title: Oral contraceptive use and psychiatric disorders in a nationally representative sample of women.
abstract: The purpose of this study is to examine the association between oral contraceptive use (any current use, duration, and type) and major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) in a nationally representative sample of women in the USA. Data were drawn from 1,105 women aged 20-39 in the National Health and Nutrition Examination Surveys from 1999 to 2004. The associations between self-reported use of oral contraceptives in the past year and DSM-IV diagnosed and subthreshold MDD, GAD, and PD in the past year were assessed comparing oral contraceptive users to all non-users, former users, and former long-term users. Women using oral contraceptives had a lower past-year prevalence of all disorders assessed, other than subthreshold MDD. When adjusted for confounders, women using oral contraceptives in the past year had significantly lower odds of subthreshold PD, compared to former users (odds ratio (OR) = 0.34, 95 % CI 0.14-0.84). Effects estimates were strongest for monophasic (versus multiphasic) oral contraceptive users. Hormonal contraceptive use was associated with reduced risk of subthreshold PD. A potential mental health benefit of hormonal contraceptives has substantial public health implications; prospective longitudinal studies are needed to confirm whether hormonal contraceptive use improves mental health.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA, kc2497@columbia.edu.
authors.forename: Keely
authors.initials: K
authors.lastname: Cheslack-Postava
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Keyes
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Lowe
authors.forename: Karestan C
authors.initials: KC
authors.lastname: Koenen
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000139:chemically induced / Q000453:epidemiology* / Q000523:psychology; D003276:Contraceptives, Oral / Q000008:administration & dosage / Q000009:adverse effects*; D003865:Major Depressive Disorder / Q000139:chemically induced / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005006:Ethnicity; D005260:Female; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016584:Panic Disorder / Q000139:chemically induced / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D003276:Contraceptives, Oral
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