Highlights
- •The menopausal transition is considered a time of increased vulnerability to depression.
- •We used health coaching to address risk factors associated with depression during the menopausal transition.
- •Compared with usual care, health coaching led to a greater decline in the severity of depressive symptoms over 12 months.
- •Women with sub-threshold symptoms of depression at baseline benefited most from the intervention.
- •Health coaching could play a useful role in decreasing mental health disturbances associated with the menopausal transition.
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
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Article info
Publication history
Published online: July 19, 2016
Accepted:
July 18,
2016
Received in revised form:
July 15,
2016
Received:
June 22,
2016
Footnotes
☆Trial registration: Australian and New Zealand Clinical Trials Registry ACTRN12613000724774 (www.anzctr.gov.au).
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
