Oral contraceptives and risk of depression in women

Abstract

Topic Overview: Use of oral contraceptives (OCs) is increasing worldwide. These have various side effects including effects on mood to various extents as proved by research. This dissertation aims to investigate the correlation, if any, between OCs and depression. Depression rates have also been rising in recent years and investigating this correlation will help to establish evidence-based practice (EBP) in this regard. Research Question and PICO Elements: Does the use of OCs affect the risk of depression in women? The population (P) consisted of women. The intervention (I) comprised use of oral contraception (OC) whereas the comparison (C) comprised no use of OC. The outcome (O) was depression. Method: A systematic search for research studies was performed via online databases. Inclusion and exclusion criteria were applied to obtain relevant articles. Inclusion criteria consisted of study designs such as cross-sectional studies, case-control studies, cohort studies, randomised controlled trials (RCTs), meta-analyses and systematic reviews. Additional inclusion criteria included women of child-bearing age, use of OCs as the main intervention, presence of a control group, depression as a main outcome, articles published since 2012, articles published in English and peer-reviewed articles. The literature search yielded five relevant articles of which two were RCTs, two were cohort studies and one was a cross-sectional study. These were critically appraised and ethical issues were properly considered. Results: The studies produced inconsistent results such that an answer to the PICO question could not be drawn upon the available literature. The studies also had various limitations which further contributed to this. However, other conclusions were drawn upon the available literature. Recommendations: Further research locally and globally must be conducted in this regard to ascertain EBP. Recommendations for practice mainly consist of encouraging doctors to take a proper patient history prior to prescribing OCs and also to schedule follow-up appointments to monitor any side effects which may develop.