Dissertation/Thesis Abstract

The influence of adverse psychological conditions on oral contraceptive-attributed side effects and discontinuation in minority adolescent and young adult women
by Hall, Kelli Stidham, Ph.D., Columbia University, 2010, 213; 3420874
Abstract (Summary)

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.

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.

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).

Depressed mood, stress, ED symptoms may increase the risk of OC discontinuation in young, minority women. Further investigation is needed to determine the impact of these psychological influences, along with OC-attributed mood and weight symptoms, on OC use. Ultimately, improved understanding of contributing factors to poor contraceptive behavior can promote positive family planning outcomes.

Indexing (document details)
Advisor: Reame, Nancy King
School: Columbia University
School Location: United States -- New York
Source: DAI-B 71/09, Dissertation Abstracts International
Subjects: Nursing, Public health
Keywords: Adverse psychological conditions, Depressed mood, Eating disorders, Minority adolescent, Oral contraceptives, Reproductive health, Side effects, Young adult women
Publication Number: 3420874
ISBN: 978-1-124-18572-9
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