{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:11:18Z","timestamp":1788862278701,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Psychological distress during menopause may reflect the combined influence of symptom burden and psychological resources. This study examined the concurrent conditional associations of nonpsychological menopausal symptom burden and general self-efficacy with anxiety and depressive symptom severity. Methods: This cross-sectional study included 247 peri- and postmenopausal women recruited from hospital and community settings in Timi\u0219oara, Romania. Participants completed the Hospital Anxiety and Depression Scale, Menopause Rating Scale, Menopause-Specific Quality of Life Questionnaire, General Self-Efficacy Scale, and COPE Inventory. Associations were examined using Spearman correlations and multivariable linear regression with HC3 robust inference. Results: At least borderline anxiety and depressive symptoms were identified in 54.7% and 42.5% of participants, respectively. In the fully adjusted psychological-resource models, greater nonpsychological menopausal symptom burden was associated with higher anxiety (\u03b2 = 0.311, p &lt; 0.001) and depression scores (\u03b2 = 0.239, p &lt; 0.001). Higher general self-efficacy was associated with lower anxiety (\u03b2 = \u22120.169, p = 0.009) and depression scores (\u03b2 = \u22120.319, p &lt; 0.001). Although self-reported surgical menopause was associated with lower anxiety and depression scores relative to early perimenopause in the primary models, these associations were attenuated and no longer statistically significant in the restricted sensitivity analysis. Conclusions: Nonpsychological menopausal symptom burden and general self-efficacy were concurrent conditional correlates of anxiety and depressive symptom severity. The cross-sectional design does not establish temporal direction or causal effects, and the surgical-menopause finding should not be interpreted as protective.<\/jats:p>","DOI":"10.3390\/jcm15186944","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:02:24Z","timestamp":1788858144000},"page":"6944","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Menopausal Stage: Symptom Burden, Self-Efficacy, and Psychological Distress"],"prefix":"10.3390","volume":"15","author":[{"given":"Andrei","family":"Pescaru","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Flavia","family":"Cri\u0219an","sequence":"additional","affiliation":[{"name":"Research Centre for Pharmaco-Toxicological Evaluations, University Clinic of Toxicology, Pharmaceutical Industry, Management and Legislation, Faculty of Pharmacy, \u2018Victor Babe\u0219\u2019 University of Medicine and Pharmacy Timi\u0219oara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3410-3870","authenticated-orcid":false,"given":"Alexia","family":"Manole","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Daiana Cerasela","family":"Ivanis","sequence":"additional","affiliation":[{"name":"Department of Neonatology and Puericulture, \u201cLouis \u0162urcanu\u201d Children Emergency Hospital, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7573-3714","authenticated-orcid":false,"given":"Camelia Corina","family":"Pescaru","sequence":"additional","affiliation":[{"name":"Center for Research and Innovation in Personalized Medicine of Respiratory Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Victor","family":"Buciu","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1355-3790","authenticated-orcid":false,"given":"Cristina","family":"Secosan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2112-2923","authenticated-orcid":false,"given":"Adelina","family":"Mari\u021bescu","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Bogdan Adrian","family":"Manta","sequence":"additional","affiliation":[{"name":"Department I\u2014Nursing, Clinical Skills University Clinic, Faculty of Nursing, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Roxana","family":"Folescu","sequence":"additional","affiliation":[{"name":"Department of Balneology, Medical Recovery and Rheumatology, Family Medicine University Clinic, Center for Preventive Medicine, Center for Advanced Research in Cardiovascular Pathology and Hemostaseology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/gme.0b013e31824d8f40","article-title":"Executive summary of the Stages of Reproductive 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