The Effect of Depression and Anxiety on Nonbarrier Contraception in Adolescents and Young Adults: A Scoping Review

Introduction: Adolescents and young adults (AYAs) are at increased risk for unintended pregnancy compared to older females. Prior research suggests that mental health, particularly depression and anxiety, is associated with inconsistent use of condoms or nonbarrier contraception (i.e., contraceptive pills, injections, implants, intrauterine devices, etc.), which contributes to an increased risk for unintended pregnancy. Most research has focused on the relationship between mental health and condom use among adults. To our knowledge, the literature looking at depression or anxiety as predictors of nonbarrier contraception use has not been synthesized for AYA females, which is the aim of this study. Methods: PubMed and Cochrane databases were searched for studies that assessed depression or anxiety as predictors and outcomes related to nonbarrier contraception use of females ages 10-25 years. Of 548 articles screened, 18 studies were eligible and included in this review. Results: Four primary outcome variables were identified: contraception consistency, nonbarrier contraception use, type of nonbarrier contraception used, and use of dual contraception. Most articles (n = 16) found a significant association between depression and/or anxiety and an increased likelihood of inconsistent contraception and/or a decreased likelihood of using nonbarrier contraception. Conclusions: The presence of depression and/or anxiety in female AYAs was associated with, and in some cases predictive of, decreased nonbarrier contraception use and/or inconsistent use, which may increase the likelihood of unintended pregnancy. This study provides evidence that depression and anxiety are important considerations for medical professionals in providing holistic care to AYAs while supporting their goals around pregnancy prevention.