Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-25T06:13:35.645Z Has data issue: false hasContentIssue false

Psychiatric Aspects of the Menopause

Published online by Cambridge University Press:  02 January 2018

C. B. Ballinger*
Affiliation:
Mental Health Unit, Royal Dundee Liff Hospital, Dundee DD2 5NE

Extract

In the debates about the association between mental illness and the menopause, the psychiatric approach contradicts assertions by the gynaecological and psychoanalytic literature that the menopause has a negative effect on mental health. General population studies show that, if at all, psychiatric morbidity is more common in women in the five years before menopause. Sociocultural and family factors are more important in the aetiology of mental illness in menopausal women than physiological changes. Anxiety and depression in such women do not respond to oestrogen therapy, although some cases respond to antidepressants.

Type
Review Article
Copyright
Copyright © Royal College of Psychiatrists, 1990 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achte, K. (1970) Menopause from the psychiatrists point of view. Acta Obstetrica et Gynaecologica Scandinavica, 49 (suppl. 1), 717.CrossRefGoogle Scholar
Ballinger, C. B. (1975) Psychiatric morbidity and the menopause: screening of general population sample. British Medical Journal, iii, 344346.CrossRefGoogle Scholar
Ballinger, C. B. (1976a) Subjective sleep disturbance at the menopause. Journal of Psychosomatic Research, 20, 509513.CrossRefGoogle ScholarPubMed
Ballinger, C. B. (1976b) Psychiatric morbidity and the menopause: clinical features. British Medical Journal, i, 11831185.CrossRefGoogle Scholar
Ballinger, C. B. (1977) Psychiatric morbidity and the menopause: survey of a gynaecological out-patient clinic. British Journal of Psychiatry, 131, 8389.CrossRefGoogle ScholarPubMed
Ballinger, C. B., Browning, M. C. K. & Smith, A. H. W. (1987) Hormone profiles and psychological symptoms in perimenopausal women. Maturitas, 9, 235251.CrossRefGoogle Scholar
Ballinger, C. B., Smith, A. H. W. & Hobbs, P. R. (1985) Factors associated with psychiatric morbidity in women - a general practice survey. Acta Psychiatrica Scandinavica, 71, 272280.CrossRefGoogle ScholarPubMed
Bancroft, J. (1977) Hormones and sexual behaviour. Psychological Medicine, 7, 553556.CrossRefGoogle ScholarPubMed
Barker, M. (1968) Psychiatric illness after hysterectomy. British Medical Journal, 2, 9195.CrossRefGoogle ScholarPubMed
Benedek, T. (1950) Climacterium: a developmental phase. Psychoanalytic Quarterly, 19, 127.CrossRefGoogle Scholar
Benjamin, S., Barnes, D., Falconer, G., et al (1984) The effect of illness behaviour on the apparent relationship between physical and mental disorders. Journal of Psychosomatic Research, 28, 387395.CrossRefGoogle ScholarPubMed
Blaikley, J. B. (1949) Menorrhagia of emotional origin. Lancet, ii, 691694.CrossRefGoogle Scholar
Briscoe, M. (1982) Sex differences in psychological well-being. Psychological Medicine (monograph suppl. 1). Cambridge: Cambridge University Press.Google Scholar
Brown, G. W. & Harris, T. (1978) Social Origins of Depression. London: Tavistock Publications Ltd.Google ScholarPubMed
Bungay, G. T., Vessey, M. P. & McPherson, C. K. (1980) Study of symptoms in middle life with special reference to the menopause. British Medical Journal, ii, 181183.CrossRefGoogle Scholar
Byrne, P. (1984) Psychiatric morbidity in a gynaecology clinic: an epidemiological survey. British Journal of Psychiatry, 144, 2834.CrossRefGoogle Scholar
