Adolescent Girls Using Oral Contraceptives Have Higher Self-Reported Depressive Symptoms

Symptoms of depression are associated with oral contraceptive use in 16-year-old girls compared with adolescents and young women up to 25 years of age.

Symptoms of depression are associated with oral contraceptive use in 16-year-old girls, a study in JAMA Psychiatry suggests.

Study researchers analyzed self-reported data from Dutch patients aged 16 to 25 years who were included in the third to sixth wave of the Tracking Adolescents’ Individual Lives Survey (TRAILS) between September 1, 2005, and December 31, 2016. Only women who had filled ≥1 and up to 4 assessments of oral contraceptive use were included in the analysis (n=1010). The Diagnostic and Statistical Manual of Mental Disorders, 4th edition-oriented affective problems scale of youth (aged 16 years) and adult self-report (aged 19, 22, and 25 years) were used to examine depressive symptoms with oral contraceptive use at 16 years, 19 years, 22 years, and 25 years of age. Crying, eating, sleeping, suicidal ideation, self-harm, feelings of worthlessness and guilt, energy, activity, sadness, and anhedonia were queried in all groups.

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Results indicated that oral contraceptive pill users differed particularly from nonusers at age 16 years. Individuals aged 16 years who did not use oral contraceptives also had a greater mean socioeconomic status (score, 0.17 [0.78] vs –0.15 [0.71]) and were more often virgins (79.5% vs 24.4%) compared with contraceptive users. Adolescents with a mean age of 16.5 years reported greater depressive symptom scores vs nonusers of the same age (mean score, 0.40 vs 0.33, respectively). This difference persisted after adjustment for age, socioeconomic status, and ethnicity (β coefficient for interaction with age, –0.021; 95% CI, –0.038 to –0.005; P =.0096). In adolescent contraceptive users, there were also greater self-reported symptoms of crying (odds ratio [OR], 1.89; 95% CI, 1.38-2.58; P <.001), hypersomnia (OR, 1.68; 95% CI, 1.14-2.48; P =.006), and eating problems (OR, 1.54; 95% CI, 1.13-2.10; P =.009).

Limitations of the study included the reliance on observational data as well as the subjective nature of participants self-reporting depressive symptoms.

The researchers concluded that monitoring for the identified depressive symptoms in adolescents aged 16 years is imperative, as these symptoms “may affect their quality of life and put them at risk for nonadherence.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

de Wit AE, Booij SH, Giltay EJ, Joffe H, Schoevers RA, Olldehinkel AJ. Association of use of oral contraceptives with depressive symptoms among adolescents and young women [published online October 2, 2019]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2019.2838