Observational studyBMJ open2021
Population heterogeneity in associations between hormonal contraception and antidepressant use in Sweden: a prospective cohort study applying intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).
Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Influence of mental health conditions and symptoms on contraceptive use among adolescent girls and young women: a scoping review.Frontiers in reproductive health · 2025Pooled it
- Assessing the impact of contraceptive use on mental health among women of reproductive age - a systematic review.BMC pregnancy and childbirth · 2024Pooled it
- Identifying psychiatric comorbidities that occur following the introduction of hormonal contraception: a scoping review.Frontiers in psychiatry · 2026Review
- Exploring Somali-born women's experiences with contraceptive services in Sweden through a reproductive justice lens.Sexual and reproductive health matters · 2025Article
- Research Review: Are sampling biases masking long-term effects of hormonal contraceptive use in adolescence on risk for depression?Journal of child psychology and psychiatry, and allied disciplines · 2025Review
- Geographic and socioeconomic differences in potentially inappropriate medication among older adults - applying a simplified analysis of individual heterogeneity and discriminatory accuracy (AIHDA) for basic comparisons of healthcare quality.BMC health services research · 2025Article
- Leveraging research into sex differences and steroid hormones to improve brain health.Nature reviews. Endocrinology · 2025Review
- A tutorial for conducting intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).SSM - population health · 2024Article
- Article
- Socioeconomic conditions and children's mental health and quality of life during the COVID-19 pandemic: An intersectional analysis.SSM - population health · 2023Article
- The effects of social determinants on children's health outcomes in Bangladesh slums through an intersectionality lens: An application of multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).PLOS global public health · 2023Article
- Article
- Oral Contraceptives and the Risk of Psychiatric Side Effects: A Review.Complex psychiatryReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesFrom a reproductive justice framework, we aimed to investigate how a possible association between hormonal contraceptive (HC) and antidepressants use (as a proxy for depression) is distributed across intersectional strata in the population. We aimed to visualise how intersecting power dynamics may operate in combination with HC use to increase or decrease subsequent use of antidepressants. Our main hypothesis was that the previously observed association between HC and antidepressants use would vary between strata, being more pronounced in more oppressed intersectional contexts. For this purpose, we applied an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy approach.
designObservational prospective cohort study using record linkage of national Swedish registers.
settingThe population of Sweden.
participantsAll 915 954 women aged 12-30 residing in Sweden 2010, without a recent pregnancy and alive during the individual 1-year follow-up. PRIMARY OUTCOME MEASURE: Use of any antidepressant, meaning being dispensed at least one antidepressant (ATC: N06A) during follow-up.
resultsPreviously mentally healthy HC users had an OR of 1.79 for use of antidepressants compared with non-users, whereas this number was 1.28 for women with previous mental health issues. The highest antidepressant use were uniformly found in strata with previous mental health issues, with highest usage in women aged 24-30 with no immigrant background, low income and HC use (51.4%). The largest difference in antidepressant use between HC users and non-users was found in teenagers, and in adult women of immigrant background with low income. Of the total individual variance in the latent propensity of using antidepressant 9.01% (healthy) and 8.16% (with previous mental health issues) was found at the intersectional stratum level.
conclusionsOur study suggests teenagers and women with immigrant background and low income could be more sensitive to mood effects of HC, a heterogeneity important to consider moving forward.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.