Calloway, S. P., Dolan, R. J., Fonagy, P., et al (1984) Endocrine changes and clinical profiles in depression: II the thyrotropin-releasing hormone test. Psychological Medicine, 14, 759765.CrossRefGoogle ScholarPubMed
Campbell, S. (1976) Double blind psychometric studies on the effects of natural oestrogens on post-menopausal women. In The Management of the Menopause and Post-Menopausal Years (ed. S. Campbell), pp. 149158. Lancaster, UK: MTP Press.CrossRefGoogle Scholar
Chakravarti, S., Collins, W. P., Forecast, J. D., et al (1976) Hormone profiles after the menopause. British Medical Journal, ii, 784787.CrossRefGoogle Scholar
Chakravarti, S., Collins, W. P., Thom, M. H., et al (1979) Relation between plasma hormone profiles, symptoms and response to oestrogen treatment in women approaching the menopause. British Medical Journal, i, 983985.CrossRefGoogle Scholar
Chessick, R. D. (1988) Thirty unresolved psychodynamic questions pertaining to feminine psychology. American Journal of Psychotherapy, 42, 8695.CrossRefGoogle ScholarPubMed
Cooke, D. J. (1985) Psychosocial vulnerability to life events during the climacteric. British Journal of Psychiatry, 147, 7175.CrossRefGoogle ScholarPubMed
Coope, J., Thomson, J. M. & Poller, L. (1975) Effects of ‘natural oestrogen’ replacement therapy on menopausal symptoms and blood clotting. British Medical Journal, iv, 139143.CrossRefGoogle Scholar
Coppen, A. (1965) The prevalence of menstrual disorders in psychiatric patients. British Journal of Psychiatry, 111, 155167.CrossRefGoogle ScholarPubMed
Craig, G. M. (1983) Guidelines for community menopause clinics. British Medical Journal, i, 20332036.CrossRefGoogle Scholar
Deutsch, H. (1945) Epilogue: the climacterium. In The Psychology of Women, vol. 2, pp. 456487. New York: Grune & Stratton.Google Scholar
Deykin, E. Y., Jacobson, S., Klerman, G., et al (1966) The empty nest: psychosocial aspects of conflict between depressed women and their grown children. American Journal of Psychiatry, 122, 14221426.CrossRefGoogle ScholarPubMed
Dohrenwend, B. P. & Dohrenwend, B. S. (1976) Sex differences and psychiatric disorders. American Journal of Sociology, 81, 14471454.CrossRefGoogle ScholarPubMed
Dowling, R. H. & Knox, S. J. (1964) Somatic syndromes in depressive illness: a problem of referral for general practitioners. British Journal of Psychiatry, 110, 720722.CrossRefGoogle Scholar
Dunnell, K. & Cartwright, A. (1972) Medicine Takers, Prescribes and Hoarders. London & Boston: Routledge & Kegan Paul.Google Scholar
Eagles, J. M. & Whalley, L. J. (1985) Ageing and affective disorders: the age at first onset of affective disorders in Scotland, 1969–1978. British Journal of Psychiatry, 147, 180187.CrossRefGoogle ScholarPubMed
English, O. S. (1954) Climacteric neuroses and their management. Geriatrics, 9, 139145.Google ScholarPubMed
Fessler, L. (1950) The psychopathology of climacteric depression. Psychoanalytic Quarterly, 19, 2842.CrossRefGoogle Scholar
Flint, M. P. (1975) The menopause: reward or punishment. Psychosomatics, 16, 161163.CrossRefGoogle ScholarPubMed
Flint, M. P. (1979) Transcultural influences in Peri-Menopause in Psychosomatics (eds A. A. Haspels & H. Musaph), pp. 4156. Lancaster, UK: MTP Press.Google Scholar
Foldes, J. J. (1972) Psychosomatic approach to the menopausal syndrome. Treatment with opipramol. In Psychosomatic Medicine in Obstetrics and Gynaecology (ed. N. Morris), pp. 517621. Basel: Karger.Google Scholar
Freud, S. (1917) Mourning and Melancholia. In Collected Papers, vol. 4 (1956), pp. 152170. London: Hogarth Press.Google Scholar
