scholarly journals Depressive Psoriasis-Patienten können ein schlechteres Ansprechen auf Etanercept zeigen

2019 ◽  
Vol 7 (2) ◽  
pp. 75-76
Author(s):  
Wiebke Sondermann
Keyword(s):  
Clinical Response ◽  
Response Rate ◽  
Depression Scale ◽  
Female Gender ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Etanercept Treatment ◽  
Depressed Patients ◽  
Pasi Score

Background/Aims: This study aimed to investigate the predicting values of depression and anxiety symptoms for clinical response to etanercept treatment in psoriasis patients. Methods: A total of 85 psoriasis patients who received 6 months of etanercept treatment were consecutively enrolled in this prospective cohort study. The Psoriasis Area and Severity Index (PASI) score was evaluated at month 0 (M0), M1, M3, and M6, and the corresponding PASI 75/90 response at each visit was assessed. Also, anxiety and depression symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS) at M0, M1, M3, and M6. Results: Depression symptoms were observed to correlate with female gender (p = 0.004), longer disease duration (p = 0.018), and higher PASI score (p < 0.001), and anxiety symptoms were seen to be associated with female gender (p = 0.017), larger psoriasis-affected body surface area (p = 0.049), and higher PASI score (p = 0.017) in psoriasis patients. After etanercept treatment, HADS-Depression (HADS-D) and HADS-Anxiety (HADS-A) scores were both decreased at M1, M3, and M6 (all p < 0.001) compared with M0. Most importantly, baseline depressed patients presented with a lower PASI 75 response rate at M3 (p = 0.014) and M6 (p = 0.005), and a reduced PASI 90 response rate at M6 (p = 0.045) compared with baseline non-depressed patients. Furthermore, multivariate logistic regression analyses revealed that depression symptoms at baseline were an independent predictive factor for the lower possibility of both PASI 75 response (p = 0.048) and PASI 90 response (p = 0.048) achievements at M6 in psoriasis patients. However, no correlation of baseline anxiety symptoms with PASI 75/90 responses was observed. Conclusion: Depression symptoms at baseline independently predict a worse clinical response to etanercept treatment in psoriasis patients.

Depressive Psoriasis-Patienten können ein schlechteres Ansprechen auf Etanercept zeigen - eine weitere Expertenmeinung

2019 ◽  
Vol 7 (2) ◽  
pp. 77-79
Author(s):  
Uwe Gieler
Keyword(s):  
Clinical Response ◽  
Response Rate ◽  
Depression Scale ◽  
Female Gender ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Etanercept Treatment ◽  
Depressed Patients ◽  
Pasi Score

Background/Aims: This study aimed to investigate the predicting values of depression and anxiety symptoms for clinical response to etanercept treatment in psoriasis patients. Methods: A total of 85 psoriasis patients who received 6 months of etanercept treatment were consecutively enrolled in this prospective cohort study. The Psoriasis Area and Severity Index (PASI) score was evaluated at month 0 (M0), M1, M3, and M6, and the corresponding PASI 75/90 response at each visit was assessed. Also, anxiety and depression symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS) at M0, M1, M3, and M6. Results: Depression symptoms were observed to correlate with female gender (p = 0.004), longer disease duration (p = 0.018), and higher PASI score (p < 0.001), and anxiety symptoms were seen to be associated with female gender (p = 0.017), larger psoriasis-affected body surface area (p = 0.049), and higher PASI score (p = 0.017) in psoriasis patients. After etanercept treatment, HADS-Depression (HADS-D) and HADSAnxiety (HADS-A) scores were both decreased at M1, M3, and M6 (all p < 0.001) compared with M0. Most importantly, baseline depressed patients presented with a lower PASI 75 response rate at M3 (p = 0.014) and M6 (p = 0.005), and a reduced PASI 90 response rate at M6 (p = 0.045) compared with baseline non-depressed patients. Furthermore, multivariate logistic regression analyses revealed that depression symptoms at baseline were an independent predictive factor for the lower possibility of both PASI 75 response (p = 0.048) and PASI 90 response (p = 0.048) achievements at M6 in psoriasis patients. However, no correlation of baseline anxiety symptoms with PASI 75/90 responses was observed. Conclusion: Depression symptoms at baseline independently predict a worse clinical response to etanercept treatment in psoriasis patients.

