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Depressive symptomatology, psychological stress, and ovarian reserve: a role for psychological factors in ovarian aging?

Bleil, Maria E. PhD1; Adler, Nancy E. PhD1; Pasch, Lauri A. PhD1; Sternfeld, Barbara PhD2; Gregorich, Steven E. PhD3; Rosen, Mitchell P. MD4; Cedars, Marcelle I. MD4

Menopause:
doi: 10.1097/gme.0b013e31825540d8
Original Articles
Editorial
Abstract

Objective: The aim of this study was to examine psychological factors in relation to antral follicle count (AFC), a marker of ovarian reserve, in a multiethnic sample of 683 premenopausal women in the Ovarian Aging (OVA) Study.

Methods: In cross-sectional analyses, linear regression was performed to determine whether AFC decline across women varied over levels of depression as well as depression in combination with psychological stress. The total and subscale scores of the Center for Epidemiological Studies Depression Scale were used to measure depression, and the Perceived Stress Scale was used to measure psychological stress.

Results: After covariate adjustment, the two-way interaction of age × positive affect and the three-way interaction of age × positive affect × stress were related to AFC (b = 0.047, P = 0.036; b = 0.012, P = 0.099, respectively). In stratified analyses, stress was related to AFC in women with low positive affect (b = –0.070, P = 0.021) but not in women with high positive affect (b = 0.018, P = 0.54). AFC decline across women was progressively higher in women with low positive affect who reported low (–0.747 follicles/year), mid (–0.920 follicles/year), and high (–1.112 follicles/year) levels of stress. Results examining the Center for Epidemiological Studies Depression Scale total and remaining subscale scores were all nonsignificant (P values > 0.05).

Conclusions: Cross-sectional evidence suggests that (1) women with low positive affect may experience accelerated AFC decline and (2) low positive affect may be a vulnerability factor, or, alternatively, high positive affect may be a protective factor, in moderating the negative effects of psychological stress on AFC decline.

Author Information

From the 1Department of Psychiatry, University of California San Francisco, San Francisco, CA; 2Division of Research, Kaiser Permanente Northern California, Oakland, CA; 3Department of Medicine, University of California San Francisco, San Francisco, CA; and 4Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA.

Received January 17, 2012; revised and accepted March 12, 2012.

Funding/support: Preparation of this manuscript and the research described here were supported by the National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development and NIH/National Institute on Aging (R01 HD044876), NIH/National Institute on Aging (K08 AG03575), NIH/University of California San Francisco-Clinical & Translational Science Institute (UL1 RR024131), Brain and Behavior Research Foundation, and Robert Wood Johnson Foundation (045820).

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Maria E. Bleil, PhD, University of California San Francisco, 3333 California Street, Suite 465, San Francisco, CA 94143-0848. E-mail: maria.bleil@ucsf.edu

©2012The North American Menopause Society