对口服避孕药的使用和抑郁症风险的基于人口的队列研究
T Johansson1,2, S Vinther Larsen3,4, M Bui5
1Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
Epidemiology and psychiatric sciences
|June 12, 2023
概括
口服避孕药 (OC) 的使用,特别是在前两年和青春期,与抑郁症的风险增加有关. 这项研究表明存在因果关系,强调需要仔细考虑OC使用和心理健康.
科学领域:
- 生殖健康 生殖健康
- 心理健康研究 心理健康研究
- 流行病学 流行病学
背景情况:
- 关于口服避孕药 (OC) 使用与成人女性抑郁风险之间的关联存在不一致的发现.
- 健康使用者偏见,源于由于不良情绪影响而停止OCs的女性被排除在外,可能导致研究结果不一致.
- 以前的研究还没有完全解决OCs的开始或与OC使用相关的终身抑郁症风险.
研究的目的:
- 估计与开始使用口服避孕药 (OC) 相关的抑郁风险.
- 确定OC使用对终身抑郁风险的影响.
- 调查潜在的健康用户偏见和OC-抑郁关系中的家族混.
主要方法:
- 基于人口的队列研究,利用英国生物银行264,557名妇女的数据.
- 通过采访,住院医院记录和初级保健数据评估的抑郁症发病率.
- 多变量考克斯回归与时间变化的暴露用于OC使用和兄弟对分析以验证因果关系.
主要成果:
- 首两年使用OC与71%更高的抑郁率有关 (HR=1.71,95% CI:1.55-1.88).
- 曾经使用过OC显示了抑郁症的终身风险增加 (HR=1.05,95% CI:1.01-1.09),青少年使用OC导致这种危险 (HR=1.18,95% CI:1.12-1.25).
- 兄弟分析支持OC使用对抑郁风险的因果关系,而在以前使用过OC的成年用户中没有发现显著的关联 (HR=1.00,95% CI:0.95-1.04).
结论:
- 口服避孕药 (OC) 的使用,特别是在前两年和青春期,会增加抑郁症的风险.
- 研究结果表明,OC使用和抑郁症之间存在因果关系,强调需要考虑健康的用户偏见和家庭层面的混.
- 医疗保健提供者和患者应该意识到与OCs相关的潜在抑郁风险,并进行个性化风险效益评估.
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