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The Harvard Study of Moods and Cycles

Bernard L. Harlow, PhD; Lee S. Cohen, MD; Michael W. Otto, PhD; Donna Spiegelman, ScD; Daniel W. Cramer, MD, ScD

Arch Gen Psychiatry. 1999;56:418-424.

Background  The Harvard Study of Moods and Cycles is a community-based cohort study designed to evaluate the relationship between major depression and changes in menstrual and ovarian function.

Methods  All women aged 36 to 44 years with a verifiable address from 7 Boston, Mass, metropolitan communities were selected from the Massachusetts Town Books. A self-administered questionnaire assessed demographic characteristics and menstrual history, depression history, and current depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D]) in 4161 women.

Results  We observed a score of 16 or more on the CES-D in 22.4% of women surveyed, and 8.6% scored 25 or more. Widowed, divorced, or separated women were twice as likely as married women to have depression scores greater than 16 (95% confidence interval, 1.6-2.8), and smokers in the upper tertile of pack-years were 1.9 times more likely to have CES-D scores of 16 or more (95% confidence interval, 1.5-2.3). Relative to nulliparous women, those with 1 or 2 children had a 30% lower risk of historic mood disorder, and those with 3 or more children had an even greater reduction in risk (odds ratio, 0.4; 95% confidence interval, 0.3-0.6). Menstrual cycle irregularities were largely unassociated with current or past depression. However, 5 of 8 premenstrual symptoms were significantly associated with CES-D scores of 16 or more.

Conclusions  These findings corroborate the prevalence of depression reported by other community-based studies, and also support a relationship between depressive symptoms and marital status, cigarette smoking, nulliparity, and premenstrual symptoms.

From Harvard Medical School (Drs Harlow, Cohen, Otto, and Cramer), the Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital (Drs Harlow and Cramer), the Perinatal Psychiatry Clinical Research Program, Massachusetts General Hospital (Drs Cohen and Otto), and the Departments of Epidemiology and Biostatistics, Harvard School of Public Health (Dr Spiegelman), Boston, Mass.

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