Gambrell, R. D. (1974) Peri-menopausal and post-menopausal bleeding: mechanism, pathology, management with progestational agents. In The Menopausal Syndrome (eds R. B. Greenblatt, V. B. Mahesh & P. G. McDonough). New York: Medicom Press.Google Scholar
Gath, D., Cooper, P. & Day, A. (1982) Hysterectomy and psychiatric disorder: I. Levels of morbidity before and after hysterectomy. British Journal of Psychiatry, 140, 335350.CrossRefGoogle ScholarPubMed
George, G. C. W., Utian, W. H. & Beumont, P. J. V. (1973) Effect of exogenous oestrogens on minor psychiatric symptoms in postmenopausal women. South African Medical Journal, 47, 23872388.Google ScholarPubMed
Gold, J. J. & Josimovich, J. B. (1980) Gynaecologic Endocrinology (3rd edn). Hagerstown: Harper Row.Google Scholar
Goldberg, D. P. (1972) The Detection of Psychiatric Illness by Questionnaire. London: Oxford University Press.Google Scholar
Gove, W. R. (1978) Sex differences in mental illness among adult men and women: an evaluation of four questions raised regarding the evidence on the higher rates of women. Social Science and Medicine, 12, 187198.Google ScholarPubMed
Gove, W. R. & Tudor, J. F. (1973) Adult sex roles and mental illness. American Journal of Sociology, 78, 812835.CrossRefGoogle ScholarPubMed
Greenberg, M. (1983) The meaning of menorrhagia: an investigation into the association between the complaint of menorrhagia and depression. Journal of Psychosomatic Research, 27, 209214.CrossRefGoogle ScholarPubMed
Greenberg, R. P. & Fisher, S. (1983) Freud and the female reproductive process: tests and issues. In Empirical Studies of Psychoanalytical Theories, vol. 1 (ed. J. M. Masling). New Jersey: The Psychoanalytic Press.Google Scholar
Greene, J. G. & Cooke, D. J. (1980) Life stress and symptoms at the climacterium. British Journal of Psychiatry, 136, 486491.CrossRefGoogle ScholarPubMed
Gregory, B. A. J. C. (1957) The menstrual cycle and its disturbance in psychiatric patients - II. Journal of Psychosomatic Research, 2, 199224.CrossRefGoogle ScholarPubMed
Hackman, B. W. & Galbraith, D. (1977) Six month pilot study of oestrogen replacement therapy with piperazine oestrone sulphate and its effect on memory. Current Medical Research and Opinion, 4 (suppl. 3), 2127.CrossRefGoogle Scholar
Hallstrom, T. (1973) Mental Disorder and Sexuality in the Climacteric. Gothenburg: Scandinavian University Books.Google Scholar
Hallstrom, T. (1977) Sexuality in the climacteric. Clinical Obstetrics and Gynaecology, 4, 227239.CrossRefGoogle ScholarPubMed
Hamilton, M. (1955) Psychosomatics. London: Chapman & Hall.Google Scholar
Haspels, A. A. & Van Keep, P. A. (1979) Endocrinology and management of the perimenopause. In Psychosomatics in Peri-Menopause (eds A. A. Haspels & H. Musaph). Lancaster: MTP Press.CrossRefGoogle Scholar
Hobbs, P., Ballinger, C. B., Greenwood, C., et al (1984) Factor analysis and validation of the General Health Questionnaire in men: a general practice survey. British Journal of Psychiatry, 144, 270275.CrossRefGoogle Scholar
Hopkinson, G. (1964) A genetic study of affective illness in patients over 50. British Journal of Psychiatry, 110, 244254.CrossRefGoogle ScholarPubMed
Hoskins, R. G. (1944) The psychological treatment of the menopause. Journal of Clinical Endocrinology, 4, 605610.CrossRefGoogle Scholar
Hutton, J. D., Jacobs, H. S., James, V. H. T. et al (1978) Relation between plasma oestrone and oestradiol and climacteric symptoms. Lancet, i, 678681.CrossRefGoogle Scholar
