Depressive symptoms and associated factors among Iranian women at midlife: A community-based, cross-sectional study

Marzieh Azizi, Ensieh Fooladi, Robin J. Bell, Fourozan Elyasi, Maryam Masoumi, Susan R. Davis

Research output: Contribution to journalArticleResearchpeer-review


Objective:Little is known of depressive symptoms in Iranian women at midlife. This population-based study was undertaken to document the prevalence of, and factors associated with, depressive symptoms using validated questionnaires.Methods:A total of 1,520 community-dwelling women, aged 40 to 64 years, residing in Sari, Northern Iran, were recruited, using multistage cluster sampling, to this cross-sectional study, between October 2016 and April 2017. Participants completed the Menopause Quality of Life Questionnaire, the Beck Depression Inventory-II, and the World Health Organization Well-being Index.Results:Participants' mean age was 49.1 (7.0) years and 88.7% were married. Overall, 167 (11%) women had moderate-severe depressive symptoms, 837 (55.1%) had low psychological well-being, and 172 (11.3%) reported taking psychotropic medication in the prior month. Factors independently associated with moderate-severe depressive symptoms included moderate-severe vasomotor symptoms (VMS) (adjusted odds ratio [AOR] 2.6, 95% CI, 1.5-4.6; P=0.001), age 60 years or older (AOR=1.9, 95% CI, 1.1-3.5; P=0.03), body mass index 30 to 39kg/m2 (AOR=1.8, 95% CI, 1.0-3.1; P=0.04), and housing insecurity (AOR=5.6, 95% CI, 3.7-8.3; P<0.001). Education beyond high school was associated with a lower risk (AOR=0.5, 95% CI, 0.3-0.9; P=0.04). Women reporting low marital satisfaction (19.2% of married women) were more likely than women who were very satisfied to have moderate-severe depressive symptoms (AOR=27.9, 95% CI, 10.5-74.2; P<0.001).Conclusions:Marital relationship dissatisfaction, reported by one in five women, was strongly associated with moderate-severe depressive symptoms in women at midlife in Iran, in addition to moderate-severe VMS, housing insecurity, obesity, and older age.

Original languageEnglish
Pages (from-to)1125-1132
Number of pages8
Issue number10
Publication statusPublished - 1 Oct 2019


  • Depressive symptoms
  • General well-being
  • Marital dissatisfaction
  • Menopause
  • Vasomotor symptoms

Cite this