Reviewer’ s report
Title: Prevalence of somatic and urogenital symptoms as well as psychological health in women
age 45 to 55 attending Primary Health Care: a cross-sectional study.
Version: 1Date: 17 Aug 2017
Reviewer: Sara Nowakowski
Reviewer's report:
I am satisfied with the changes the authors made to the manuscript, and appreciate the effort to
address reviewers' comments. I have one remaining comment that appeared to be brought up byboth reviewers. The issue of depressive/mood symtoms being assessed in MADRS and MRS. I amnot quite satisfied with the response that MADRS and MRS are evaluating different constructs.The authors state, "The depression component and the psychological component of MRS containssimilar but not identical items." However, some of the items are almost identical. For example,apparent sadness (MADRS) and feeling sad - depressive mood subscale (MRS); inner tenstion(MADRS) and inner tenstion - irritability subscale (MRS); concentration difficulties (MADRS)and decrease in concentration - mental exhaustion subscale (MRS). Regardless of being similarbut not identical, the constructs are overlapping enough that I am still worried about the issue ofcolinearity, and recommend this issue be addressed further before the manuscript is publish-ed.Below are the reviewer comments and authors' responses I am referring to:Reviewer1:25.Please clarify if the MADRS score was compared to the MRS score. Both of thesequestionnaires measure psychological symptoms. Collinearity makes it inappropriate to comparethese two measures. Our response: That was a good point of view and we will explain that. TheMADRS measures degree of depression status while the MRS measure severity of subjectively
perceived complaints of symptoms common in women aged 45-55 years. MRS psychological
subscale measure four mental symptoms: depressive mood (feeling down, sad, on the verge oftears, lack of drive, mood swings) Irritability (feeling nervous, inner tension, feeling aggressive)Anxiety (inner restlessness, feeling panicky) Physical and mental exhaustion (general decrease inperformance, impaired memory, decrease in concentration, forgetfulness). MADRS measure andcontains depression symptoms as: Apparent Sadness, Inner Tension , Reduced Sleep, ReducedAppetite, Concentration Difficulties , Lassitude, Inability to Feel, Pessimistic Thoughts and)Suicidal Thoughts . We wanted to know to what extent these similar but not identical dimensionscorrelated.Reviewer 2:# 37, P. 10 and Fig 1. 'Depression and age were associated with more severemenopausal symptoms' - depression is included here as an independent variable and also items ofdepressed mood are contained within the dependent variable - MRS (psychological symptoms)which would increase the association between these variables. Our respons: The depressioncomponent and the psychological component of MRS contains similar but not identical items. Wewanted to investigate to what extent depression measured with MADRS correlates to severesymptoms measured by MRS. The result indicates that in women that are slightly older (close to55) with a likely depression identified by MADRS are also likely to have symptoms as describedby MRS and these types of symptoms could actively be asked for to clarify if there is anythingmore than the depression.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
YesAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?If an additional statistical review is recommended, please specify what aspects require furtherassessment in your comments to the editors.
I am able to assess the statisticsQuality of written English
Please indicate the quality of language in the manuscript:
Acceptable
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