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Related Experiment Videos

Adverse Childhood Experiences and Risk for First-Episode Major Depression During the Menopause Transition.

C Neill Epperson1,2,3,4, Mary D Sammel2,5, Tracy L Bale2,6

  • 1Professor of Psychiatry and Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, 3535 Market St, Rm 3001, Philadelphia, PA 19104. cepp@mail.med.upenn.edu.

The Journal of Clinical Psychiatry
|April 11, 2017
PubMed
Summary

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Adverse childhood experiences (ACEs) before puberty may offer resilience against depression later in life. However, multiple ACEs, especially after puberty, increase the risk for major depressive disorder (MDD) during menopause.

Area of Science:

  • Reproductive Psychiatry
  • Developmental Psychology
  • Epidemiology

Background:

  • Stress exposures can differentially impact depression risk and resilience based on developmental timing.
  • Adverse Childhood Experiences (ACEs) are linked to mental health outcomes.
  • The menopause transition is a critical period for mental health, with potential links to early life stress.

Purpose of the Study:

  • To investigate if ACEs, and their timing relative to puberty, contribute to the risk of first-episode major depressive disorder (MDD) during the menopause transition.
  • To examine the differential impact of prepubertal versus postpubertal ACEs on MDD risk.
  • To explore resilience factors related to ACEs timing.

Main Methods:

  • Analysis of data from the Penn Ovarian Aging Study cohort (n=243) including women from Philadelphia.

Related Experiment Videos

  • Assessment of ACEs using the Adverse Childhood Experiences Questionnaire at study endpoint.
  • Definition of prepubertal ACEs as those occurring ≥2 years before menarche; incident menopause MDD identified using structured clinical interviews.

    • Main Results:

    • Women with ≥2 total ACEs had significantly greater risk for lifetime MDD and incident MDD during menopause (aOR=2.05-2.58).
    • ≥2 postpubertal ACEs increased the likelihood of incident menopause MDD by 2.3 times.
    • Experiencing only 1 ACE before puberty, irrespective of later ACEs, was linked to reduced risk for lifetime and menopause-related MDD.

    Conclusions:

    • The timing and number of ACEs relative to puberty significantly influence MDD risk and resilience across the female lifespan.
    • Prepubertal ACEs may confer resilience, while postpubertal ACEs increase vulnerability, particularly during the menopause transition.
    • Understanding ACEs timing is crucial for predicting and mitigating MDD risk in women during menopause.