychology(all)


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