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1.  The Influence of Menopausal Status and Postmenopausal Use of Hormone Therapy on Presentation of Major Depression in Women 
Menopause (New York, N.Y.)  2010;17(4):828-839.
Objective:
The purpose of this study was to determine whether there are differences in depression characteristics among premenopausal, perimenopausal, and postmenopausal women with major depressive disorder. This study also evaluated these differences between postmenopausal women with major depressive disorder who are taking and not taking hormone therapy.
Methods:
Analyses conducted with data from the Sequenced Treatment Alternatives to Relieve Depression study focused on female outpatients with non-psychotic major depressive disorder seeking treatment in 41 primary or psychiatric care settings across the United States. Baseline demographic and clinical characteristics were compared among women not taking hormone therapy who were premenopausal (N=950), perimenopausal (N=380), or postmenopausal (N=562). These comparisons were also made between postmenopausal women (n=768) taking (N=171) or not taking (N=562) hormone therapy.
Results:
After adjusting for sociodemographic and clinical baseline differences, premenopausal women were more likely to present with irritability than either peri- or postmenopausal women, and were more likely to have decreased appetite and less likely to have early morning insomnia than perimenopausal women. Postmenopausal women were more likely to have suicidal ideation and poorer physical functioning than either of the other groups, and were more likely to have sympathetic arousal and gastrointestinal symptoms than premenopausal women. After adjusting for baseline differences, postmenopausal women taking hormone therapy had better physical functioning, fewer melancholic features, less sympathetic arousal, and more lack of involvement in activities than women not taking hormone therapy.
Conclusions:
Menopausal status and postmenopausal use of hormone therapy may influence the clinical presentation of major depressive episodes in women.
doi:10.1097/gme.0b013e3181d770a8
PMCID: PMC2949279  PMID: 20616669
menopause; hormone therapy; depression; major depressive disorder
2.  Sex Differences in Response to Citalopram: A STAR*D Report 
Journal of psychiatric research  2008;43(5):503-511.
Objective
Controversy exists as to whether women with depression respond better to selective serotonin reuptake inhibitors (SSRIs) than men. The purpose of this report was to determine whether men and women differ in their responses to treatment with the SSRI citalopram using a large sample of real world patients from primary and psychiatric specialty care settings.
Method
As part of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, 2876 participants were treated with citalopram for up to 12-14 weeks. Baseline demographic and clinical characteristics and outcomes were gathered and compared between men and women.
Results
At baseline, women were younger, had more severe depressive symptoms and were more likely to have: early onset; previous suicide attempt(s); a family history of depression, alcohol abuse or drug abuse; atypical symptom features; and one or more of several concurrent psychiatric disorders. Despite greater baseline severity and more Axis I comorbidities, women were more likely to reach remission and response with citalopram than men.
Conclusions
Women have a better response to the SSRI citalopram than men, which may be due to sex-specific biological differences particularly in serotonergic systems.
doi:10.1016/j.jpsychires.2008.07.002
PMCID: PMC2681489  PMID: 18752809
antidepressants; gender differences; estradiol; women's health; depression
3.  Gender Differences in Depression Symptoms in Treatment-Seeking Adults: STAR*D Confirmatory Analyses 
Comprehensive psychiatry  2008;49(3):238-246.
Background
While epidemiologic research consistently reports greater prevalence of major depressive disorder in women, small sample sizes in many studies do not allow for full elaboration of illness characteristics. This paper examines gender differences in terms of illness attributes in a cohort of 2541 outpatients from across the United States who enrolled in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study.
Method
Confirmatory analyses were performed in 2541 outpatients comparing men and women with regard to socio-demographic features, comorbid Axis I and Axis III conditions, and illness characteristics. Results were compared to those of our previous report on the initial population of the first 1500 individuals enrolled in STAR*D.
Results
In both samples, nearly two-thirds of the sample (62.5%) were women. Women had greater symptom severity, but men had more episodes of major depression, despite no difference in the length of illness. No differences in age of onset emerged. As in the first cohort, women showed greater rates of an anxiety disorder, bulimia and somatoform disorder, as well as more past suicide attempts, while men showed more alcohol and substance abuse. Women reported more appetite, weight, hypersomnia, interpersonal sensitivity, gastrointestinal and pain complaints, and less suicidal ideation. Irritability was equally common in men and women.
Conclusion
This large analysis confirmed most of the clinical features and co-morbidities found to be more prevalent in the first cohort of women. Additionally, this analysis corroborated previous research suggesting higher rates of atypical and anxious depression in women, but refuted the notion of an “irritable depression” found in men. The report confirmed the 1.7:1 ratio for depression seen across genders in the National Comorbidity Survey.
doi:10.1016/j.comppsych.2007.06.012
PMCID: PMC2759282  PMID: 18396182
Women; Depression; Prevalence; Gender
4.  Influences of Hormone-Based Contraception on Depressive Symptoms in Premenopausal Women with Major Depression 
Psychoneuroendocrinology  2007;32(7):843-853.
Summary
Objective
Hormone-based contraceptives affect mood in healthy women or in women with Premenstrual Dysphoric Disorder. No study has yet examined their association with mood in women with major depressive disorder (MDD). The purpose of this study was to determine whether estrogen-progestin combination or progestin-only contraceptives are associated with depression severity, function and quality of life, or general medical or psychiatric comorbidity in women with MDD.
Methods
This analysis focused on a large population of female outpatients less than 40 years of age with non-psychotic MDD who were treated in 18 primary and 23 psychiatric care settings across the United States, using data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Baseline demographic and clinical information was gathered and compared between three groups based on hormonal use: combination (estrogen-progestin)(N=232), progestin-only (N=58), and no hormone treatment (N=948).
Results
Caucasians were significantly more likely to use combined hormone contraception. Women on progestin-only had significantly more general medical comorbidities; greater hypersomnia, weight gain and gastrointestinal symptoms; and worse physical functioning than women in either of the other groups. Those on combined hormone contraception were significantly less depressed than those with no hormone treatment by the 16-item Quick Inventory of Depressive Symptomatology - Self-Rated. The combined hormone group also demonstrated better physical functioning and less obsessive-compulsive disorder comorbidity than either of the other groups.
Conclusions
Synthetic estrogen and progestins may influence depressive and physical symptoms in depressed women.
doi:10.1016/j.psyneuen.2007.05.013
PMCID: PMC2100423  PMID: 17629629
Estradiol; Progesterone; Major Depression; Mood symptoms; Oral contraceptives; Norplant

Results 1-4 (4)