Department of Psychology, University of British Columbia, Vancouver, Canada.
Leibniz-Institut für Wissensmedien, Tübingen, Germany.
BMC Womens Health. 2022 Feb 23;22(1):48. doi: 10.1186/s12905-022-01623-2.
The incidence of depression in human females rises steadily throughout adolescence, a critical period of pubertal maturation marked by increasing levels of gonadal hormones including estrogens and progesterone. These gonadal hormones play a central role in social and emotional development and may also contribute to the increased occurrence of depression in females that begins in early adolescence. In this study, we examine whether and how introducing synthetic estrogen and progestin derivatives through the use of combined hormonal contraceptives (CHC), affects adolescent females' risk for developing depression. We further assess potential links between CHC use and alterations in stress responses and social-emotional functioning.
Using a longitudinal cohort design, we will follow a sample of adolescent females over the span of three years. Participants will be assessed at three time points: once when they are between 13 and 15 years of age, and at approximately 18 and 36 months after their initial assessment. Each time point will consist of two online sessions during which participants will complete a clinical interview that screens for key symptoms of mental health disorders, along with a series of questionnaires assessing their level of depressive symptoms and history of contraceptive use. They will also complete a standardized social-evaluative stress test and an emotion recognition task, as well as provide saliva samples to allow for assessment of their circulating free cortisol levels.
In this study we will assess the effect of CHC use during adolescence on development of Major Depressive Disorder (MDD). We will control for variables previously found to or proposed to partially account for the observed relationship between CHC use and MDD, including socioeconomic status, age of sexual debut, and CHC-related variables including age of first use, reasons for use, and its duration. In particular, we will discover whether CHC use increases depressive symptoms and/or MDD, whether elevated depressive symptoms and/or MDD predict a higher likelihood of starting CHC, or both. Furthermore, this study will allow us to clarify whether alterations in stress reactivity and social-emotional functioning serve as pathways through which CHC use may result in increased risk of depressive symptoms and/or MDD.
女性在青春期的抑郁发病率稳步上升，青春期是生殖成熟的关键时期，其特征是包括雌激素和孕激素在内的性腺激素水平不断升高。这些性腺激素在社会和情感发展中起着核心作用，也可能导致女性在青春期早期抑郁发病率增加。在这项研究中，我们研究了通过使用复方激素避孕药（CHC）引入合成雌激素和孕激素衍生物是否以及如何影响青春期女性患抑郁症的风险。我们进一步评估了 CHC 使用与应激反应和社会情感功能改变之间的潜在联系。
使用纵向队列设计，我们将在三年内跟踪一组青春期女性。参与者将在三个时间点进行评估：一次是在他们 13 至 15 岁之间，以及在初始评估后大约 18 个月和 36 个月。每个时间点将包括两次在线会议，在此期间，参与者将完成一次临床访谈，以筛选出精神健康障碍的关键症状，以及一系列评估其抑郁症状水平和避孕史的问卷。他们还将完成标准化的社会评价应激测试和情绪识别任务，并提供唾液样本以评估其循环游离皮质醇水平。
在这项研究中，我们将评估青春期使用 CHC 对重度抑郁症（MDD）发展的影响。我们将控制以前发现或提出的部分解释 CHC 使用与 MDD 之间关系的变量，包括社会经济地位、性初潮年龄以及与 CHC 相关的变量，包括首次使用年龄、使用原因和使用时间。特别是，我们将发现 CHC 使用是否增加抑郁症状和/或 MDD，抑郁症状和/或 MDD 是否预测更高的开始使用 CHC 的可能性，或者两者兼而有之。此外，这项研究将使我们能够澄清应激反应和社会情感功能的改变是否是 CHC 使用导致抑郁症状和/或 MDD 风险增加的途径。
