Depo-Provera and Mood in Adolescence: A Pilot Study

Abstract

<h3>Background</h3> Some reports suggest that the use of depot medroxyprogesterone acetate (DMPA or Depo-Provera) as a contraceptive agent may be associated with an increase in depression. Few studies have used standardized instruments to measure changes in mood, especially depression, in adolescents. The purpose of this study is to invesugate mood changes, using standardized questionnaires, in adolescents on Depo-Provera as a contraceptive agent. <h3>Methods</h3> 22 adolescent females aged 15–21 years choosing Depo-Provera as a method of contraception were enrolled as subjects and 20 adolescents in the same age group coming to an adolescent clinic for well or sick visits, who were not on any hormonal contraception, were enrolled as controls. Females with a history of psychiatric illness requiring hospitalization or psychotropic medication, were excluded. At baseline the Beck Depression Inventory (BDI) was administered, demographic profile obtained and Body Mass Index (BMI) calculated for both subjects and controls. Subsequently the BDI was re-administered at 3, 6, and 12 months after the first visit. Baseline BDIs, BMIs and demographics were compared between subjects and controls using two-sample t-tests. The mean changes from baseline BDI scores at 3,6, and 12 months were evaluated using paired t-tests for subjects and controls separately. (BDI scores: 0.9 = normal:10–16 = mild; 17–29 = moderate: 30–63 = severe depression) <h3>Results</h3> The mean BDI scores for subjects and controls at baseline were 12.5 and 7.1 respectively (p–=–0.06). The mean change in BDI scores from baseline to one year in those who completed 1 year data was + 0.5 for controls and −12.3 in subjects. with the latter decrease being statistically significant (p=0.013). The mean change in BDI scores from baseline to 3 or 6 months was not statistically significantly different in either subjects or controls. There was no significant difference between subjects and controls considering age. ethnicity, school attendance. employment status. parity and BMIs. However patients were more likely to be sexually active (p=0.001), and also perfonn worse in school than controls (p=0.009). <h3>Conclusion</h3> Adolescents using Depo-Provera for contraception do not get depressed on this contraceptive agent. On the contrary, those who were mildly or moderately depressed at baseline show an apparent improvement as measured by the Beck Depression Inventory.