Prevalence and predictors of depressive symptoms in older premenopausal women: the Harvard Study of Moods and Cycles

Arch Gen Psychiatry. 1999 May;56(5):418-24. doi: 10.1001/archpsyc.56.5.418.


Background: The Harvard Study of Moods and Cycles is a community-based cohort study designed to evaluate the relationship between major depression and changes in menstrual and ovarian function.

Methods: All women aged 36 to 44 years with a verifiable address from 7 Boston, Mass, metropolitan communities were selected from the Massachusetts Town Books. A self-administered questionnaire assessed demographic characteristics and menstrual history, depression history, and current depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D]) in 4161 women.

Results: We observed a score of 16 or more on the CES-D in 22.4% of women surveyed, and 8.6% scored 25 or more. Widowed, divorced, or separated women were twice as likely as married women to have depression scores greater than 16 (95% confidence interval, 1.6-2.8), and smokers in the upper tertile of pack-years were 1.9 times more likely to have CES-D scores of 16 or more (95% confidence interval, 1.5-2.3). Relative to nulliparous women, those with 1 or 2 children had a 30% lower risk of historic mood disorder, and those with 3 or more children had an even greater reduction in risk (odds ratio, 0.4; 95% confidence interval, 0.3-0.6). Menstrual cycle irregularities were largely unassociated with current or past depression. However, 5 of 8 premenstrual symptoms were significantly associated with CES-D scores of 16 or more.

Conclusions: These findings corroborate the prevalence of depression reported by other community-based studies, and also support a relationship between depressive symptoms and marital status, cigarette smoking, nulliparity, and premenstrual symptoms.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Body Mass Index
  • Cohort Studies
  • Comorbidity
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / epidemiology*
  • Female
  • Humans
  • Marital Status
  • Massachusetts / epidemiology
  • Menstrual Cycle
  • Parity
  • Premenopause*
  • Premenstrual Syndrome / epidemiology
  • Prevalence
  • Probability
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Risk Factors
  • Smoking / epidemiology