Depression Symptoms Predict Worse Clinical Response to Etanercept Treatment in Psoriasis Patients

Dermatology ◽  
2018 ◽  
Vol 235 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Waishu Jin ◽  
Shuqing Zhang ◽  
Yanjuan Duan
Keyword(s):  
Clinical Response ◽  
Response Rate ◽  
Depression Scale ◽  
Female Gender ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Etanercept Treatment ◽  
Depressed Patients ◽  
Pasi Score

Background/Aims: This study aimed to investigate the predicting values of depression and anxiety symptoms for clinical response to etanercept treatment in psoriasis patients. Methods: A total of 85 psoriasis patients who received 6 months of etanercept treatment were consecutively enrolled in this prospective cohort study. The Psoriasis Area and Severity Index (PASI) score was evaluated at month 0 (M0), M1, M3, and M6, and the corresponding PASI 75/90 response at each visit was assessed. Also, anxiety and depression symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS) at M0, M1, M3, and M6. Results: Depression symptoms were observed to correlate with female gender (p = 0.004), longer disease duration (p = 0.018), and higher PASI score (p < 0.001), and anxiety symptoms were seen to be associated with female gender (p = 0.017), larger psoriasis-affected body surface area (p = 0.049), and higher PASI score (p = 0.017) in psoriasis patients. After etanercept treatment, HADS-Depression (HADS-D) and HADS-Anxiety (HADS-A) scores were both decreased at M1, M3, and M6 (all p < 0.001) compared with M0. Most importantly, baseline depressed patients presented with a lower PASI 75 response rate at M3 (p = 0.014) and M6 (p = 0.005), and a reduced PASI 90 response rate at M6 (p = 0.045) compared with baseline non-depressed patients. Furthermore, multivariate logistic regression analyses revealed that depression symptoms at baseline were an independent predictive factor for the lower possibility of both PASI 75 response (p = 0.048) and PASI 90 response (p = 0.048) achievements at M6 in psoriasis patients. However, no correlation of baseline anxiety symptoms with PASI 75/90 responses was observed. Conclusion: Depression symptoms at baseline independently predict a worse clinical response to etanercept treatment in psoriasis patients.

scholarly journals Social anxiety in a multiple sclerosis clinic population

2009 ◽  
Vol 15 (3) ◽  
pp. 393-398 ◽  
Author(s):  
K Poder ◽  
K Ghatavi ◽  
JD Fisk ◽  
TL Campbell ◽  
S Kisely ◽  
...  
Keyword(s):  
Social Anxiety ◽  
Depression Scale ◽  
Research Unit ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Neurological Disability ◽  
General Anxiety ◽  
Neurologic Disability

Background Little is known about social anxiety in MS. Objective We estimated the prevalence of social anxiety symptoms and their association with demographic and clinical features in a clinic-attending sample of patients with MS. Methods Patients attending the Dalhousie MS Research Unit for regularly scheduled visits completed the Social Phobia Inventory (SPIN), the Hospital Anxiety and Depression Scale (HADS), and the Health Utilities Index (HUI). Neurological disability was determined by ratings on the Expanded Disability Status Scale (EDSS). Results A total of 251 patients completed self-report scales of anxiety and depression symptoms. In all, 245 (98%) provided sufficient data for analysis. In all, 30.6% ( n = 75) had clinically significant social anxiety symptoms as defined by a SPIN threshold score of 19. Half of those with social anxiety had general anxiety (HADSA ≥ 11) and a quarter had depression (HADSD ≥ 11). Severity of social anxiety symptoms was associated with reduced health-related quality of life and not related to neurological disability. Conclusions Social anxiety symptoms are common in persons with MS, contribute to overall morbidity, but are unrelated to the overall severity of neurologic disability. Greater awareness and routine systematic inquiry of social anxiety symptoms is an important component of comprehensive care for persons with MS.

