Depressive Symptoms and Subjective Stress in the Course of the Menstrual Cycle - an Ambulatory Assessment Study.
Condition: Major Depressive Episode
MeSH terms: Depression
Study type: Observational

Summary: 
      Background:

      Major changes in female sex hormone concentrations influence the development of depressive
      symptoms in women. This hypothesis has been thoroughly investigated with regard to the
      menopause, the postpartal phase and also premenstrual dysphoric disorder. However, much less
      is known regarding the impact of female sex hormone fluctuations on depression during the
      regular menstrual cycle. There are indications that during the luteal phase, women might be
      more vulnerable to the development of depressive symptoms, while during the follicular phase
      and at ovulation, hormone concentrations might present a protective factor against depressive
      symptomatology. Subjective stress could mediate the relationship between depressive symptom
      development and the menstrual cycle phases. The complex interaction between sex hormones and
      psychological symptoms in the course of menstrual cycle phases is still understudied.

      Method:

      74 women (37 with and 37 without current depressive episode), will take part in a
      smartphone-based ambulatory assessment. Women will provide daily ratings of depressive
      symptoms and perceived stress for a period of one menstrual cycle (approx. 26-30 days). Three
      menstrual cycle phases will be assessed - the follicular phase, ovulation and the luteal
      phase. An ambulatory assessment will be used for these daily assessments. To assess the
      menstrual cycle phase participants will use ovulation tests on five days in the late
      follicular phase.

      The following research questions will be investigated:

      Research question 1: Do depressive symptoms (number and severity) change in the course of the
      menstrual cycle within the two groups? Research question 2: Which depressive symptoms are
      particularly sensitive to changes in the course of the menstrual cycle phases? Research
      question 3: Does the subjective stress change in the course of the menstrual cycle within the
      two groups? Research question 4: Are there differences between depressive and healthy women
      in terms of changes in depressive symptoms and subjective stress experience?

      Implications:

      The aim of the study is to investigate women-specific psychobiological factors influencing
      depression. Therefore, fluctuations in depressive symptoms and subjective stress experience
      will be investigated as a function of the respective menstrual cycle phases. The
      identification of cycle phases associated with increased or reduced vulnerability to
      depressive symptoms will support the development of women-specific prevention and treatment
      programs.
    


Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Sample will be recruited all over Germany.
      
Keywords: Menstrual Cycle; Major Depressive Disorder; Stress; Sex hormones; Depression; Female; Ambulatory Assessment