Jaszmann, L., Van Lith, N. D. & Zaat, J. C. A. (1969) The perimenopausal symptoms: the statistical analysis of a survey. Medical Gynaecology and Sociology, 4, 268277.Google Scholar
Jeffcoate, T. N. A. (1975) Principles of Gynaecology (4th edn) pp. 90. London: Butterworths.Google Scholar
Jones, E. C. (1979) The post-fertile life of non-human primates and other mammals. In Psychosomatics in Peri-Menopause (eds A. A. Haspels & H. Musaph), pp. 1319. Lancaster, U.K.: MTP Press.CrossRefGoogle Scholar
Jones, M. J., Marshall, D. H. & Nordin, B. E. C. (1977) Quantitation of menopausal symptomatology and its response to ethinyl oestradiol and piperazine oestrone sulphate. Current Medical Research and Opinion, 4 (suppl. 3), 1220.CrossRefGoogle Scholar
Kantor, H. I., Michael, C. M. & Shore, H. (1973) Estrogen for older women. A three year study. American Journal of Obstetrics and Gynaecology, 116. 115118.CrossRefGoogle Scholar
Kendell, R. E. (1968) The Classification of Depressive Illness (Maudsley monograph 18). London: Oxford University Press.Google Scholar
Kerr, M. (1970) Amitriptyline in emotional states at the menopause. New Zealand Medical Journal, 72, 243245.Google ScholarPubMed
Kinsey, A. C., Pomeroy, W. B., Martin, C. E., et al (1953) Sexual Behaviour in the Human Female. Philadelphia: Saunders.Google Scholar
Kraepelin, E. (1906) Lecture 1 - Introduction: melancholia. In Lectures on Clinical Psychiatry (rev. & ed. Johnston, T.). New York: Bailliere, Tindall & Cox.Google Scholar
Kraepelin, E. (1921) Manic–Depressive Insanity and Paranoia (trans. Barclay, R. M.; ed. Robertson, G. M.). Edinburgh: E. & S. Livingstone.CrossRefGoogle Scholar
Kroger, W. S. & Freed, S. C. (1951) Psychosomatic Gynaecology. Philadelphia & London: W. B. Saunders.Google Scholar
Kruskemper, G. (1975) Results of psychological testing (MMPI) in climacteric women. In Estrogens in the Post-Menopause: Frontiers in Hormone Research (eds P. Van Keep & C. Lauritzen), pp. 105111. Basel: Karger.Google Scholar
Kupperman, H. S., Wetchler, B. B. & Blatt, M. H. G. (1959) Contemporary therapy of the menopausal syndrome. Journal of the American Medical Association, 171, 16271637.CrossRefGoogle ScholarPubMed
Levy, S. (1967) Depressive reaction. Its diagnosis and treatment with special reference to the ‘somatic mask’ and the newer psychopharmacologic agents. In Psychosomatic Medicine (eds E. Dunlop & M. N. Weisman) pp. 3341. Amsterdam: Excerpta Medical Foundations.Google Scholar
Lewis, A. (1936) Melancholia: prognostic study and case material. Journal of Mental Science, 82. 488558.CrossRefGoogle Scholar
McClure Browne, J. C. (1973) Postgraduate Obstetrics and Gynaecology (4th edn). London: Butterworths.Google Scholar
McGhie, A. & Russell, S. M. (1962) The subjective assessment of normal sleep patterns. Journal of Mental Science, 108, 642654.CrossRefGoogle Scholar
McKinlay, J. B., McKinlay, S. M. & Brambilla, D. (1987) The relative contributions of endocrine changes and social circumstances to depression in mid-aged women. Journal of Health and Social Behavior, 28, 345363.CrossRefGoogle ScholarPubMed
McKinlay, S. M. & Jeffreys, M. (1974) The menopausal syndrome. British Journal of Preventative and Social Medicine, 28, 108115.Google ScholarPubMed
MacNaughton, M. C. (1985) Medical Gynaecology. Oxford: Blackwell Scientific Publications.Google Scholar
Malamud, W., Sands, S. L. & Malamud, I. (1941) The involutional psychoses: a socio-psychiatric study. Psychosomatic Medicine, 3, 410426.CrossRefGoogle Scholar
