Causality, the menopause, and depression

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7080.608 (Published 22 February 1997) Cite this as: BMJ 1997;314:608

Review did not fully examine the evidence

  1. Mark Petticrew, Research fellow in health services researcha
  1. a NHS Centre for Reviews and Dissemination, University of York, York Y01 5DD
  2. b Fururabben 19, N-1345 Østerås, Norway

    Editor-Louise Nicol-Smith's critical review concludes that there is insufficient evidence to maintain that the menopause causes depression.1 This finding is echoed by Myra S Hunter's editorial.2 The title of the paper refers to a critical review, but both the discussion section and the editorial refer to it as a systematic review. I am not convinced that the review is systematic, and several major methodological issues concern me.

    Firstly, the author searched only for evidence that the menopause caused depression; research that showed no association was “not considered.” Non-English language studies also seem to have been excluded. This approach is inconsistent with the ethos of systematic reviews, one of whose strengths is that they are comprehensive.

    Secondly, the author's conclusions do not seem to be based on the results of the 17 studies included. These studies are largely …

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