关键词:
Reproductive health
Adverse psychological conditions
Side effects
Minority adolescent
Young adult women
Oral contraceptives
Depressed mood
Eating disorders
摘要:
Oral contraceptive (OC) discontinuation leading to unwanted pregnancy is a serious maternal-child health problem, particularly for young, minority women. Depressed mood, stress and eating disordered (ED) symptoms contribute to risky sex and medication misuse, but how these adverse psychological conditions influence OC-attributed symptoms and use is unknown.@pqdt@break@A prospective study of the associations among depressed mood (Center for Epidemiologic Studies-Depression Screen), perceived stress (Perceived Stress Scale-10), and ED symptoms (Eating Disorder Screen for Primary Care) and OC mood and weight changes and discontinuation was conducted among family planning patients participating in an OC continuation intervention trial. Data from interview-administered questionnaires (baseline and 6-month) with 354 adolescents and young adults (ages 13-24 years) were analyzed with multiple logistic regression.@pqdt@break@Baseline rates of elevated depressed mood, stress, and ED symptoms were 21% (n=73), 19% (n=67), and 24% (n=60), respectively. The 6-month OC discontinuation rate was 62% (n=218). Twenty-five percent of participants (n=87) reported mood changes and 57% (n=200) reported weight changes at 6 months. Subjects with high depressed mood scores at baseline were over twice as likely to report both mood (CI 1.30---4.07, p=.004) and weight changes (yes/no) at 6-months (OR 2.14, CI 1.20---3.80, P=.01) than low scoring participants. Participants with high baseline depressed mood (OR .54, CI .29---.99, p=.05), stress (OR .48, CI .25---.91, p=.03) and ED symptom scores (OR .49, CI .25---.97, p=.04) were less likely to continue OCs at 6-months. Participants reporting weight, but not mood, changes were at increased risk for OC discontinuation (OR .60, CI .38---.94, p=.03). Adolescents were similar to young adults except for lower baseline stress scores (mean difference 2.06, p=.003).@pqdt@break@Depressed mood, stress, ED symptoms may increase the risk of OC discontinuatio