The Prevalence of Depression, Anxiety, and Stress and Their Association with Vitamin D and Estrogen Levels in Postmenopausal Women in Semnan

Abstract

Background: Depression, stress, and anxiety are of the most prevalent psychological disorders among postmenopausal women. Inadequate evidence is available on the association between vitamin D and estrogen with depression, anxiety, and stress in this group. Objectives: The objective of this study was to determine the prevalence of depression, anxiety, and stress and their association with vitamin D and estrogen levels in postmenopausal women in Semnan. Methods: The present analytical cross-sectional study was carried out using multistage sampling among women aged 45 to 70 years in Semnan (Iran) in summer 2016. Data collection tools were the demographic questionnaire, Spielberger State-Trait anxiety inventory, the Beck depression inventory, and the perceived stress scale. In addition, the levels of blood vitamin D and estrogen were measured. Results: In 120 postmenopausal women, depression levels were mild (22.5%), moderate (13.3%), and severe (1.7%); anxiety levels were mild (46.7%), moderate (50.8%), and severe (2.5%); additionally, 79.2% had lower stress and 20.8% had greater stress. Negative and significant correlations were found between vitamin D and depression (r = -0.1982, P = 0.031), anxiety (r = -0.3636, P < 0.001) and stress (r = -0.2884, P = 0.001). However, there was no correlation between estrogen and depression (r = -0.130, P = 0.159), anxiety (r = -0.105, P = 0.254), and stress (r = -0.104, P = 0.262). No significant correlation was seen between estrogen and vitamin D (r = -0.070, P = 0.450). Conclusions: In postmenopausal women, no significant relationship was observed between estrogen and depression, anxiety, and perceived stress; however, there was a significant relationship between vitamin D and depression, anxiety, and stress.