Oral contraceptive use and psychiatric disorders in a nationally representative sample of women

Abstract

The purpose of this study is to examine the association between oral contraceptive use (any current use, duration, and type) and major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) in a nationally representative sample of women in the USA. Data were drawn from 1,105 women aged 20–39 in the National Health and Nutrition Examination Surveys from 1999 to 2004. The associations between self-reported use of oral contraceptives in the past year and DSM-IV diagnosed and subthreshold MDD, GAD, and PD in the past year were assessed comparing oral contraceptive users to all non-users, former users, and former long-term users. Women using oral contraceptives had a lower past-year prevalence of all disorders assessed, other than subthreshold MDD. When adjusted for confounders, women using oral contraceptives in the past year had significantly lower odds of subthreshold PD, compared to former users (odds ratio (OR) = 0.34, 95 % CI 0.14–0.84). Effects estimates were strongest for monophasic (versus multiphasic) oral contraceptive users. Hormonal contraceptive use was associated with reduced risk of subthreshold PD. A potential mental health benefit of hormonal contraceptives has substantial public health implications; prospective longitudinal studies are needed to confirm whether hormonal contraceptive use improves mental health.

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Acknowledgments

The authors would like to acknowledge Michelle Haloossim for the literature review and writing assistance and Kirstin H. Heinrich for the assistance with literature review and figure preparation. At the time of manuscript preparation, Ms. Haloossim was a student in the Department of Sociomedical Sciences and Ms. Heinrich was a student in the Department of Epidemiology at the Columbia University Mailman School of Public Health. Funding for this study was provided by the National Institute of Mental Health (2-T32-MH-13043 to KCP and SRL and K01-AA021511 to KMK).

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The authors declare that they have no conflicts of interest.

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Correspondence to Keely Cheslack-Postava.

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Cheslack-Postava, K., Keyes, K.M., Lowe, S.R. et al. Oral contraceptive use and psychiatric disorders in a nationally representative sample of women. Arch Womens Ment Health 18, 103–111 (2015). https://doi.org/10.1007/s00737-014-0453-4

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Keywords

  • Generalized anxiety disorder
  • Hormonal contraceptives
  • Major depressive disorder
  • Oral contraceptives
  • Panic disorder