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Use of hormonal contraception and attempted suicide: a nested case-control study

Published online by Cambridge University Press:  01 September 2022

E. Toffol ,
T. Partonen ,
A. Latvala ,
A. But ,
O. Heikinheimo  and
J. Haukka
E. Toffol*
Affiliation:
University of Helsinki, Department Of Public Health, Helsinki, Finland
T. Partonen
Affiliation:
Finnish Institute for Health and Welfare, Department Of Public Health And Welfare, Helsinki, Finland
A. Latvala
Affiliation:
University of Helsinki, Institute Of Criminology And Legal Policy, Helsinki, Finland
A. But
Affiliation:
University of Helsinki, Department Of Public Health, Helsinki, Finland
O. Heikinheimo
Affiliation:
University of Helsinki and Helsinki University Hospital, Department Of Obstetrics And Gynaecology, Helsinki, Finland
J. Haukka
Affiliation:
University of Helsinki, Department Of Public Health, Helsinki, Finland
*
*Corresponding author.

Abstract

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Introduction

In Finland more than 40% of fertile aged women used some type of hormonal contraception (HC) in the period 2010-2013. A proportion of women using HC complains of side effects, including mood symptoms. The relationship between the use of HC and the risk of attempted suicide (AS) is still a matter of debate.

Objectives

To assess the association of the use of HC with the risk of AS during 2017-2019.

Methods

Data were retrieved from the Prescription Centre, Care Register of Health Care, Register of Primary Health Care Visits and Statistics Finland. A total of 587 823 women, aged 15-49 years, using and not using HC in 2017 were analysed in the initial incidence study. All incident AS cases during 2018-2019, and their 4:1 age-matched controls (1 174 346 person-years) were analysed in a nested case-control setting via conditional logistic regression models.

Results

Altogether 818 AS cases occurred during the follow-up (incidence rate: 0.70/1000 person-years, 95% CI 0.65–0.75), with an IRR of HC vs. no-HC use of 0.73 (0.63–0.83). Current use (in the 180 days before the event) of estradiol- or ethinylestradiol-containing HC was associated with a lower risk of AS (0.53, 0.33–0.87; 0.49, 0.37–0.64, respectively) compared to non-use of HC. After controlling for covariates (marital and socioeconomic status, education level, use of psychotropic medications), only current use of HC containing ethinylestradiol remained significant (0.39, 0.23–0.65).

Conclusions

A lower risk of AS is associated with the use of HC, and specifically of ethinylestradiol-containing HC.

Disclosure

No significant relationships.

Keywords

hormonal contraceptionnested-case controlwomenattempted suicide
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S122 - S123
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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