Three Cases of Depression which were Suspected Menopausal Symptoms

Abstract

Climacteric depression is difficult to distinguish from climacteric disorder, and since climacteric depression can accompany climacteric disorder, it is often misdiagnosed and thus left untreated for a long period of time. Although the following three patients experienced depression, they were not diagnosed or treated for depression. They visited our institution wishing to undergo gynecological treatment on an outpatient basis, and besides the characteristic symptoms, clinically significant psychosocial factors were confirmed in all three patients. Case 1: A 54 year-old postmenopausal female (had experienced menopause one year ago) presented with insomnia and anxiety as her chief complaints. Although some psychiatrist had dispensed an antidepressant, symptoms did not improve and she visited our clinic. During childhood she had been raised by an abusive father and lived with a schizophrenic aunt. These are some of the factors associated with onset of depression. Case 2 : A 49 year-old perimenopausal female presented with anxiety, depression and fatigue as her chief complaints. Past medical history included gastric ulcer and anxiety neurosis. Regarding psychosocial factors, her husband is 16 years younger and this age difference is heightening her anxiety about getting old and raising her child at her age. In addition he could not resolve her anxiety for child rearing. Case 3 : A 46 year-old menopausal female (had experienced menopause one year ago) presented with dizziness and hypersensitivity as her chief complaints. At the age of 17, her parents divorced, and her mother later died of ovarian cancer. About this time, she experienced anxiety neurosis and difficulty leaving her house due to a fear of meeting people. In order to diagnose depression in climacteric women, it is necessary to assume an active approach. Not only the characteristic symptoms associated with depression need to be examined, but also psychosocial factors such as childhood, past medical history and family history.