Psychological distress in adults with congenital heart disease: focus beyond depression

2019 ◽  
Vol 29 (2) ◽  
pp. 185-189 ◽  
Author(s):  
Lacey P. Gleason ◽  
Lisa X. Deng ◽  
Abigail M. Khan ◽  
David Drajpuch ◽  
Stephanie Fuller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Depression Scale ◽  
Anxiety Symptoms ◽  
Satisfaction With Life Scale ◽  
Anxiety And Depression ◽  
Depression Symptoms

AbstractBackgroundAdults with congenital heart disease face psychological challenges although an understanding of depression vs. anxiety symptoms is unclear. We analyzed the prevalence of elevated symptoms of anxiety and depression and explored associations with demographic and medical factors as well as quality of life.MethodsAdults with congenital heart disease enrolled from an outpatient clinic completed the Hospital Anxiety and Depression Scale and two measures of quality of life: the Linear Analogue Scale and the Satisfaction with Life Scale. Medical data were obtained by chart review.ResultsOf 130 patients (median age = 32 years; 55% female), 55 (42%) had elevated anxiety symptoms and 16 (12%) had elevated depression symptoms on subscales of the Hospital Anxiety and Depression Scale. Most patients with elevated depression symptoms also had elevated anxiety symptoms (15/16; 94%). Of 56 patients with at least one elevated subscale, 37 (66%) were not receiving mental health treatment. Compared to patients with 0 or 1 elevated subscales, patients with elevations in both (n=15) were less likely to be studying or working (47% vs. 81%; p=0.016) and reported lower scores on the Linear Analogue Scale (60 vs. 81, p<0.001) and the Satisfaction with Life Scale (14 vs. 28, p<0.001).ConclusionsAmong adults with congenital heart disease, elevated anxiety symptoms are common and typically accompany elevated depressive symptoms. The combination is associated with unemployment and lower quality of life. Improved strategies to provide psychosocial care and support appropriate engagement in employment are required.

scholarly journals 0320 Psychological Correlates of Morningness/Eveningness in Latinx Pre-Adolescents

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A121-A122
Author(s):  
S T Nguyen-Rodriguez ◽  
O M Buxton
Keyword(s):  
Depressive Symptoms ◽  
Perceived Stress ◽  
Psychological Health ◽  
Depression Scale ◽  
Well Being ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Anxiety And Depression ◽  
Average Score ◽  
Depression Symptoms

Abstract Introduction Chronotype refers to a preference for morning hours (morningness) vs. evening hours (eveningness) when individuals tend to feel their best (e.g., higher energy levels). People may be classified at either end of this spectrum or along a continuum between these preferences. Among adolescents, eveningness is positively related to depression and anxiety, whereas morningness is negatively related to depression. However, less is known about the relationship of chronotype and psychological health in pre-teens and Latinx youth. The present study explored associations of morningness/eveningness with anxiety symptoms, depressive symptoms, and perceived stress among Latinx pre-adolescents in Southern California. Methods A purposive sample of 100 Latinx children, ages 10-12 years old, completed self-report surveys in their homes or a preferred location chosen by the parent. Measures included the Morningness/Eveningness Scale for Children (higher scores indicate morning preference), Revised Child Anxiety and Depression Scale and the Perceived Stress Scale (higher scores indicate higher anxiety, depression and stress, respectively). Associations were tested with Pearson correlations. Results The sample was 47% male with a mean±SD age of 10.9±0.8 years. Average score for morningness/eveningness was M=30.2±4.4 (range: 18-41), for anxiety symptoms was M=0.7±0.7 (range: 0-2.8), for depression symptoms was M=0.5±0.4 (range: 0-1.9) and for perceived stress was M=15.2±5.8 (range: 2-30). Greater morningness/eveningness scores, indicating more morningness, were associated with lower scores for anxiety symptoms (r=-.41, p&lt;.001), depressive symptoms (r=-.36, p&lt;.001) and perceived stress (r=-.33, p=.001). Conclusion As has been found for adolescents, higher morningness in Latinx pre-teens was related to less frequent anxiety and depression symptoms, as well as lower perceived stress. Youth experience a circadian phase delay during adolescence, shifting their preference toward eveningness, which may exacerbate stressors and negative mental health. Therefore, interventions to promote psychological well-being in pre-adolescents may help prevent worse psychological outcomes in Latinx children as they transition to adolescence. Support This work was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Numbers UL1GM118979, TL4GM118980, and RL5GM118978.