Malleson, J. (1953) An endocrine factor in certain affective disorders. Lancet, ii, 158164.CrossRefGoogle Scholar
Mannes, M. (1968) Of time and the woman. Psychosomatics, 9 (suppl.), 811.CrossRefGoogle ScholarPubMed
Maoz, B., Dowty, N., Antonovsky, A., et al (1970) Female attitudes to menopause. Social Psychiatry, 5, 3540.CrossRefGoogle Scholar
Martin, R. L., Roberts, W. V., Clayton, P. J., et al (1977) Psychiatric illness and non-cancer hysterectomy. Diseases of the Nervous System, 38, 974980.Google ScholarPubMed
Masters, V. H. & Johnson, V. E. (1966) Human Sexual Response. Boston: Little, Brown.Google Scholar
Mechanic, D. (1978) Sex, illness, illness behavior and the use of health services. Social Science and Medicine, 12, 207214.Google Scholar
Mechanic, D. (1986) The concept of illness behaviour; culture, situation and personal predisposition. Psychological Medicine, 16, 17.CrossRefGoogle ScholarPubMed
Mechanic, D. & Volkart, E. H. (1960) Illness behaviour and medical diagnoses. Journal of Health and Human Behaviour, 1, 8694.CrossRefGoogle Scholar
Merson, J. (1876) The climacteric period in relation to insanity. The West Riding Lunatic Asylum Medical Reports, 6, 85107.Google Scholar
Mitchell, P. B., Bearn, J. A., Corn, T. H., et al (1988) Growth hormone response to clonidine after recovery in patients with endogenous depression. British Journal of Psychiatry, 152, 3438.CrossRefGoogle ScholarPubMed
Munro, A. (1969) Psychiatric illness in gynaecological out-patients: a preliminary study. British Journal of Psychiatry, 115, 807809.CrossRefGoogle ScholarPubMed
Neugarten, B. L. & Kraines, R. J. (1965) ‘Menopausal symptoms’ in women of various ages. Psychosomatic Medicine, 27, 266273.CrossRefGoogle ScholarPubMed
Neugarten, B. L., Wood, V., Kraines, R. J., et al (1968) Women's attitudes towards the menopause. In Middle Age and Ageing (ed. B. L. Neugarten), pp. 195200. Chicago & London: University of Chicago Press.Google Scholar
Nikula-Baumann, L. (1971) Endocrinological studies on subjects with involutional melancholia. Acta Psychiatrica Scandinavica (suppl. 226).Google Scholar
Novak, E. R., Jones, G. S. & Jones, H. W. (1975) Novak's Textbook of Gynaecology (9th edn). Baltimore: Williams & Wilkins.Google Scholar
O'Neill, D. (1952) Uterine bleeding in tension states. Journal of Obstetrics and Gynaecology of the British Empire, 59, 234239.CrossRefGoogle Scholar
Orme, J. E. (1972) Duration of sleep and its relationship to age, personality and psychiatric illness. British Journal of Social and Clinical Psychology, 11, 7072.CrossRefGoogle ScholarPubMed
Osborn, M., Hawton, K. & Gath, D. (1988) Sexual dysfunction among middle aged women in the community. British Medical Journal, 296, 959962.CrossRefGoogle ScholarPubMed
Palmer, H. D., Hastings, D. W. & Sherman, S. H. (1941) Therapy in involutional melancholia. American Journal of Psychiatry, 97, 10861115.CrossRefGoogle Scholar
Pfeiffer, E., Verwoerdt, A. & Davis, G. C. (1972) Sexual behaviour in middle life. American Journal of Psychiatry, 128, 12621267.CrossRefGoogle ScholarPubMed
Prados, M. (1967) Emotional factors in the climacterium of women. Psychotherapy and Psychosomatics, 15, 231244.CrossRefGoogle ScholarPubMed
Priest, R. G. & Crisp, A. H. (1972) The menopause and its relationship with reported somatic experiences. In Psychosomatic Medicine in Obstetrics and Gynaecology (ed. N. Morris) pp. 605607. Basel: Karger.Google Scholar
