Oral contraceptive use and psychiatric disorders in a nationally representative sample of women
Oral contraceptive use and psychiatric disorders in a nationally representative sample of women
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DOI：
10.1007/s00737-014-0453-4
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发表时间：
2015-02-01
影响因子：
4.5
通讯作者：
Koenen, Karestan C.
中科院分区：
文献类型：
--
作者：
Cheslack-Postava, Keely;Keyes, Katherine M.;Koenen, Karestan C.
这项研究的目的是在具有全国代表性的美国妇女样本中检查口服避孕药使用(任何当前使用、持续时间和类型)与严重抑郁障碍(MDD)、广泛性焦虑症(GAD)和恐慌症(PD)之间的关系。数据来自1999年至2004年全国健康和营养检查调查中年龄在20-39岁之间的1105名妇女。过去一年自我报告的口服避孕药的使用与DSM-IV诊断和过去一年的阈值下MDD、GAD和PD之间的关联被评估为比较口服避孕药使用者与所有非使用者、以前的使用者和以前的长期使用者之间的关系。除阈值以下MDD外，使用口服避孕药的女性在过去一年中所有被评估的疾病的患病率都较低。在调整混杂因素后，过去一年使用口服避孕药的妇女与以前使用过避孕药的妇女相比，发生阈值下帕金森病的几率显著降低(优势比(OR)=0.34，95%可信区间0.14-0.84)。对单相(与多相)口服避孕药使用者的效果估计最强。激素避孕药的使用与降低阈值下帕金森病的风险有关。荷尔蒙避孕药的潜在心理健康益处具有重大的公共卫生影响；需要前瞻性的纵向研究来证实激素避孕药的使用是否改善了心理健康。
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.