Incidence of depressive symptoms in users of the oral contraceptive

Abstract

Evidence is presented that the incidence of depression among users of oral contraceptives is no higher than that among matched controls not taking such medication. There is an association between high depression scores and high neuroticism scores, more marked in controls than takers. Intensity of depression is related more to age, personality and occupation than to the use of oral contraceptives. A higher proportion of users than of controls experience sexual satisfaction. Past takers include a large number of individuals with a high neuroticism score. The incidence of depression symptoms in women increases with age. A higher proportion of housewives than of women going out to full-time work show depressive symptoms.

PIP: The incidence of depression was found to be unrelated to the use of oral contraceptives in this study, which used controlled samples and defined criteria for measuring depression. The survey, conducted in the general practice of one of the authors, was based on the population of a predominantly working class area and used the technique of the Royal College of General Practitioners Oral Contraceptives Study. 335 women currently taking oral contraceptives, mostly combined pills, were matched for age with 2 groups of controls: 172 past takers and 179 non-takers. 3 questionnaires were used: 1) information about the patient's current menstrual history, medical and psychiatric state, 2) a depression rating scale with scores 0-6 indicating virtual absence of depression, 7-12 mild depressive symptoms, and 13+ depressive illness, and 3) The Eysenck Personality Inventory, used to gauge levels of neuroticism. The following results were obtained. 1) the depression scores of non-takers and takers were similar, those of past takers higher; 2) takers and non-takers displayed similar neuroticism scores, while past takers had a smaller percentage of low-neuroticism scores, but higher percentages of scores above 11; and 3) 20% of takers, 22% of non-takers, and 29% of past takers reported diminished libido. An examination of depressive symptoms and certain social and personal factors revealed a positive relationship, which was unaffected by the use of oral contraceptives. Depressive symptoms increased with age in all groups, but particularly in the controls; depression scores in all groups remained unchanged during the premenstrual stage; and depression was more pronounced the higher the number of children and less pronounced in women going out to work. A comparison of neuroticism and depression scores showed a disproportion in controls with high depression and neuroticism scores; neurotic women produce more depressive symptoms and presumably blame them on the pill. 6 tables, 3 figures, and 2 appendices accompany this article.