Skip to main content

Unfortunately we don't fully support your browser. If you have the option to, please upgrade to a newer version or use Mozilla Firefox, Microsoft Edge, Google Chrome, or Safari 14 or newer. If you are unable to, and need support, please send us your feedback.

Elsevier
Publish with us
Press release

Hormonal contraceptives further increase risk for depression in young women with ADHD

Washington, DC | May 30, 2023

study(opens in new tab/window) in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that girls and young women with attention deficit hyperactivity disorder (ADHD) have a high risk of depression, which is increased with the use of oral contraceptive pills. Women aged 15-24 with ADHD had a three-fold higher risk of developing depression overall and were at least five times more at risk than their peers not affected by ADHD irrespective of oral contraceptives.

Overall, 41.9% of women with ADHD developed depression or were prescribed antidepressants during the study period, whereas, the corresponding number in women without ADHD was 10.5%. Girls and young women with ADHD had three times increased risk of developing depression compared to those without ADHD. Other independent risk factors for depression were age, education levels, parental history of mental health diagnoses or suicide, and each of the medical indications for hormonal contraceptive use-acne, dysfunctional bleeding, dysmenorrhea, endometriosis, and PCOS.

In this large nationwide Swedish register study, the researchers set out to explore potential adverse effects of hormonal contraception, including depression, that may affect adherence to user-dependent contraception and increase the risk for unplanned pregnancies and teenage birth in women with ADHD.  In this sample, 29,767 girls and young women with ADHD aged 15 to 24 years and 763,146 without ADHD provided were included through diagnostic codes for ADHD and prescription of stimulant medication, contraceptives, and antidepressant medication.

Young women have the highest risk to develop psychiatric conditions in comparison with women and men of all age groups. Unintended early pregnancies overlap with formative academic and occupational years, interfering with the economic and psychosocial life trajectory of individuals experiencing this risk factor.

It is not known if these young women are more susceptible to adverse effects of hormonal contraceptives, compared to women without ADHD. This study is important as the most tolerable contraceptive methods should be used to prevent the risk of unplanned and unwanted pregnancies in vulnerable groups such as young women with ADHD. Teenage parents are at risk for low educational attainment, welfare dependency, and becoming single parents.

In addition, their children are at increased risk for perinatal morbidity and mortality, low socioeconomic status, and low quality of life, effectively transmitting psychosocial vulnerability across generations. Other types of non-oral contraceptives (e.g. – patches, implants, injections) were not associated with an elevated risk for depression in women with ADHD. Thus, integrating information on risks with hormonal contraceptives as well as the potential benefits of long-acting reversible contraceptives in shared decision-making and contraception counseling for young women with ADHD has the potential to affect public mental health in generations to come.

---

Notes for editors

The article is "Hormonal Contraceptive Use and Risk of Depression Among Young Women With Attention-Deficit/Hyperactivity Disorder," by Cecilia Lundin, MD, PhD, Anna Wikman, PhD, Per Wikman, PhD, Helena Kopp Kallner, MD, PhD, Inger Sundstrom-Poromaa, MD, PhD, Charlotte Skoglund, MD, PhD (https://doi.org/10.1016/j.jaac.2022.07.847). It appears in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 62, issue 6 (June 2023), published by Elsevier.

Copies of this paper are available to credentialed journalists upon request; please contact Charlotte Skoglund, MD, PhD, at [email protected].

About JAACAP

Journal of the American Academy of Child and Adolescent Psychiatry(opens in new tab/window) (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

About Elsevier

As a global leader in scientific information and analytics, Elsevier helps researchers and healthcare professionals advance science and improve health outcomes for the benefit of society. We do this by facilitating insights and critical decision-making with innovative solutions based on trusted, evidence-based content and advanced AI-enabled digital technologies.

We have supported the work of our research and healthcare communities for more than 140 years. Our 9,500 employees around the world, including 2,500 technologists, are dedicated to supporting researchers, librarians, academic leaders, funders, governments, R&D-intensive companies, doctors, nurses, future healthcare professionals and educators in their critical work. Our 2,900 scientific journals and iconic reference books include the foremost titles in their fields, including Cell Press, The Lancet and Gray’s Anatomy.

Together with the Elsevier Foundation(opens in new tab/window), we work in partnership with the communities we serve to advance inclusion and diversity in science, research and healthcare in developing countries and around the world.

Elsevier is part of RELX(opens in new tab/window), a global provider of information-based analytics and decision tools for professional and business customers. For more information on our work, digital solutions and content, visit www.elsevier.com.

Contact

JEO

JAACAP Editorial Office

+1 202 587 9674

E-mail JAACAP Editorial Office