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- Title
There is no association between combined oral hormonal contraceptives and depression: a Swedish register-based cohort study.
- Authors
Lundin, C; Wikman, A; Lampa, E; Bixo, M; Gemzell‐Danielsson, K; Wikman, P; Ljung, R; Sundström Poromaa, I; Gemzell-Danielsson, K
- Abstract
<bold>Objective: </bold>To investigate whether users of hormonal contraceptives (HCs) are at increased risk of depression compared with non-users.<bold>Design: </bold>Register-based cohort study.<bold>Setting: </bold>Sweden.<bold>Sample: </bold>Women aged 15-25 years between 2010 and 2017 with no prior antidepressant treatment, psychiatric diagnose or contraindication for HCs (n = 739 585).<bold>Methods: </bold>Women with a prescription of HC were identified via the Swedish Prescribed Drug Register (SPDR). Relative risks (RRs) for first depression diagnosis in current HC-users compared with non-users were modelled by Poisson regression. Adjustments included age, medical indication for HC-use and parental history of mental disorders, among others.<bold>Main Outcome Measures: </bold>Depression, captured by a redeemed prescription of antidepressant treatment, or a first depression diagnosis in the SPDR and the National Patient Register.<bold>Results: </bold>Compared with non-users, women on combined oral contraceptives (COCs) and oral progestogen-only products had lower or no increased risk of depression, relative risk (RR) 0.89 (95% CI 0.87-0.91) and 1.03 (95% CI 0.99-1.06) after adjustments, respectively. Age-stratified analyses demonstrated that COC use in adolescents conferred no increase in risk (RR 0.96, 95% CI 0.93-0.98), whereas use of progestogen-only pills (RR 1.13, 95% CI 1.07-1.19), contraceptive patch/vaginal ring (RR 1.43, 95% CI 1.30-1.58), implant (RR 1.38, 95% CI 1.30-1.45) or a levonorgestrel intrauterine device (RR 1.59, 95% CI 1.46-1.73) were associated with increased risks.<bold>Conclusions: </bold>This study did not find any association between use of COCs, which is the dominating HC in first time users, and depression. Non-oral products were associated with increased risks. Residual confounding must be addressed in the interpretation of the results.<bold>Tweetable Abstract: </bold>There is no association between combined hormonal contraceptives and depression.
- Subjects
SWEDEN; ANTIDEPRESSANTS; ORAL contraceptives; MENTAL depression; PROGESTATIONAL hormones; LONGITUDINAL method
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2022, Vol 129, Issue 6, p917
- ISSN
1470-0328
- Publication type
Journal Article
- DOI
10.1111/1471-0528.17028