Young Elizabeth A, Kornstein Susan G, Harvey Anne T, Wisniewski Stephen R, Barkin Jennifer, Fava Maurizio, Trivedi Madhukar H, Rush A John
Department of Psychiatry and Molecular and Behavioral Neurosciences Institute, University of Michigan, MBNI, 205 Zina Pitcher place, Ann Arbor, MI 48109-0720, and Massachusetts General Hospital, Boston 02114, USA.
Psychoneuroendocrinology. 2007 Aug;32(7):843-53. doi: 10.1016/j.psyneuen.2007.05.013. Epub 2007 Jul 16.
Hormone-based contraceptives affect mood in healthy women or in women with premenstrual dysphoric disorder (PMDD). No study has yet examined their association with mood in women with major depressive disorder (MDD). The purpose of this study was to determine whether estrogen-progestin combination or progestin-only contraceptives are associated with depression severity, function and quality of life, or general medical or psychiatric comorbidity in women with MDD.
This analysis focused on a large population of female outpatients less than 40 years of age with non-psychotic MDD who were treated in 18 primary and 23 psychiatric care settings across the US, using data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Baseline demographic and clinical information was gathered and compared between three groups based on hormonal use: combination (estrogen-progestin)(N=232), progestin-only (N=58), and no hormone treatment (N=948).
Caucasians were significantly more likely to use combined hormone contraception. Women on progestin-only had significantly more general medical comorbidities; greater hypersomnia, weight gain and gastrointestinal symptoms; and worse physical functioning than women in either of the other groups. Those on combined hormone contraception were significantly less depressed than those with no hormone treatment by the 16-item Quick Inventory of Depressive Symptomatology-Self-Rated. The combined hormone group also demonstrated better physical functioning and less obsessive-compulsive disorder (COCD) comorbidity than either of the other groups.
Synthetic estrogen and progestins may influence depressive and physical symptoms in depressed women.
基于激素的避孕药会影响健康女性或患有经前烦躁障碍（PMDD）的女性的情绪。尚无研究探讨其与重度抑郁症（MDD）女性情绪的关联。本研究的目的是确定雌激素 - 孕激素联合避孕药或仅含孕激素的避孕药是否与MDD女性的抑郁严重程度、功能和生活质量，或一般医学或精神共病有关。
本分析聚焦于美国18个初级医疗机构和23个精神科护理机构中接受治疗的大量年龄小于40岁、患有非精神病性MDD的女性门诊患者，使用缓解抑郁的序贯治疗方案（STAR*D）研究的数据。收集了基线人口统计学和临床信息，并在基于激素使用情况划分的三组之间进行比较：联合用药组（雌激素 - 孕激素）（N = 232）、仅用孕激素组（N = 58）和未接受激素治疗组（N = 948）。
白人使用联合激素避孕的可能性显著更高。仅用孕激素的女性有更多的一般医学共病；更严重的嗜睡、体重增加和胃肠道症状；并且身体功能比其他两组中的任何一组女性都更差。根据16项抑郁症状快速自评量表，联合激素避孕组女性的抑郁程度明显低于未接受激素治疗的女性。联合激素组在身体功能方面也表现更好，并且与其他两组相比，强迫症（COCD）共病更少。
合成雌激素和孕激素可能会影响抑郁女性的抑郁和身体症状。
