Postmenopausal Anxiety Linked to Severe Quality-of-Life Impairment

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Severe anxiety was independently associated with poor quality of life in postmenopausal patients.
Severe anxiety was independently associated with poor quality of life in postmenopausal patients.

Anxiety in postmenopausal women negatively affects quality of life (QoL), according to research published in Menopause.1

Edward Mezones-Holguin, MD, from the Universidad Peruana de Ciencias Aplicadas, Lima, Peru, and the Collaborative Group for Research of the Climacteric in Latin America (REDLINC), and colleagues conducted a secondary analysis of a multicenter cross-sectional study of 3503 postmenopausal women from 11 countries in Latin America. 

The participants included women between 40 and 59 years of age who had not menstruated for more than 12 months or who had undergone a bilateral oophorectomy. Those with preexisting psychiatric illness, stroke sequelae, malignancy, and kidney disease were excluded from the study.

 

Researchers used the Spanish-language version of the Goldberg Anxiety and Depression Scale, consisting of 2 subscales (1 for depression and 1 for anxiety). Anxiety was defined as having 5 or more positive responses, including 2 items from the questionnaire's screening section. To determine participants' QoL, investigators used the Spanish-language Menopause Rating Scale, which assesses 11 menopausal symptoms across 3 subscales.

Mean age of the study participants was 52.5 ± 4.7 years. Nearly 34% of participants indicated having a steady partner, and 8.2% had no children. Participants reported having diabetes (10.4%), hypertension (28.0%), and arthrosis (10.5%), and nearly 60% were either overweight or obese; 18.4% reported using hormone therapy.

According to results of the questionnaires, 49.1% of the participants were depressed, and 61.9% had anxiety; 13.7% displayed severe QoL impairment, as defined by a total Menopause Rating Scale score of 17 or higher.

Bivariate analysis showed that severe QoL impairment was positively associated with anxiety and depression, education level, parity, the presence of a steady partner, past or current smoking status, higher body mass index, hypertension, and arthrosis. Generalized linear models identified an independent positive association between anxiety and severe QoL impairment.

"There is a need to conduct longitudinal studies to determine the causality of this association and the benefit of early detection of anxiety in this group of women," Dr Mezones-Holguin and colleagues concluded.

In an accompanying press release,2 JoAnn V. Pinkerton, MD, NCMP, executive director of the North American Menopause Society, added: "Although anxiety is a common symptom during menopause, panic attacks are not. This study documents the importance of screening patients for anxiety."

Study Limitations

  • The cross-sectional design did not allow the investigators to establish causality.
  • The study was focused on native Spanish-speaking women and cannot be generalized to other populations.
  • Ethnicity was not considered in this study.

References

  1. Nunez-Pizarro JL, Gonzalez-Luna A, Mezones-Holguin E, et al. Association between anxiety and severe quality-of-life impairment in postmenopausal women: analysis of a multicenter Latin American cross-sectional study [published online January 23, 2017]. Menopause. doi: 10.1097/GME.0000000000000813
  2. New study shows anxiety imparing quality of life for postmenopausal women [news release]. The North American Menopause Society website. http://www.menopause.org/docs/default-source/default-document-library/anxiety-during-postmenopause-1-25.pdf. January 25, 2017. Accessed January 31, 2017. 
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