afbeelding bij artikel NICE

Thema hormonale depressie: publicaties

Op deze pagina vind je een aantal onderzoeken en publicaties over het onderwerp hormonale depressie. De tekst geeft een korte samenvatting. Als je op het PDF icon klikt naast de tekst, ga je naar de complete tekst van de publicatie via een link.

1. Sex hormone-sensitive gene complex linked to premenstrual mood disorder
Dysregulated cellular response to estrogen and progesterone suspected.

In januari 2017 publiceerde de National Institute of Health de uitkomsten van het onderzoek naar de gevoeligheid van sommige vrouwen voor fluctuaties in de sekshormonen oestrogeen en progesteron. De onderzoekers ontdekten dat vrouwen die last hebben van PMDD op een moleculair niveau anders reageren op dezelfde levels of hormonen dan vrouwen die geen klachten hebben. Dit onderzoek is baanbrekend voor de ontwikkeling van nieuwe behandelingen voor vrouwen met hormonale depressie.

“We found dysregulated expression in a suspect gene complex which adds to evidence that PMDD is a disorder of cellular response to estrogen and progesterone,” explained Peter Schmidt, M.D. of the NIH’s National Institute of Mental Health, Behavioral Endocrinology Branch. “Learning more about the role of this gene complex holds hope for improved treatment of such prevalent reproductive endocrine-related mood disorders.”

2. Estradiol variability, stressful life events, and the emergence of depressive symptomatology during the menopausal transition.

In november 2015 verscheen het bericht van de North American Menopause Society dat een nieuwe studie van de universiteit van North Caroline laat zien dat de schommeling van estradiol levels in het bloed gedurende de (pre)menopauze zorgt voor een verhoogde gevoeligheid voor stress en depressie. De uitkomsten van het onderzoek "Estradiol variability, stressful life events, and the emergence of depressive symptomatology during the menopausal transition," zal in de eerste helft van 2016 gepubliceerd worden in het blad Menopause van de NAMS.

NAMS Executive Director JoAnn Pinkerton, MD, NCMP, says: "the results of this study provide tremendous insight for practitioners. Clinicians need to understand the impact of perimenopausal hormonal fluctuations and the degree of stressful events that a woman is experiencing to determine the best treatment options when a middle-aged woman complains of depression or exaggerated irritability. This study provides a foundation for future studies to evaluate the value of psycho-social interventions, such as cognitive therapies, to lessen the effect of major life events, as well as the use of estrogen therapy during perimenopausal and menopausal stressful times."

3. Hormone treatment of depression

Op 31 maart 2011 verscheen de publicatie over de effecten van behandeling met hormonen bij depressie in het US National Library of Medicine, National Institute of Health. Dialogue in clinical neuroscience. Article: Hormone treatment of depression by Russell T. Joffe, Chair of Psychiatry and Behavioral Science, LIJ North Shore Staten Island University Hospital, New York, USA; Professor of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.

“Perimenopausal/postmenopausal period: during this life phase, there is an increasingly erratic cyclic variation in estrogen and progestogen followed by increasing periods of estrogen withdrawal. During this phase there is a significant increase in the risk for major depression, especially in those women who have a past history of depressive episodes. As with any other stage of life, treatment of depressive disorder in the peri- and postmenopausal period usually involves antidepressant treatment. However, given that this phase of life is associated with progressive ovarian failure and hypoestrogenism, the role of estrogen replacement therapy in the treatment of depression has been a focus of research. In some but not all open-label and placebo-controlled studies, estrogen has been shown to reduce both physical and depressive symptoms. In particular, two of three recent controlled trials documented the efficacy of estrogen replacement therapy in reducing depression in postmenopausal women. Estrogen replacement therapy may also enhance antidepressant response in such women.”

4. When is depression in women a matter of hormones?

By Professor John Studd, consultant Gynecologist London PMS & Menopause Clinic.Published August 17th, 2012 | Last updated August 21st, 2014

“It is important to realize that hormone responsive depression cannot be diagnosed by any blood test. Too frequently, women who believe that their depression is related to their hormones will have their hormone levels measured and the results will be normal. Any association with hormonal changes is then simply dismissed. However, these women are all pre-menopausal and their follicle stimulating hormone (FSH) and estradiol levels will be within the normal range, even though they may not be optimal for the individual woman. It is therefore a huge mistake to exclude hormone responsive depression because of seemingly normal hormonal levels. The clue to the diagnosis is in each woman’s medical history but even then, doctors will often regard the association of depression with periods and childbirth as irrelevant.”

5. Longitudinal Change in Reproductive Hormones and Depressive Symptoms Across the Menopausal Transition

Results From the Study of Women's Health Across the Nation. Joyce T. Bromberger, PhD; Laura L. Schott, PhD; Howard M. Kravitz, DO, MPH; MaryFran Sowers, PhD; Nancy E. Avis, PhD; Ellen B. Gold, PhD; John F. Randolph Jr, MD; Karen A. Matthews.

PhDObjectives: To evaluate the relationship between serum hormone levels and high depressive symptoms and whether hormone levels or their change might explain the association of menopausal status with depressive symptoms previously reported in a national sample of midlife women.

Conclusions: “The contribution of reproductive hormones to mood has been a focus of efforts to explain sex differences in depression. Recent longitudinal studies have found that women are more susceptible to higher levels of depressed mood during the menopausal transition than just prior to it, reinforcing the need to address the question about the role of reproductive hormones in the development of depression and negative mood.”

6. Hormone-specific psychiatric disorders: do they exist?

Margaret Altemus, Department of Psychiatry, Weill Medical College, Cornell University, New York. Published in the Arch Womens Ment Health. 2010 February. 

A stated goal of the DSM-V process is to try to use the biological pathophysiology of mental disorders to inform psychiatric diagnoses, including dimensional features which may cut across diagnostic categories (Charney et al. 2002; Regier et al. 2009). At this point in time, however, biological markers have not been identified which are robust enough to be incorporated in diagnostic criteria. Progress in developing biologically-based diagnoses will depend on more detailed examination of clinical phenomenology associated with particular genetic, physiological, and neural processing characteristics. It is reasonable to expect that such an effort could result in identification of syndromes that map more closely to biological abnormalities than current diagnostic categories. As part of this effort, hormone-related syndromes deserve close attention as potential diagnostic entities or potential supraordinate dimensions that would cross diagnostic boundaries.

Conclusion: "Excessive or reduced hormonal activity during development or in adulthood may be associated with particular clusters of psychiatric symptoms. However, more work is needed to clearly characterize the nature of such syndromes. If discrete syndromes can be identified, hormonal mechanisms should be considered in future DSM diagnostic systems. If hormonally induced psychiatric syndromes do exist, expression may depend on other elements of individual vulnerability, in addition to the hormonal challenge."