scholarly journals Self-reported symptoms of depression and anxiety among informal caregivers of persons with dementia: a cross-sectional comparative study between Sweden and Italy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Joseba Wulff ◽  
Agneta Malmgren Fänge ◽  
Connie Lethin ◽  
Carlos Chiatti
Keyword(s):  
Informal Caregivers ◽  
Depression Scale ◽  
Well Being ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
People With Dementia

Abstract Background Around 50 million people worldwide are diagnosed with dementia and this number is due to triple by 2050. The majority of persons with dementia receive care and support from their family, friends or neighbours, who are generally known as informal caregivers. These might experience symptoms of depression and anxiety as a consequence of caregiving activities. Due to the different welfare system across European countries, this study aimed to investigate factors associated with self-reported depression and anxiety among informal dementia caregivers both in Sweden and Italy, to ultimately improve their health and well-being. Methods This comparative cross-sectional study used baseline data from the Italian UP-TECH (n = 317) and the Swedish TECH@HOME (n = 89) studies. Main outcome variables were the severity of self-reported anxiety and depression symptoms, as measured by the Hospital Anxiety and Depression Scale (HADS). HADS scores were investigated using descriptive and bivariate statistics to compare means and standard deviations. Linear regressions were used to test for associations between potential factors and self-reported symptoms of depression and anxiety. Results Italian informal caregivers reported more severe symptoms of depression and anxiety than Swedish caregivers. In Italy, a higher number of hours of caregiving was associated with anxiety symptoms (β = − 1.205; p = 0.029), being 40–54 years-old with depression symptoms (β = − 1.739; p = 0.003), and being female with symptoms of both depression (β = − 1.793; p < 0.001) and anxiety (β = 1.474; p = 0.005). In Sweden, a higher number of hours of caregiving and being < 39 years-old were associated with depression symptoms (β = 0.286; p < 0.000; β = 3.945; p = 0.014) and a higher number of hours of caregiving, the lack of additional informal caregivers and dementia severity were associated with anxiety symptoms (β = 0.164; p = 0.010; β = − 1.133; p = 0.033; β = − 1.181; p = 0.031). Conclusion Multiple factors are associated with self-reported symptoms of depression and anxiety among informal caregivers in Sweden and Italy. Factors found in this study partly differ between the two countries, suggesting the important role of cultural and social factors affecting the experience of caregiving. A deeper knowledge of these factors may increase the knowledge on potential protective and risk factors, provide information to policymakers and ultimately improve the psychological well-being of informal caregivers to people with dementia across Europe.

scholarly journals Determinants of increased frequency of depressive and anxiety symptoms in exercise professionals during the COVID-19 pandemic

Work ◽  
2021 ◽  
pp. 1-11
Author(s):  
Natan Feter ◽  
Eduardo L. Caputo ◽  
Igor R. Doring ◽  
Marcelo C. da Silva ◽  
Felipe F. Reichert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
Exercise Program ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Social Distancing

