Margot Morssinkhof

OC, depressive and insomnia symptoms in adult women with and without depression 55 p=0.83; Table 2.2). OC use was not associated with higher atypical depressive sub-scores in both the unadjusted and adjusted model. Furthermore, measurements during OC use did not show a significantly different prevalence of MDD diagnoses in comparison to the NC measurements in the adjusted model (Odds Ratio (OR)=0.99, 95% CI=(0.77, 1.27), p=0.93; Table 2.2). Prevalence of dysthymia diagnoses also did not differ significantly between OC and NC measurements (adjusted model: OR=0.65, 95% CI=(0.32, 1.27), p=0.21; Table 2.2). The full model results are displayed in Table 2.2, and scores and estimates per depression group are visualized in Figure 2.2. 3.3. Current oral contraceptive status and insomnia We observed a higher WHI-IRS score during OC use in the unadjusted model, although this difference was not significant. The adjusted model, which included adjustments for age, country of birth and education resulted in a significant difference between OC and NC measurements of 0.54 points (B=0.54, 95% CI=(0.17, 0.91), p=0.004; Table 2.2). The Cohen’s d effect size of the difference in WHI-IRS score was 0.12, meaning the effect size for the association between OC use and insomnia symptoms is small (Cohen, 1998). The results are summarized in Table 2.2, and the scores per depression group are displayed in Figure 2.2. 3.4. Moderation through history of depressive disorder To assess whether vulnerability for depressive disorder (MDD and/or dysthymia) moderates the relationship between OC status and severity of depressive symptoms or insomnia symptoms, an analysis was conducted which incorporated depression group in interaction with OC status. There was no significant interaction effect of OC status X remitted depression on IDS scores (B=-0.005, 95% CI=(-1.89, 1.78), p=0.96), nor on atypical depression scores (B=-0.40, 95% CI=(-1.20, 0.40), p=0.32) or WHI-IRS scores (B=-0.34, 95% CI=(-1.17, 0.48), p=0.41). Similarly, no significant interaction effect of OC status X current depression was found on IDS scores (B=-0.59, 95% CI=(-2.52, 1.34), p=0.55), atypical depression scores (B=-0.22, 95% CI= (-1.07, 0.63), p=0.61) or WHI-IRS scores (B=-0.54, 95% CI=(-1.42, 0.34), p=0.23).

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