{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T19:18:50Z","timestamp":1789240730715,"version":"build-2803163510"},"reference-count":73,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"unspecified","delay-in-days":336,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2045796025100334_sec1a\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>While depressive symptoms are common during menopausal transition, the relationship between the two remains unclear. Therefore, this study aimed to examine the longitudinal changes in depressive symptoms among middle-aged Korean women and identify those with elevated and worsening symptoms during this period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796025100334_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1,178 participants who underwent comprehensive health examinations at Kangbuk Samsung Hospital in Korea were followed for a median of 10.8\u00a0years (IQR, 9.2\u201311.6; maximum, 12.7), including all women who reached natural menopause during follow-up, with only data prior to HRT initiation included. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), and menopausal stages were classified according to the STRAW\u00a0+\u00a010 criteria and final menstrual period (FMP). Linear mixed-effects models and group-based trajectory modelling (GBTM) were applied to evaluate longitudinal changes in depressive symptoms and to identify distinct trajectories in the severity and stability of depressive symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796025100334_sec3c\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The age-adjusted prevalence of CES-D\u00a0\u2265\u00a016 was 11.0%, 11.5%, 11.2% and 12.4%, with corresponding mean scores of 6.7, 6.6, 6.9 and 7.1 across stages. After adjusting for time-varying age and covariates, menopausal stage transitions were not significantly associated with higher levels of depressive symptoms, whether analysed as continuous or binary variables. For binary CES-D (\u226516), the estimated coefficients (95% CI) were 0.10 (\u20130.20 to 0.41) for early transition, 0.09 (\u20130.21 to 0.39) for late transition and 0.26 (\u20130.09 to 0.61) for post-menopause. Similarly, time relative to the FMP (\u201311 to\u00a0+9\u00a0years) showed no significant association with depressive symptoms. GBTM identified three distinct trajectories: most participants (75.5%) maintained consistently low depressive symptoms throughout the transition, whereas 5.8% showed worsening symptoms. Poor sleep quality (OR 5.83, 95% CI 3.25 to 10.45) and moderate-to-severe vasomotor symptoms (OR 2.95, 95% CI 1.30 to 6.70) were significantly associated with the worsening trajectory. Suicidal ideation was higher in this group (45.4% at baseline, increasing to 70.5% at follow-up).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796025100334_sec4d\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most women maintained low depressive symptoms during the menopausal transition; however, a subset experienced worsening symptoms linked to menopause-related physical symptoms. Medical visits for menopause-related symptoms may provide opportunities for screening depressive symptoms in higher-risk women, though the screening effectiveness requires further evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s2045796025100334","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T08:31:04Z","timestamp":1764750664000},"source":"Crossref","is-referenced-by-count":2,"title":["Longitudinal patterns and group heterogeneity of depressive symptoms during menopausal transition in middle-aged Korean women"],"prefix":"10.1017","volume":"34","author":[{"given":"Yoonyoung","family":"Jang","sequence":"first","affiliation":[{"name":"Sungkyunkwan University School of Medicine"},{"name":"Institute of Medical Research, Sungkyunkwan University School of 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