Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
BMJ Sex Reprod Health. 2021 Jul;47(3):e8. doi: 10.1136/bmjsrh-2020-200658. Epub 2021 Jan 15.
The study aim was to establish which demographic, clinical, reproductive and psychiatric factors are associated with self-reported hormonal contraceptive (HC)-induced adverse mood symptoms.
We compiled baseline data from two Swedish studies: one cross-sectional study on combined oral contraceptive (COC)-induced adverse mood symptoms (n=118) and one randomised controlled trial on adverse mood symptoms on COC (n=184). Both included women eligible for COC use, aged over 18 years. All women answered a questionnaire on HC use and associated mood problems. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was used to capture mood and anxiety disorders. Women who acknowledged HC-induced adverse mood symptoms, ongoing or previously (n=145), were compared with women without any such experience (n=157).
Compared with women without self-reported HC-induced adverse mood symptoms, women with these symptoms were younger at HC start (adjusted odds ratio (aOR) 0.83, 95% CI 0.72 to 0.95), had more often undergone induced abortion (OR 3.36, 95% CI 1.57 to 7.23), more often suffered from an ongoing minor depressive disorder (n=12 vs n=0) and had more often experienced any previous mental health problem (aOR 1.90, 95% CI 1.01 to 3.59).
In line with previous research, this study suggests that women with previous or ongoing mental health problems and women who are younger at HC start are more likely to experience HC-induced adverse mood symptoms. Former and current mental health should be addressed at contraceptive counselling, and ongoing mental health disorders should be adequately treated.
This study adds valuable knowledge for identification of women susceptible to HC-induced adverse mood symptoms. It should facilitate the assessment of whether or not a woman has an increased risk of such symptoms, and thus enable clinicians to adopt a more personalised approach to contraceptive counselling.
本研究旨在确定哪些人口统计学、临床、生殖和精神因素与自我报告的激素避孕（HC）引起的不良情绪症状相关。
我们整合了两项瑞典研究的基线数据：一项关于联合口服避孕药（COC）引起的不良情绪症状的横断面研究（n=118）和一项关于 COC 引起的不良情绪症状的随机对照试验（n=184）。两项研究均纳入了适合使用 COC 的年龄超过 18 岁的女性。所有女性均回答了关于 HC 使用和相关情绪问题的问卷。采用迷你国际神经精神访谈（MINI）来评估情绪和焦虑障碍。将承认有 HC 引起的不良情绪症状（目前或既往）的女性（n=145）与没有任何此类经历的女性（n=157）进行比较。
与没有自我报告的 HC 引起的不良情绪症状的女性相比，有这些症状的女性开始使用 HC 的年龄更小（调整后的优势比（aOR）0.83，95%CI 0.72 至 0.95），更常经历人工流产（OR 3.36，95%CI 1.57 至 7.23），更常患有持续的轻度抑郁障碍（n=12 与 n=0），更常经历过任何既往心理健康问题（aOR 1.90，95%CI 1.01 至 3.59）。
与既往研究一致，本研究表明，有既往或持续心理健康问题的女性以及开始使用 HC 时年龄较小的女性更有可能经历 HC 引起的不良情绪症状。在避孕咨询时应解决既往和当前的心理健康问题，并且应充分治疗正在进行的心理健康障碍。
本研究为识别易受 HC 引起的不良情绪症状影响的女性提供了有价值的知识。它有助于评估女性是否有发生此类症状的风险增加，并使临床医生能够对避孕咨询采取更个性化的方法。
