Little is known of depressive symptoms
in Iranian women at midlife. This population-based study was undertaken to document the prevalence of, and factors associated with, depressive symptoms
using validated questionnaires.
A total of 1,520 community-dwelling women, aged 40 to 64 years, residing in Sari, Northern Iran, were recruited, using multistage cluster sampling, to this cross-sectional study, between October 2016 and April 2017. Participants completed the Menopause
Quality of Life Questionnaire, the Beck Depression Inventory-II, and the World Health Organization Well-being Index.
Participants’ mean age was 49.1 (7.0) years and 88.7% were married. Overall, 167 (11%) women had moderate–severe depressive symptoms
, 837 (55.1%) had low psychological well-being, and 172 (11.3%) reported taking psychotropic medication in the prior month. Factors independently associated with moderate–severe depressive symptoms
included moderate–severe vasomotor symptoms
(VMS) (adjusted odds ratio [AOR] 2.6, 95% CI, 1.5-4.6; P
= 0.001), age 60 years or older (AOR = 1.9, 95% CI, 1.1-3.5; P
= 0.03), body mass index 30 to 39 kg/m2
(AOR = 1.8, 95% CI, 1.0-3.1; P
= 0.04), and housing insecurity (AOR = 5.6, 95% CI, 3.7-8.3; P
< 0.001). Education beyond high school was associated with a lower risk (AOR = 0.5, 95% CI, 0.3-0.9; P
= 0.04). Women reporting low marital satisfaction (19.2% of married women) were more likely than women who were very satisfied to have moderate–severe depressive symptoms
(AOR = 27.9, 95% CI, 10.5-74.2; P
Marital relationship dissatisfaction, reported by one in five women, was strongly associated with moderate–severe depressive symptoms
in women at midlife in Iran, in addition to moderate–severe VMS, housing insecurity, obesity, and older age.