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Joyce T. Bromberger, PhD, Peter M. Meyer, PhD, Howard M. Kravitz, DO, MPH, Barbara Sommer, PhD, Adriana Cordal, MD, Lynda Powell, PhD, Patricia A. Ganz, MD and Kim Sutton-Tyrrell, DrPH

Joyce T. Bromberger and Kim Sutton-Tyrrell are with the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pa. Peter M. Meyer is with the Section of Biostatistics, Department of Preventive Medicine, Rush-Presbyterian-St. Luke's Medical Center, Rush University, Chicago, Ill. Howard M. Kravitz is with the Departments of Psychiatry, Preventive Medicine, and Pharmacology, Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Ill. Barbara Sommer is with the Psychology Department, University of California, Davis. Adriana Cordal is with the Department of Psychiatry, Hackensack University Medical Center, Hackensack, NJ. Lynda Powell is with the Department of Preventive Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Ill. Patricia A. Ganz is with the School of Public Health, School of Medicine, and Jonsson Comprehensive Cancer Center, University of California, Los Angeles.

Correspondence: Requests for reprints should be sent to Joyce T. Bromberger, PhD, Departments of Epidemiology and Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA 15213 (e-mail: brombergerjt{at}msx.upmc.edu).

Objectives. This study examined the association between psychologic distress and natural menopause in a community sample of African American, White, Chinese, Hispanic, and Japanese women participating in a national women's health study.

Methods. A cohort of 16 065 women aged 40 to 55 years provided information on menstrual regularity in the previous year, psychosocial factors, health, and somatic–psychologic symptoms. Psychologic distress was defined as feeling tense, depressed, and irritable in the previous 2 weeks.

Results. Rates of psychologic distress were highest in early perimenopause (28.9%) and lowest in premenopause (20.9%) and postmenopause (22%). In comparison with premenopausal women, early perimenopausal women were at a greater risk of distress, with and without adjustment for vasomotor and sleep symptoms and covariates. Odds of distress were significantly higher for Whites than for the other racial/ethnic groups.

Conclusions. Psychologic distress is associated with irregular menses in midlife. It is important to determine whether distress is linked to alterations in hormone levels and to what extent a mood–hormone relationship may be influenced by socioeconomic and cultural factors.

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