Reducing depression during the menopausal transition with health coaching: Results from the healthy menopausal transition randomised controlled trial

Osvaldo P. Almeida, Kylie Marsh, Karen Murray, Martha Hickey, Moira Sim, Andrew H. Ford, Leon Flicker
In: Maturitas · 2016 · vol. 92 , pp. 41–48 · doi:10.1016/j.maturitas.2016.07.012 · PMID:27621237 · W2494966211
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A randomized controlled trial found that phone-delivered health coaching improved depressive and anxiety symptoms and quality of life in women experiencing the menopausal transition, particularly those with sub-threshold symptoms.

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This parallel, single-blinded randomized controlled trial evaluated whether six phone-delivered health coaching sessions during the menopausal transition reduce the incidence and severity of depressive symptoms and improve quality of life in 351 community-dwelling women without major depression at baseline. Over 52 weeks, nine participants developed clinically significant depressive symptoms, with a lower number in the health coaching group (OR = 0.26; p = 0.099), while intention-to-treat analyses showed a greater decline in depressive scores than usual care, particularly among women with sub-threshold depressive symptoms. Anxiety scores and the mental component summary of the SF-12 improved to a lesser extent, and Menopause Rating Scale scores declined by week 26 alongside subtle changes in body mass, vegetable intake, and smoking. The authors report no clear statistically significant reduction in incident depression (p = 0.099) and note the modest effects as the primary limitation. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Objective To determine if health coaching (HC) decreases the incidence of depression, reduces the severity of symptoms, and increases quality of life during the menopausal transition (MT). Research design and methods Parallel, single-blinded, randomised controlled trial of 6 sessions of phone-delivered HC compared with usual care. Participants were 351 community-dwelling women free of major depression going through the MT, of whom 180 were assigned the intervention and 171 usual care. The primary outcome of interest was the incidence of clinically significant depressive symptoms over 52 weeks. Other study measures included the Hospital Anxiety and Depression Scale, quality of life (SF-12), the Menopause Rating Scale (MRS), diet, body mass index, alcohol use, smoking and physical activity. We considered that women with Patient Health Questionnaire (PHQ-9) scores between 5 and 14 (inclusive) had sub-threshold depressive symptoms. Results Nine women developed clinically significant symptoms of depression during the study—2 had been assigned HC (odds ratio, OR = 0.26, 95%CI = 0.05, 1.29; p = 0.099). Intention-to-treat showed that, compared with usual care, the intervention led to a greater decline in depressive scores, most markedly for participants with sub-threshold depressive symptoms. Similar, but less pronounced, benefits were noticed for anxiety scores and the mental component summary of the SF-12. The intervention led to a decline in MRS scores by week 26 and subtle improvements in body mass, consumption of vegetables and smoking. Conclusions HC addressing relevant risk factors for depression during the MT improves mental health measures. Our findings indicate that women with sub-threshold depressive symptoms may benefit the most from such interventions, and suggest that HC could play a useful role in minimizing mental health disturbance for women going through the MT.

Keywords

depression, depressive disorder, health coaching, major depression, menopausal transition, perimenopause, randomised controlled trial Document Type Journal Article Date of Publication 2016 Location of the Work Ireland Publication Title Maturitas Publisher Elsevier School School of Medical and Health Sciences RAS ID 21779 Comments Almeida, P. P., Marsh, K., Murray, K., Hickey, M., Sim. M., Ford, A., & Flicker, L. (2016). Reducing depression during the menopausal transition with health coaching: Results from the healthy menopausal transition randomised controlled trial. Maturitas, 92, 41-48. Available here Copyright subscription content

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