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: 10665761
• 负责人: Elaine M Boland
• 金额: $ 20.31万
• 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 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10665761
• 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; Hypothalamic structure; Intervention; Interview; Investigation; Life; Life Stress; Link; Major Depressive Disorder; Measures; Mediating; Menopause; Menstruation; Mental Depression; Methods; Moods; Participant; Pathway interactions; Patient Self-Report; Perimenopause; Periodicity; Persons; Phase; Premenopause; Prevention; Procedures; Progesterone; Proxy; Questionnaires; Reporting; Research; Rest; Risk Management; Role; Sampling; Serum; Signal Transduction; Sleep; Stress; Stressful Event; Symptoms; Testing; Woman; Wrist; actigraphy; affective disturbance; aged; behavior influence; circadian; clinical development; clinically significant; comparison control; contextual factors; depressive symptoms; experience; follow up assessment; high risk; improved; indexing; psychosocial stressors; 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.

项目概要 更年期过渡期是发生具有临床意义的抑郁症的高危时期 女性的症状。在过渡到更年期（即围绝经期）期间患抑郁症的可能性是 相对于绝经前时期大约增加3倍。迫切需要了解 抑郁症发病率增加的机制，为预防和风险管理提供最佳信息 策略。昼夜节律在更年期发生改变，并且与抑郁症广泛相关。 特别是更年期女性。最近的研究还表明，对雌激素波动的敏感性 可能与生殖转变期间的抑郁症状有关。哪些还有待彻底 阐明的是 1) 昼夜节律改变与抑郁症发展相关的程度 围绝经期期间的症状以及 2) 昼夜节律变化是否纯粹受 荷尔蒙变化或社会节奏的环境失调。 R21 提案的目标是 同时探索荷尔蒙和社会节律对昼夜节律影响的关系 在进入更年期的女性中，有（n = 20）和没有（n = 20）临床显着症状 重度抑郁症（MDD）。基线评估将包括临床访谈和自我报告 抑郁症的测量、对当前压力源及其对日常生活的影响的详细访谈，以及 关于睡眠、睡眠时间型和社交节律规律的问卷调查。参与者还将完成血液检查 绘制生殖激素雌二醇和卵泡刺激素。在4周的时间里， 参与者将每 4 天提供一次早晨唾液样本，其中含有雌二醇和黄体酮，总共 7 样品。参与者还将在研究期间佩戴手腕活动记录仪来检查休息/活动节奏 并参与每日一次的情绪、压力和日常生活的生态瞬时评估，以便 更深入地分析可能影响昼夜节律和情绪的背景因素。第 4 周结束时， 参与者将接受重复抽血并完成压力和情绪的后续评估。这些 方法将为 R01 奠定基础，研究昼夜节律和社会节律的中介作用 在大量不同的围绝经期样本中扰乱抑郁症状的发展 女性。