Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
Department of Economics, Stockholm School of Economics, Stockholm, Sweden.
Fertil Steril. 2017 May;107(5):1238-1245. doi: 10.1016/j.fertnstert.2017.02.120. Epub 2017 Apr 19.
To determine whether there is a causal effect of oral contraceptive (OC) treatment on general well-being and depressed mood in healthy women.
Double-blind, randomized, and placebo-controlled trial.
University hospital.
PATIENT(S): Three hundred and forty healthy women aged 18-35 years randomized to treatment, of whom 332 completed the data collection at follow-up evaluation.
INTERVENTION(S): A combined OC (150 μg levonorgestrel and 30 μg ethinylestradiol) or placebo for 3 months of treatment.
MAIN OUTCOME MEASURE(S): Primary outcome measures: global score of Psychological General Well-Being Index (PGWBI) and the Beck Depression Inventory (BDI); secondary outcome measures: six separate dimensions of the PGWBI.
RESULT(S): The OC treatment statistically significantly decreased general well-being compared with placebo -4.12 (95% CI, -7.18 to -1.06). Furthermore, OC decreased the following PGWBI dimensions compared with placebo: positive well-being -3.90 (95% CI, -7.78 to -0.01), self-control -6.63 (95% CI, -11.20 to -2.06), and vitality -6.84 (95% CI, -10.80 to -2.88). The effect of OC on depressive symptoms and on the PGWBI dimension depressed mood were not statistically significant.
CONCLUSION(S): This study demonstrates a statistically significant reduction in general well-being by a first-choice OC in comparison with placebo in healthy women. We found no statistically significant effects on depressive symptoms. A reduction in general well-being should be of clinical importance.
确定口服避孕药(OC)治疗对健康女性的整体幸福感和抑郁情绪是否有因果影响。
双盲、随机、安慰剂对照试验。
大学医院。
340 名年龄在 18-35 岁的健康女性随机分组接受治疗,其中 332 名在随访评估时完成了数据收集。
连续服用 3 个月的复方 OC(150μg 左炔诺孕酮和 30μg 炔雌醇)或安慰剂。
主要观察指标:心理综合健康指数(PGWBI)和贝克抑郁量表(BDI)的总体评分;次要观察指标:PGWBI 的六个单独维度。
OC 治疗与安慰剂相比,整体幸福感显著下降-4.12(95%置信区间,-7.18 至-1.06)。此外,OC 与安慰剂相比,以下 PGWBI 维度下降:积极幸福感-3.90(95%置信区间,-7.78 至-0.01)、自我控制-6.63(95%置信区间,-11.20 至-2.06)和活力-6.84(95%置信区间,-10.80 至-2.88)。OC 对抑郁症状和 PGWBI 维度抑郁情绪的影响没有统计学意义。
与安慰剂相比,本研究表明首选 OC 可显著降低健康女性的整体幸福感。我们未发现 OC 对抑郁症状有统计学显著影响。幸福感下降应具有临床重要意义。