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 Ford; Leon Flicker

doi:10.1016/j.maturitas.2016.07.012

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

Maturitas. 2016 Oct:92:41-48. doi: 10.1016/j.maturitas.2016.07.012. Epub 2016 Jul 19.

Authors

Osvaldo P Almeida¹, Kylie Marsh², Karen Murray², Martha Hickey³, Moira Sim⁴, Andrew Ford⁵, Leon Flicker⁶

Affiliations

¹ Western Australian Centre for Health & Ageing (M573), Centre for Medical Research of the Perkins Institute for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Australia; Department of Psychiatry, Royal Perth Hospital, Australia. Electronic address: osvaldo.almeida@uwa.edu.au.
² Western Australian Centre for Health & Ageing (M573), Centre for Medical Research of the Perkins Institute for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Australia.
³ Department of Obstetrics & Gynaecology, University of Melbourne and Royal Women's Hospital, Parkville, VIC 3052, Australia.
⁴ School of Medical Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
⁵ Western Australian Centre for Health & Ageing (M573), Centre for Medical Research of the Perkins Institute for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Australia; Department of Psychiatry, Royal Perth Hospital, Australia.
⁶ Western Australian Centre for Health & Ageing (M573), Centre for Medical Research of the Perkins Institute for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; School of Medicine and Pharmacology, University of Western Australia, Australia; Department of Geriatric Medicine, Royal Perth Hospital, Australia.

PMID: 27621237
DOI: 10.1016/j.maturitas.2016.07.012

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.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Depression / diagnosis
Depression / psychology
Depression / therapy*
Depressive Disorder, Major / diagnosis
Depressive Disorder, Major / psychology
Depressive Disorder, Major / therapy*
Female
Humans
Menopause / psychology*
Mentoring*
Middle Aged
Quality of Life / psychology*
Severity of Illness Index
Treatment Outcome