Rauramo, L., Lagerspetz, K., Engblom, P., et al (1975) The effect of castration and peroral estrogen therapy on some psychological factors. In Estrogens in the Post-Menopause: Frontiers of Hormone Research, (eds P. A. Van Keep & C. Lauritzen) (vol. 3), pp. 94104. Basel: Karger.Google Scholar
Richards, D. H. (1974) A post-hysterectomy syndrome. Lancet, 2, 983985.CrossRefGoogle ScholarPubMed
Ripley, H. S., Shorr, E. & Papanicolaou, G. N. (1940) The effect of treatment of depression in the menopause with estrogenic hormone. American Journal of Psychiatry, 96, 905911.CrossRefGoogle Scholar
Rogers, J. (1956) The menopause. New England Journal of Medicine, 254, 697703, 750–756.CrossRefGoogle ScholarPubMed
Rosenthal, S. H. (1968) The involutional depressive syndrome. American Journal of Psychiatry, 124 (suppl.), 2135.CrossRefGoogle ScholarPubMed
Rubin, L. B. (1979) Women of a Certain Age. The Midlife Search for Self. New York: Harper & Row.Google Scholar
Sachar, E. J., Asnis, G. & Nathan, R. S. (1980) Dextroamphetamine and Cortisol in Depression. Archives of General Psychiatry, 37, 755757.CrossRefGoogle ScholarPubMed
Sainsbury, P. (1960) Psychosomatic disorders and neurosis in outpatients attending a general hospital. Journal of Psychosomatic Research, 4, 261273.CrossRefGoogle ScholarPubMed
Severne, L. (1979) Psychosocial aspects of the menopause. In Psychosomatics in Peri-Menopause (eds A. A. Haspels & H. Musaph), pp. 101120. Lancaster, UK: MTP Press.CrossRefGoogle Scholar
Sheffery, J. B., Wilson, T. A. & Walsh, J. C. (1969) Double-blind cross-over study comparing chlordiazepoxide, conjugated estrogens, combined chlordiazepoxide and conjugated estrogens, and placebo in treatment of the menopause. Medical Annals of the District of Columbia, 38, 433436.Google ScholarPubMed
Sherman, B. M., West, J. H. & Korenman, S. G. (1976) The menopausal transition: analysis of LH, FSH, estradiol and progesterone concentrations during menstrual cycles of older women. Journal of Clinical Endocrinology and Metabolism, 42, 629636.CrossRefGoogle ScholarPubMed
Smith, W. G. (1971) Critical life-events and prevention strategies in mental health. Archives of General Psychiatry, 25, 103109.CrossRefGoogle ScholarPubMed
Stenback, A. (1963) On involutional and middle-age depression. Acta Psychiatrica Scandinavica, 39 (suppl. 169), 1432.CrossRefGoogle Scholar
Stenstedt, A. (1959) Involutional melancholia. Acta Psychiatrica et Neurologica Scandinavica, 34 (suppl. 127).Google Scholar
Strickler, R. C., Borth, R., Cecutti, A., et al (1977) The role of oestrogen replacement in the climacteric syndrome. Psychological Medicine, 7, 531639.Google ScholarPubMed
Studd, J. W. W. (1979) The climacteric syndrome. In Female and Male Climacteric (eds P. A. Van Keep, D. M. Serr & R. B. Greenblatt), pp. 2333. Lancaster, UK: MTP Press.CrossRefGoogle Scholar
Studd, J. W. W., Collins, W. P., Chakravarti, S., et al (1977) Oestradiol and testosterone implants in the treatment of psychosexual problems in the postmenopausal women. British Journal of Obstetrics and Gynaecology, 84, 314315.CrossRefGoogle Scholar
Tait, A. C., Harper, J. & McClatchey, W. T. (1957) Initial psychiatric illness in involutional women. 1. Clinical aspects. Journal of Mental Science, 103, 132145.CrossRefGoogle Scholar
Thompson, B., Hart, S. A. & Durno, D. (1973) Menopausal age and symptomatology in a general practice. Journal of Biosocial Science, 5, 7182.CrossRefGoogle ScholarPubMed
Thomson, J. & Oswald, I. (1977a) Hormones and sleep. Current Medical Research and Opinion, 4 (suppl. 3), 6772.CrossRefGoogle Scholar
Thomson, J. & Oswald, I. (1977b) Effect of oestrogen on the sleep, mood and anxiety of menopausal women. British Medical Journal, ii, 13171319.CrossRefGoogle Scholar