BACKGROUND: The coronavirus disease (COVID-19) pandemic has affected workers in different health services including exercise professionals (EP). The urgent need to adapt in-person to online activities might have led to increased frequency of anxiety and depressive symptoms. OBJECTIVE: We aimed to identify the determinants of aggravated depressive and anxiety symptoms in EP in southern Brazil during social distancing from the COVID-19. METHODS: A cross-sectional study was conducted with EP who worked at fitness centers, sports clubs, private schools, or at a public exercise program offered by the municipal council. We used an online-based, self-administered, adapted version of the Hospital Anxiety and Depression scale to compare symptoms of depression and anxiety pre- and during social distancing. RESULTS: Participants (n = 201) had a mean age of 32.7±8.0 years, with more than half being male, white, and having an university degree. We observed that 81%and 71%of respondents reported higher frequency in anxiety and depression symptoms, respectively, during social distancing than in the period before it. Physical education teachers, women, non-white professionals, and those with chronic disease were more likely to worsen anxiety symptoms. Women had higher odds to increased frequency in depressive symptoms. Physical activity and previous experience with internet-based tools for working activities reduced the risk of increased depressive symptoms. CONCLUSIONS: Sex, ethnicity, chronic diseases, educational level, physical activity, and experience with online tools were determinants for increased frequency of depression and anxiety symptoms in EP.

scholarly journals Symptoms of mood disorders in family carers of older people with dementia who experience caregiver burden: a network approach

2020 ◽  
Vol 49 (4) ◽  
pp. 628-633
Author(s):  
Alex Bacadini França ◽  
Adam Lee Gordon ◽  
Rajvinder Samra ◽  
Evelise Saia Rodolpho Duarte ◽  
Alessandro Ferrari Jacinto
Keyword(s):  
Network Analysis ◽  
Older People ◽  
Depression Scale ◽  
Anxiety Symptoms ◽  
Warning Signs ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Family Carers ◽  
People With Dementia

Abstract Background informal carers of people with dementia are at greater risk of anxiety and depressive disorders if they find caregiving to be a burden. The aim of this study was to use a network analysis of cross-sectional data to investigate the relationships between anxiety and depressive symptoms in family carers of older people with dementia who experience burden. Methods sixty family carers exhibiting high levels of burden using the Zarit Burden Interview were included in the study. Participants completed the Hospital Anxiety and Depression Scale. The network analysis identified the depression and anxiety symptom network using features including a topological graph, network centrality metrics and community analysis. The network was estimated through the graphical LASSO technique in combination with a walktrap algorithm to obtain the clusters within the network and the connections between the nodes (symptoms). A directed acyclic graph was generated to model symptom interactions. Results the resulting network architecture shows important bridges between depression and anxiety symptoms. Lack of pleasure and loss of enjoyment were identified as potential gateway symptoms to other anxiety and depression symptoms and represent possible therapeutic targets for psychosocial interventions. Fear and loss of optimism were highly central symptoms, indicating their importance as warning signs of more generalised anxiety and depression. Conclusions this network analysis of depressive and anxiety symptoms in overburdened family carers provides important insights as to what symptoms may be the most important targets for behavioural interventions.

scholarly journals Change in Physical Activity During the Coronavirus Disease 2019 Lockdown in Norway: The Buffering Effect of Resilience on Mental Health

2020 ◽  
Vol 11 ◽  
Author(s):  
Frederick Anyan ◽  
Odin Hjemdal ◽  
Linda Ernstsen ◽  
Audun Havnen
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Mental Health Problems ◽  
Depression Scale ◽  
Health Problems ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Cross Sectional Survey ◽  
Common Mental Health Problems

