Associations Of Perimenopausal Symptoms, Psychological Resilience And Social Support With Psychological Distress In Perimenopausal Women

Objective:The aim of this study was to investigate the prevalence of psychological distress in perimenopausal women in China; the relationships of perimenopausal symptoms, psychological resilience, social support and psychological distress; the interaction effects of perimenopausal symptoms with psychological resilience and social support, to improve the mental health in perimenopausal women.Methods:A convenience sample of 850 perimenopausal women from 3 selected districts of Jinan, Shandong province, China was recruited to participate in the study. 10-item Kessler Psychological Distress Scale (K10), Menopause Rating Scale (MRS),10-item Connor-Davidson Resilience Scale (CD-RISC), Perceived Social Support Scale (PSSS), and provided sociodemographic information were used to assess the level of psychological distress, psychological resilience and social support in this study. Binary logistic regression analysis was used to explore the protective and risk factors of psychological distress. Hierarchical linear regression analyses were conducted to examine the interaction effects of perimenopausal symptoms with psychological resilience and social support. SPSS 17.0 software was used for the data analyses.Results:1. Scores of psychological distress, perimenopausal symptoms, psychological resilience and social support in perimenopausal womenThe mean (SD) global psychological distress score was 20.44 (5.78), and 41.3% of the perimenopausal women reported some degree of psychological distress. The average score of perimenopausal symptoms was (10.06+5.80). Among them, the highest average scores were found for psychological symptoms (4.07±2.66), the lowest scores were found for urogenital symptoms (1.92±1.93). Furthermore, the average scores of psychological resilience and social support were (25.05+7.32) and (59.05±12.07).2. Univariate analysis of psychological distress in the perimenopausal womenChi-squares found that more perimenopausal women in the distress group(K10>22) experienced no exercise, chronic diseases, menarche age(aged>16) and decreasing menstruation than those in the non-distress group(K10<22) (χ2=25.65,χ2=15.12,χ2=7.75 and χ2=17.06, all P values<0.05). Furthermore, significant difference between groups in perimenopausal symptoms, psychological resilience and social support were detected, the distress group scored significantly higher than the non-distress group on perimenopausal symptoms (/=-15.17, P<0.001), while lower than the non-distress group on psychological resilience and social support (t=8.66 and t=8.92, all P values<0.001).3. Logistic regression analysis of psychological distressBinary logistic regression analysis showed that perimenopausal symptoms (including somatic symptoms, psychological symptoms and urogenital symptoms) were significantly positively associated with psychological distress, were the risk factors of psychological distress (odds ratio(OR)=1.159, OR= 1.425, OR=1.181, all P values<0.001); Psychological resilience and social support were associated with a low likelihood of psychological distress, were the important protective factors(OR=0.965, OR=0.924, all P values<0.05).4. Interaction effect analyses of perimenopausal symptoms with psychological resilience and social supportHierarchical multiple regression analysis indicated the interaction effect between perimenopausal symptoms and psychological resilience was significant (β=-0.071, P<0.05), and total explained 1% variance of psychological distress. However, no interaction effect was observed between perimenopausal symptoms and social support (β=-0.025, P>0.05).Conclusions:1. Psychological distress was highly prevalent in perimenopausal women, with a prevalent rate of 41.3%.2. Exercise, chronic conditions, age of menarche and existing menstrual conditions were associated with psychological distress in perimenopausal women.3. Perimenopausal symptoms were critical risk factors for psychological distress; Psychological resilience and social support were important protective predictors for psychological distress during the perimenopause. Psychological resilience buffered the negative impact of perimenopausal symptoms on psychological distress.