Tilt, E. J. (1857) The Change of Life in Health and Disease (2nd edn). London: Churchill.Google Scholar
Treloar, A. E., Boynton, R. E., Benn, B. G., et al (1967) Variation of the human menstrual cycle through reproductive life. International Journal of Fertility, 12, 77126.Google ScholarPubMed
Tyrer, P., Lee, I., Alexander, J. (1980) Awareness of cardiac function in anxious, phobic and hypochondriacal patients. Psychological Medicine, 10, 171174.CrossRefGoogle ScholarPubMed
Utian, W. H. (1972a) The true clinical features of post-menopause and oophorectomy and their response to oestrogen therapy. South African Medical Journal, 46, 732737.Google ScholarPubMed
Utian, W. H. (1972b) The mental tonic effect of oestrogens administered to oophorectomized females. South African Medical Journal, 46, 10791082.Google ScholarPubMed
Utian, W. H. (1978) Plasma-oestrogens and climacteric symptoms. Lancet, i, 10991100.CrossRefGoogle Scholar
Utian, W. H. & Serr, D. (1976) The climacteric syndrome. In Consensus on Menopause Research (eds P. A. Van Keep, R. B. Greenblatt & M. Albeaux-Fernet), pp. 14. Lancaster, UK: MTP Press.Google Scholar
Veith, I. (1965) Hysteria: the History of a Disease. Chicago: University of Chicago Press.Google Scholar
Wandless, I. (1979) Illness seen at a menopause clinic. British Medical Journal, 1, 1356.CrossRefGoogle Scholar
Weissman, M. M. (1979) The myth of involutional melancholia. Journal of the American Medical Association, 242, 742744.CrossRefGoogle ScholarPubMed
Weissman, M. M. & Klerman, G. L. (1977) Sex differences and epidemiology of depression. Archives of General Psychiatry, 34, 98111.CrossRefGoogle ScholarPubMed
Weissman, M. M. & Myers, J. K. (1978) Rates and risks of depressive symptoms in a United States urban community. Acta Psychiatrica Scandinavica, 57, 219231.CrossRefGoogle Scholar
Werner, A. A., Johns, G. A., Hoctor, E. F., et al (1934) Involutional melancholia. Probable etiology and treatment. Journal of the American Medical Association, 103, 1316.CrossRefGoogle Scholar
Wheatley, D. (1972) The use of psychotropic drugs in the female climacteric. In Psychosomatic Medicine in Obstetrics and Gynaecology (ed N. Morris), pp. 612616. Basel: Karger.Google Scholar
Wilkinson, G., Borsey, D. Q., Leslie, P., et al, (1987) Psychiatric disorder in patients with insulin-dependent diabetes mellitus attending a general hospital clinic: (i) two-stage screening and (ii) detection by physicians. Psychological Medicine, 17, 515517.CrossRefGoogle Scholar
Wilson, R. A. & Wilson, T. A. (1963) The fate of the nontreated postmenopausal woman: a plea for the maintenance of adequate estrogen from puberty to the grave. Journal of the American Geriatrics Society, 11, 347362.CrossRefGoogle Scholar
Winokur, G. (1973) Depression in the menopause. American Journal of Psychiatry, 130, 9293.CrossRefGoogle ScholarPubMed
Wittson, C. L. (1940) Involutional melancholia. Psychiatric Quarterly, 14, 167184.CrossRefGoogle Scholar
Wood, C. (1979) Menopausal myths. Medical Journal of Australia, 1, 496499.CrossRefGoogle ScholarPubMed
World Health Organization (1981) Research on the Menopause. Report of a WHO scientific group. Technical Report Series, 670. Geneva: WHO.Google Scholar
Worsley, A., Walters, W. A. W. & Wood, E. C. (1977) Screening for psychological disturbance amongst gynaecology patients. Australia and New Zealand Journal of Obstetrics and Gynaecology, 17, 214219.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.