Imposition of lockdown restrictions during the coronavirus disease 2019 (COVID-19) pandemic was sudden and unprecedented and dramatically changed the life of many people, as they were confined to their homes with reduced movement and access to fitness training facilities. Studies have reported significant associations between physical inactivity, sedentary behavior, and common mental health problems. This study investigated relations between participants’ reports of change in physical activity (PA; i.e., Reduced PA, Unchanged PA, or Increased PA) and levels of anxiety and depression symptoms during the COVID-19 pandemic lockdown in Norway in the time period from March 12, 2020 to June 15, 2020. The relations between age and gender and levels of anxiety and depression symptoms as well as how different levels of resilience influenced the relation between changes in PA and levels of anxiety and depression symptoms were also investigated. A cross-sectional survey design was used. Participants (N = 1,314; females = 31%) were members of an endurance sports organization aged between 18 and 81 years (M = 49 years; SD = 11.50 years). Participants completed the Resilience Scale for Adults and the Hospital Anxiety and Depression Scale and reported their changes in PA after lockdown restrictions were implemented on March 12, 2020. Regression analysis, independent samples t-test, and two-way multivariate analysis of variance were conducted. Reduced PA was associated with a higher risk of anxiety and depression symptoms. Younger participants in Reduced PA and Unchanged PA subgroups scored significantly higher on levels of anxiety symptoms and significantly higher on depression symptoms in Unchanged PA subgroup. Females in Unchanged PA and Increased PA subgroups scored significantly higher on levels of anxiety symptoms, whereas no gender differences were found for depression symptoms. The main and interaction effects of change in PA and resilience were significantly associated with depression symptoms. For anxiety symptoms, only the main effect of resilience, but not PA, and the interaction effect were significant. Results further showed that resilience was an important factor that influenced the levels of change in PA. High levels of resilience were associated with lower anxiety and depression symptoms in Reduced, Unchanged, and Increased PA subgroups during the COVID-19 lockdown. Promoting PA while boosting resilience factors such as confidence in own ability and drawing on the social support of even reduced social networks or connections while under lockdown can protect against common mental health problems.

scholarly journals Relationships between depression and anxiety symptoms and adipocyte-derived proteins in postmenopausal women

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248314
Author(s):  
Yu-Ting Wu ◽  
Wan-Yu Huang ◽  
Chew-Teng Kor ◽  
Ko-Hung Liu ◽  
Ting-Yu Chen ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Rating Scale ◽  
Linear Regression Analysis ◽  
Depression Scale ◽  
Anxiety Symptoms ◽  
Population Heterogeneity ◽  
Anxiety And Depression ◽  
Future Research ◽  
Depression Symptoms ◽  
Depression And Anxiety

Introduction Studies on the association between adiponectin and leptin and anxiety and depression among postmenopausal women are limited. Therefore, the present study specifically evaluates the mutual relationships between adiponectin and leptin and anxiety and depression in postmenopausal women. Participants and design In this cross-sectional study, a total of 190 women aged 40–65 years were enrolled. Depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), and anxiety symptoms were evaluated using the Hamilton Anxiety Rating Scale (HAM-A). Fasting specimens were collected to measure sex hormone, glucose, insulin, and adipokine levels. Multiple linear regression analysis was performed to evaluate the associations between depression and anxiety and adipocyte-derived hormones. Settings The study was performed in a hospital medical center. Results Among 190 enrolled postmenopausal women, Spearman’s rank correlation analysis revealed significant correlations between CES-D and HAM-A (r = 0.715, P < 0.0001), between CES-D and adiponectin (p = 0.009) and leptin (p = 0.015), and between HAM-A and adiponectin (p = 0.01) and leptin (p = 0.001). The subjects with CES-D ≥ 16 and with HAM-A ≥ 18 had higher adiponectin levels than those with CES-D < 16 and HAM-A < 18, respectively. After adjusting for age, body mass index, exercise, alanine amino transferase and parameters of lipid profiles, Log adiponectin levels were found to be significantly associated with both CES-D and HAM-A, and Log leptin levels were only significantly associated with HAM-A. Conclusions The data show that adiponectin and leptin levels are significantly associated with depression and anxiety symptoms. These results suggest that higher adiponectin and lower leptin levels may serve as potential markers related to anxiety and mood in postmenopausal women. More future research that is designed to deal with the important confounders (e.g., population heterogeneity) is needed to investigate comprehensively on these associations.

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