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More research needed into the pill and mood disorders

The use of the pill, in combination with genetic factors, can influence experimental psychological research in women. More research is needed into the influence of the pill on mood disorders, concludes psychologist Daniëlle Hamstra. PhD defence on 30 September.

‘By chance we had registered whether or not our test participants were on the pill, and then we discovered that those who were recognised much fewer negative emotions.’

In various psychological experiments you have studied whether the contraceptive pill, the menstrual cycle and stress sensitivity influence women’s moods.  Why isn’t your conclusion: the pill can influence mood disorders?

‘That would be too strong a conclusion because I mainly researched these effects in experimental psychological research. What is more, I only studied young female students and the results indicate a possible influence. My dissertation primarily points to a research lacuna: in previous psychological research too little account has been taken of the female hormonal status and consequently the contraceptive pill. In addition, to reach conclusions about the influence of the pill you need to research not only satisfied pill users but those who have stopped or just started using it. International collaboration would be good here because we would then be able to conduct this important research with more researchers and more resources and in a uniform way. And not all countries prescribe the same pill generation. Austrian Gps prefer to prescribe the fourth-generation contraceptive pill and Dutch Gps the second-generation one (the pill has been developed in different generations, ed.). I have also found indications that the genetically determined stress sensitivity could also play a role in the mood effects of the pill.’

How did you end up researching this topic?

‘It all began with a chance discovery. We were researching the possible antidepressant effect of a certain drug. This involved a task in which people had to identify emotions. Test participants are shown facial expressions on a screen and have to identify basic emotions like happy, sad and angry. This is about whether they correctly identify the emotion and how quickly. Placebo controlled studies have shown that healthy volunteers perform differently in this task after taking an antidepressant. And people who are or have been depressed perform differently too. ‘By chance we had registered whether or not our test participants were on the pill, and then we discovered that those who were recognised much fewer negative emotions.’ That made me curious. Could this explain why the pill makes some women feel more numb? And could genetic stress sensitive have an influence on this? We already knew that a genetic variant of one of the two receptors for the stress hormone cortisol protects young women against depression.’

‘Very little is known about whether the genes play a role in the mood effects of the contraceptive pill. Pharmacogenetic research can make an important contribution to this.’

How did you go about your research?

‘In multiple experiments we used this task, and looked at specific differences between test subjects. How did people who didn’t use the pill compare with those who did? And did those who didn’t use it perform differently with a lower than with a higher hormone level? On the basis of all these experiments we see indications that people who take the pill differ from those who don’t in emotion recognition and mood and that the genetic element also has an influence.’

Will you continue with your research?

‘Not as a researcher. I’m also a psychologist, and I’ve noticed that this knowledge provides some good pointers during treatments. Obviously I shared the findings in my network and hope that more research will be done in the coming years in response to my research.’

What else would you like to say about the topic?

‘My research is about women and mood disorders. I chose a biological perspective but I don’t want to ignore the social factors that make women more sensitive to mood disorders. Social factors are particularly important because women are still more often the victim of violence.’

Hamstra's research was supervised by prof. dr. A.J.W. van der Does and prof. dr. E.R. de Kloet (promotores) and dr. M. de Rover (co-promotor).

Text: Jan Joost Aten

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