Observational design can determine associations but not causation
Depression diagnoses from registries focus on specialty care
Depression medications can be used for other indications
The authors suggest various explanations for the study findings
Previous studies indicate that women who present with elevated depressive symptoms are more inclined (or, perhaps, are advised) to choose more effective and user-independent contraceptive methods such as IUDs and implants
… adolescents more often use HCs for medical reasons. These medical reasons, such as acne, can themselves constitute a risk factor for depressive symptoms
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