A recent study by researchers at Brigham and Women’s Hospital and University Medical Center Groningen (UMCG) and Leiden University Medical Center in the Netherlands has provided new insight into whether there is any connection between oral contraceptive use and mood.

The study published in JAMA Psychiatry included a survey of young women about depressive symptoms, such as crying, sleeping excessively, and eating issues, which can be far subtler than diagnosed clinical depression. The investigators surveyed a cohort of more than 1,000 women from age 16 through 25 years, every three years, and collected a unique set of data about these sub-clinical symptoms.

The study demonstrated that there was no association between oral contraceptive use and severity of depressive symptom in the whole population that had been investigated. However, it was found that 16-year-old girls reported higher depressive symptom severity in comparison to 16-year-old girls not consuming birth-control pills.

The corresponding author of the study, Anouk de Wit, MD, PhD said, “One of the most common concerns women have when starting the pill, and teens and their parents have when an adolescent is considering taking the pill, is about immediate depressive risks.” De Wit now a trainee in the Department of Psychiatry at UMCG, further added, “Most women first take an oral contraceptive pill as a teen. Teens have lots of challenging emotional issues to deal with so it’s especially important to monitor how they are doing.”

According to co-author Hadine Joffe, MD, MSc, vice chair for Psychiatry Research for the Brigham’s Department of Psychiatry and executive director of the Connors Center for Women’s Health and Gender Biology, theirs is the “first study of this scale to dive deep into the more subtle mood symptoms that occur much more commonly than a depression episode but impact quality of life and are worrying to girls, women and their families.”

For this study, the researchers analyzed data from Tracking Adolescents’ Individual Lives Survey (TRAILS), a longitudinal study of teens and young adults from the Netherlands. Each female participant filled out a survey with questions about depressive symptoms, such as crying, suicidal ideation, self-harm, eating, sleeping, feelings of worthlessness and guilt, energy, sadness, and lack of pleasure. A depressive symptom severity score was generated based on the responses of those participants.

It was found that the association between oral contraceptive use and depressive symptoms may be bidirectional: birth-control pill intake may contribute to severity of symptoms, more severe symptoms may prompt teens to begin taking oral contraceptives, or both. Observational studies, such as this one, cannot however confirm the direction of causality.

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