In the Journals

Menopause questionnaires useful tools to detect anxiety, depression

Items in two widely used menopause questionnaires were effective in ruling out the existence of anxiety and depression, indicating whether symptoms were present and establishing whether a women had anxiety or depression disorder, according to findings from a cross-sectional study published in Menopause.

“Several instruments have been designed to assess climacteric symptoms, including depression and anxiety, and [quality of life],” Carolina Marin Martin, PhD, of the department of clinical psychology at Universidad Complutense de Madrid, Spain, and colleagues wrote. “However, there are few studies on depression and anxiety-specific questionnaires, leading to a need to determine the accuracy of those questionnaires most often used to provide appropriate therapies. In addition, women suffering from climacteric symptoms usually visit their GP (general practitioner), and they are not necessarily referred to a psychologist to assess possible psychological disorders in more depth. For this reason, it is necessary to offer GPs a specific and accurate tool to discriminate the individuals whose symptoms may require further assessment and treatment.”

Martin and colleagues analyzed data from 416 women aged 45 to 60 years who reported not going through premature or surgical menopause and not using hormone therapy, recruited in Madrid between November 2015 and November 2016 (mean age, 51 years; 77% married). Participants completed items relating to anxiety and depression from three questionnaires: items four and six from the 11-item Menopause Rating Scale (MRS), developed to measure the presence and severity of menopausal symptoms; items five and eight from the 29-item Menopause Quality of Life Questionnaire (MENQOL), developed to assess the health-related quality of life in the immediate postmenopausal period; and all items from the 14-item Hospital Anxiety and Depression Scale (HADS), developed to determine the degree of anxiety and depression symptoms exhibited by patients (seven items each related to anxiety and depression). Researchers used receiver operator curves (ROC) to assess the diagnostic accuracy of the MRS and MENQOL items related to anxiety and depression relative to the HADS questionnaire.

Researchers found that item six of the MRS (area under the ROC curve = 0.773; 95% CI, 0.721-0.824) and item five of the MENQOL (AUC = 0.772; 95% CI, 0.723-0.822) were accurate tools to identify individuals with anxiety or with a likelihood to develop anxiety disorder.

Similarly, item four of the MRS (AUC = 0.711; 95% CI, 0.625-0.797) and item eight of the MENQOL (AUC = 0.744; 95% CI, 0.668-0.821) accurately identified individuals with depression disorder, according to researchers.

Researchers also found that the lowest cutoff points for the MRS and the MENQOL had high sensitivity and a high negative predictive value.

“Scores below this cutoff point make it possible to discard [anxiety disorder] or [depression disorder] with high probability,” the researchers wrote. “In contrast, the highest cutoff points show high specificity and high [positive predictive value]. This indicates that people scoring above the cutoff points are more likely to present with [anxiety disorder] or [depression disorder].” – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.

Items in two widely used menopause questionnaires were effective in ruling out the existence of anxiety and depression, indicating whether symptoms were present and establishing whether a women had anxiety or depression disorder, according to findings from a cross-sectional study published in Menopause.

“Several instruments have been designed to assess climacteric symptoms, including depression and anxiety, and [quality of life],” Carolina Marin Martin, PhD, of the department of clinical psychology at Universidad Complutense de Madrid, Spain, and colleagues wrote. “However, there are few studies on depression and anxiety-specific questionnaires, leading to a need to determine the accuracy of those questionnaires most often used to provide appropriate therapies. In addition, women suffering from climacteric symptoms usually visit their GP (general practitioner), and they are not necessarily referred to a psychologist to assess possible psychological disorders in more depth. For this reason, it is necessary to offer GPs a specific and accurate tool to discriminate the individuals whose symptoms may require further assessment and treatment.”

Martin and colleagues analyzed data from 416 women aged 45 to 60 years who reported not going through premature or surgical menopause and not using hormone therapy, recruited in Madrid between November 2015 and November 2016 (mean age, 51 years; 77% married). Participants completed items relating to anxiety and depression from three questionnaires: items four and six from the 11-item Menopause Rating Scale (MRS), developed to measure the presence and severity of menopausal symptoms; items five and eight from the 29-item Menopause Quality of Life Questionnaire (MENQOL), developed to assess the health-related quality of life in the immediate postmenopausal period; and all items from the 14-item Hospital Anxiety and Depression Scale (HADS), developed to determine the degree of anxiety and depression symptoms exhibited by patients (seven items each related to anxiety and depression). Researchers used receiver operator curves (ROC) to assess the diagnostic accuracy of the MRS and MENQOL items related to anxiety and depression relative to the HADS questionnaire.

Researchers found that item six of the MRS (area under the ROC curve = 0.773; 95% CI, 0.721-0.824) and item five of the MENQOL (AUC = 0.772; 95% CI, 0.723-0.822) were accurate tools to identify individuals with anxiety or with a likelihood to develop anxiety disorder.

Similarly, item four of the MRS (AUC = 0.711; 95% CI, 0.625-0.797) and item eight of the MENQOL (AUC = 0.744; 95% CI, 0.668-0.821) accurately identified individuals with depression disorder, according to researchers.

Researchers also found that the lowest cutoff points for the MRS and the MENQOL had high sensitivity and a high negative predictive value.

“Scores below this cutoff point make it possible to discard [anxiety disorder] or [depression disorder] with high probability,” the researchers wrote. “In contrast, the highest cutoff points show high specificity and high [positive predictive value]. This indicates that people scoring above the cutoff points are more likely to present with [anxiety disorder] or [depression disorder].” – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.