Hampson Elizabeth, Abrahamson Sara N, Breddy Taylor N, Iqbal Maisha, Wolff Elena R
Laboratory of Neuroendocrinology, Department of Psychology, University of Western Ontario, London, ON, Canada.
Neuroscience Program, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada.
Front Psychol. 2024 Oct 18;15:1462891. doi: 10.3389/fpsyg.2024.1462891. eCollection 2024.
Some data suggest that increased depressive symptoms may occur in women using combined oral contraceptives (OCs). However, this idea is controversial and the existing evidence is conflicting. The present study compared negative affect in 53 healthy women ( = 19.9 years) during intervals of active daily OC hormone intake and during the washout week of the contraceptive cycle when no exogenous estrogens or progestins are used. A prospective counterbalanced repeated-measures study design was employed. Depressive affect was evaluated using standard psychometric tests of explicit (self-perceived) and implicit negative affect. Implicit measures are considered less subject to bias related to social expectations, self-awareness, or willingness to disclose. Other than their usual OCs, participants were medication-free and had been using OCs for a median of 12 mo. We found that measures of implicit affect (e.g., Affect Misattribution Procedure, Emotional Stroop Test) displayed a more depressive-like pattern of performance during active hormone intake, particularly among a subgroup of OC users who reported experiencing high levels of depressive affect more generally. In contrast, participants' self-perceptions suggested that they perceived their negative symptoms to be greater during the 'off' phase of the OC cycle, when OC steroids are withdrawn and menses occurs. The present findings reinforce the possibility of depressive mood effects associated with OC usage, and highlight the utility of including implicit measures, but also illustrate the complexity of mood assessment in OC users.
一些数据表明，使用复方口服避孕药（OCs）的女性可能会出现抑郁症状加重的情况。然而，这一观点存在争议，现有证据相互矛盾。本研究比较了53名健康女性（平均年龄19.9岁）在每日积极摄入OC激素期间以及在避孕周期的洗脱期（即不使用外源性雌激素或孕激素时）的负面情绪。采用了前瞻性平衡重复测量研究设计。使用明确（自我感知）和内隐负面情绪的标准心理测量测试来评估抑郁情绪。内隐测量被认为较少受到与社会期望、自我意识或披露意愿相关的偏差影响。除了她们常用的OCs外，参与者未服用其他药物，且使用OCs的时间中位数为12个月。我们发现，内隐情绪测量（如情感错误归因程序、情绪斯特鲁普测试）在积极摄入激素期间表现出更类似抑郁的模式，特别是在一组总体上报告经历高水平抑郁情绪的OC使用者亚组中。相比之下，参与者的自我认知表明，她们认为自己的负面症状在OC周期的“停药”阶段更大，此时OC类固醇被停用且月经来潮。本研究结果强化了与使用OCs相关的抑郁情绪影响的可能性，并突出了纳入内隐测量的效用，但也说明了OC使用者情绪评估的复杂性。
