Investigation of Social and Circadian Rhythm Dysregulation in the Development of Depression Symptoms During the Menopause Transition

更年期过渡期间抑郁症状发展中社会和昼夜节律失调的调查

• 批准号: 10507660
• 负责人: Elaine M Boland
• 金额: $ 24.38万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10507660
• 关键词: Affect; Amenorrhea; Attention; Blood; Circadian Dysregulation; Circadian Rhythms; Clinical; Cohort Studies; Data; Data Collection; Depressed mood; Development; Ecological momentary assessment; Equilibrium; Estradiol; Estrogens; Feedback; Follicle Stimulating Hormone; Frequencies; Future; Goals; Hormonal; Hormonal Change; Hormones; Intervention; Interview; Investigation; Lead; Life; Life Stress; Link; Major Depressive Disorder; Measures; Mediating; Menopause; Menstruation; Mental Depression; Methods; Moods; Participant; Pathway interactions; Patient Self-Report; Perimenopause; Persons; Phase; Plant Roots; Premenopause; Prevention; Procedures; Progesterone; Proxy; Questionnaires; Reporting; Research; Rest; Risk Management; Role; Sampling; Serum; Signal Transduction; Sleep; Stress; Stressful Event; Symptoms; Testing; Time; Woman; Wrist; actigraphy; affective disturbance; aged; behavior influence; circadian; clinical development; clinically significant; contextual factors; depressive symptoms; experience; follow up assessment; high risk; improved; indexing; psychosocial; recruit; reproductive; reproductive hormone; saliva sample; sleep onset; social; stressor; theories

Project Summary The menopausal transition is a high-risk period for the development of clinically significant depression symptoms in women. The likelihood of depression during the transition to menopause (i.e., perimenopause) is approximately 3 times greater relative to the pre-menopause period. There is a critical need to understand the mechanisms of these increased depression rates to optimally inform prevention and risk-management strategies. Circadian rhythms are altered in menopause and have been linked to depression broadly and in menopausal women specifically. Recent research has also shown that sensitivity to fluctuations in estrogen may be linked to depression symptoms during this reproductive transition. What has yet to be thoroughly elucidated is 1) the degree to which altered circadian rhythms are linked to the development of depression symptoms during the perimenopausal period and 2) whether circadian alterations are influenced purely by hormonal changes or also by environmental dysregulation of social rhythms. The goal of this R21 proposal is to explore simultaneously the relationship of both hormonal and social rhythm influences on circadian rhythms in women transitioning into menopause both with (n=20) and without (n=20) clinically significant symptoms of major depressive disorder (MDD). Baseline assessments will include clinical interview and self-report measures of depression, a detailed interview of current stressors and their impact on daily routines, and questionnaires about sleep, chronotype, and social rhythm regularity. Participants will also complete a blood draw for reproductive hormones estradiol and follicle stimulating hormone. Over the course of 4 weeks, participants will provide morning salivary samples of estradiol and progesterone every 4 days for a total of 7 samples. Participants will also wear a wrist actigraph during the study period to examine rest/activity rhythms and participate in once daily ecological momentary assessments of mood, stress, and routines allowing for deeper analysis of contextual factors that may affect circadian rhythms and mood. At the end of week 4, participants will undergo a repeat blood draw and complete follow-up assessments of stress and mood. These methods will set the stage for an R01 that will investigate the mediational role of circadian and social rhythm disruption in the development of depression symptoms in a large and diverse sample of perimenopausal women.

项目摘要 更年期过渡是临床上显着抑郁症的高风险时期 女性的症状。过渡到更年期（即，围绝经期）期间抑郁的可能性是 相对于年期前期大约大约3倍。迫切需要了解 这些抑郁率提高的机制，可最佳地为预防和风险管理提供信息 策略。昼夜节律在更年期发生了变化，并且与抑郁症的联系广泛相关。 更年期的妇女。最近的研究还表明，对雌激素的波动的敏感性 在这种生殖过渡期间，可能与抑郁症状有关。尚未彻底的 阐明是1）昼夜节律改变与抑郁症的发展的程度 围绝经期的症状和2）昼夜节律是否纯粹受到 激素的变化或通过环境失调的社会节奏。该R21提案的目标是 同时探索激素和社会节奏对昼夜节律的影响 在以（n = 20）和没有（n = 20）的临床显着症状的妇女中， 重度抑郁症（MDD）。基线评估将包括临床面试和自我报告 抑郁症的措施，对当前压力源的详细访谈及其对日常工作的影响以及 有关睡眠，时间型和社交节奏规律性的问卷。参与者还将完成血液 绘制用于生殖激素雌二醇和卵泡刺激激素。在4周的过程中， 参与者将每4天提供每4天的雌二醇和孕酮的早晨唾液样本，总计7 样品。参与者还将在研究期间佩戴腕部行动图，以检查休息/活动节奏 并每天对情绪，压力和常规的每日生态瞬时评估 对可能影响昼夜节律和情绪的上下文因素的更深入分析。在第4周结束时， 参与者将重复抽血，并对压力和情绪进行完整的随访评估。这些 方法将为R01奠定基础，该R01将研究昼夜节律的中介作用 在大量多样的临床中，抑郁症状发展的破坏 女性。