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To evaluate whether levonorgestrel intrauterine devices (LNG-IUD) or oral contraceptive pills (OCPs) users are more likely to have a positive depression screen after 12 months of use compared to copper IUD users.
We conducted a secondary analysis of the Contraceptive CHOICE Project of LNG-IUD, OCP, and copper IUD users. Participants completed the Center for Epidemiologic Studies Depression Scale (CESD-10) at baseline and at 12 months. We examined differences in participant characteristics, depression/anxiety history, and CESD-10 scores between method groups using chi-square test, and used Poisson regression to assess factors associated with a positive depression screen (CESD-10 score ≥10) at 12 months.
At enrollment, 5,217 initiated an IUD or OCPs. At 12 months, 3,882 participants were still using their method and were included in this analysis. LNG-IUD users were more likely to have a positive depression screen at baseline, followed by copper IUD and OCP users (22.1% vs. 20.1% vs. 17.1%, p=0.04). After adjusting for positive depression screen at baseline, history of depression or anxiety, and parity, LNG-IUD and OCP users were no more likely to have a positive depression screen at 12 months compared with copper IUD users (Rradj 1.02; 95% CI, 0.87–1.18; Rradj 0.93, 0.72–1.19, respectively). The proportion of patients discontinuing their method prior to 12 months due to worsening mood did not differ between method groups (range, 2.2–4.9%; p=0.31).
Among individuals using contraception for 12 months, those initiating a LNG-IUD or OCPs were no more likely to screen positive for depression at 12 months compared to copper IUD users.
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