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Association Between Oral Contraceptive Use and Depressive Symptoms Reported in Adolescent Girls

Oral contraceptives are widely taken by young women, with many taking their first pill as a teen. A previous study in JAMA Psychiatry reported no correlation between oral contraceptive use and depressive symptom severity in 16-25-year-old women as a population; however, they did notice higher depressive symptom severity amongst 16-year-old girls specifically. This study carried out at the Brigham and Women’s Hospital and University Center Groningen (UMCG), Groningen, the Netherlands, and Leiden university Medical Center, Leiden, the Netherlands, sought to investigate this association further.

Dr Anouk de Wit and her colleagues at the UMCG examined the Tracking Adolescent’s Individual Lives Survey (TRAILS); a prospective longitudinal study involving 1,010 participants aged 16-25. Depressive symptoms were measured in a survey containing questions about self-harm, sadness, crying, and lack of pleasure, of which their responses created a depressive symptom severity score. In agreement with the JAMA Psychiatry paper, the only association of note was with 16-year-old participants taking oral contraceptives, who achieved depressive severity scores 21% higher on average than those not taking contraceptives. Though depressive symptoms are more subtle than diagnosed clinical depression, these girls reported increased behaviours such as crying and sleeping in comparison to their teenage counterparts. Co-author Dr Hadine Joffe, vice-chair for Psychiatry Research at the UMCG and executive director of the Connors Center for Women’s Health and Gender Biology notes that “depressive symptoms are more prevalent than clinical depression and can have a profound impact on quality of life.”

Although Dr Joffe and Dr de Wit realise the link between adolescent girls and depressive symptoms is not large, both deem it significant enough for parents and health care professionals to be aware of these symptoms which may demonstrate in young girls; already a vulnerable population. Depressive symptoms occur far more frequently than depressive episodes and so de Wit notes that “one of the most common concerns women have when starting the pill, and teens and their parents have when an adolescent is considering taking the pill, is about immediate depressive risks.”

In the future, as well as monitoring oral contraceptive-taking adolescents, the authors would like to see alternative forms of birth control such as long-acting reversible contraceptives to be investigated for a depressive symptom association.