Menopausal Hormone Therapy and Suicide in a National Sample of Midlife and Older Women Veterans

Gibson, Carolyn J.; Li, Yixia; Jasuja, Guneet K.; Self, Kyle J.; Seal, Karen H.; Byers, Amy L.

doi:10.1097/mlr.0000000000001433

Cited by 11 publications

(6 citation statements)

References 45 publications

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“…Moreover, it also revealed that oral estradiol stimulated thyrotropin-releasing hormone to induce the secretion of TSH ( 38 ). At the same time, a large sample study on the relationship between menopausal hormone therapy and suicide risk in middle-aged and older women showed that hormone therapy increased the risk of suicide attempts by 1.4-fold ( 39 ). Currently, the percentage of women is 76.30% (90/118) among suicide attempters, accounting for a large proportion.…”

Section: Discussionmentioning

confidence: 99%

Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China

Zhang

Zhao²,

Liu³

et al. 2023

Front. Psychiatry

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ObjectivesEvidence suggested that thyroid-stimulating hormone (TSH) and lipid levels were associated with major depressive disorder (MDD). However, its role in suicide attempts in adolescents with MDD was unclear. This investigation was to probe into the relationship between TSH, lipid levels, and attempted suicide in adolescents with MDD.MethodsA total of 179 adolescents with MDD were included from January 2021 to January 2022. Socio-demographic data and clinical data were obtained through self-made questionnaires. TSH and lipid levels were analyzed by a recognized laboratory. The Epidemiological Studies Depression Scale (CES-D) was used to assess the severity of depression. Questions about whether there was a behavior of suicide attempts were completed through conversation interviews.ResultsResults showed that the CES-D total score, TSH, and low-density lipoprotein cholesterol (LDL-C) of suicide attempters were significantly higher than those of non-suicide attempters. Ordinary family relationships were more likely to attempt suicide than good family relationships. The CES-D total score, ordinary family relationships, TSH and LDL-C were still significant in binary logistic regression, with an adjusted odds ratio (OR) of 1.04, 3.42, 5.14, and 1.76, respectively. The area under the receiver operating characteristic (ROC) curve showed that the area under the ROC curve (AUC) ranged from 0.60 to 0.74.ConclusionSuicide attempts are common among adolescents with MDD and were associated with CES-D total score, ordinary family relationships, TSH, and LDL-C. Given the association between suicide attempts and TSH and LDL-C, the dynamic changes in TSH and LDL-C levels should be detected regularly.

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Section: Discussionmentioning

confidence: 99%

Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China

Zhang

Zhao²,

Liu³

et al. 2023

Front. Psychiatry

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“…Our study seems to be the first nationwide observational study that has followed up women who initiate HT for clinically verified depression in time-to-event analyses. However, a recent cohort study 49 followed up 291 709 US women older than 50 years for 4.5 years and found that HT was associated with a 2 times higher risk of suicide, which may be an indicator of severe depression. A review from 2015 including 19 experimental studies on the effect of systemically administered HT for developing depressive symptoms in women without depression 17 provided no support for an effect of oral or transdermal estrogen alone or combined with progestin on mood in nondepressed women.…”

Section: Discussionmentioning

confidence: 99%

Association of Hormone Therapy With Depression During Menopause in a Cohort of Danish Women

et al. 2022

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ImportanceDuring menopause, the levels of estrogen and progesterone decrease and 60% to 70% of women experience menopausal symptoms, including mood disturbances. The latter might be prevented by hormone therapy (HT), yet some studies have suggested that use of HT might be associated with increased risk of depression.ObjectiveTo examine whether use of HT during menopause was associated with a subsequent diagnosis of depression.Design, Setting, and ParticipantsThis nationwide register–based cohort and self-controlled case series study included all women in Denmark aged 45 years between January 1, 1995, through December 31, 2017 (n = 825 238), without prior oophorectomy, breast cancer, or cancer in reproductive organs. Follow-up was completed on December 31, 2018. The statistical analysis was performed from September 1, 2021, through May 31, 2022.ExposuresRedeemed prescriptions of different types of HT identified by the Anatomical Therapeutic Chemical classification system codes (G03C [estrogen] and G03F [estrogen combined with progestin]) in the Danish National Prescription Registry between 1995 and 2017. Type of administration was divided into systemic (oral or transdermal) and local (intravaginal or intrauterine).Main Outcomes and MeasuresA hospital diagnosis of depression (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes F32-F33 and International Classification of Diseases, Eighth Revision, codes 296.09, 296.29, 298.0, and 300.49) between 1995 through 2018. Associations were examined in cohort and self-controlled case series analysis using Cox proportional hazards and fixed-effects Poisson regression models.ResultsDuring follow-up from 45 years of age to a mean of 56.0 (range, 45.1-67.7) years, 189 821 women (23.0%) initiated systemically or locally administered HT and 13 069 (1.6%) were diagnosed with depression. Systemically administered HT was mainly initiated before 50 years of age and was associated with a higher risk of a subsequent depression diagnosis (hazard ratio [HR] for 48-50 years of age, 1.50 [95% CI, 1.24-1.81]). The risk was especially elevated the year after initiation of both treatment with estrogen alone (HR, 2.03 [95% CI, 1.21-3.41]) and estrogen combined with progestin (HR, 2.01 [95% CI,1.26-3.21]). Locally administered HT was initiated across all ages and was not associated with depression risk (HR, 1.15 [95% CI, 0.70-1.87]). It was, however, associated with a lower risk of depression when initiated after 54 years of age (HR for 54-60 years of age, 0.80 [95% CI, 0.70-0.91]). In self-controlled analysis, which efficiently accounts for time-invariant confounding, users of systemically administered HT had higher rates of depression in the years after initiation compared with the years before treatment (incidence rate ratio for 0-1 year after initiation, 1.66 [95% CI, 1.30-2.14]).Conclusions and RelevanceThese findings suggest that systemically administered HT before and during menopause is associated with higher risk of depression, especially in the years immediately after initiation, whereas locally administered HT is associated with lower risk of depression for women 54 years or older.

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“…However, androgen deprivation therapy has been linked to increased insomnia symptoms ( Savard et al, 2013 ). Of particular relevance to the current review, menopausal hormone therapy has been linked to increased risk of suicide attempt and increased risk of death by suicide in a large-scale sample of midlife and older veterans ( Gibson et al, 2021 ).…”

Section: Sexual and Gender Minority People And Sleepmentioning

confidence: 99%

Sleep disturbance and suicide risk among sexual and gender minority people

Dolsen

Byers²,

Flentje³

et al. 2022

Neurobiology of Stress

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Menopausal Hormone Therapy and Suicide in a National Sample of Midlife and Older Women Veterans

Cited by 11 publications

References 45 publications

Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China

Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China

Association of Hormone Therapy With Depression During Menopause in a Cohort of Danish Women

Sleep disturbance and suicide risk among sexual and gender minority people

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