Associations between Abortion, Mental Disorders, and Suicidal Behaviour in a Nationally Representative Sample
Abstract
Abstract
Objective:
Most previous studies that have investigated the relation between abortion and mental illness have presented mixed findings. We examined the relation between abortion, mental disorders, and suicidality using a US nationally representative sample.
Methods:
Data came from the National Comorbidity Survey Replication (n = 3310 women, aged 18 years and older). The World Health Organization-Composite International Diagnostic Interview was used to assess mental disorders based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and lifetime abortion in women. Multiple logistic regression analyses were employed to examine associations between abortion and lifetime mood, anxiety, substance use, eating, and disruptive behaviour disorders, as well as suicidal ideation and suicide attempts. We calculated the percentage of respondents whose mental disorder came after the first abortion. The role of violence was also explored. Population attributable fractions were calculated for significant associations between abortion and mental disorders.
Results:
After adjusting for sociodemographics, abortion was associated with an increased likelihood of several mental disorders—mood disorders (adjusted odds ratio [AOR] ranging from 1.75 to 1.91), anxiety disorders (AOR ranging from 1.87 to 1.91), substance use disorders (AOR ranging from 3.14 to 4.99), as well as suicidal ideation and suicide attempts (AOR ranging from 1.97 to 2.18). Adjusting for violence weakened some of these associations. Forall disorders examined, less than one-half of women reported that their mental disorder had begun after the first abortion. Population attributable fractions ranged from 5.8% (suicidal ideation) to 24.7% (drug abuse).
Conclusions:
Our study confirms a strong association between abortion and mental disorders. Possible mechanisms of this relation are discussed.
Résumé
Objectif:
La plupart des études antérieures qui ont recherché la relation entre l'avortement et la maladie mentale ont présenté des résultats partagés. Nous avons examiné la relation entre l'avortement, les troubles mentaux et la suicidabilité à l'aide d'un échantillon nationalement représentatif des É.-U.
Méthodes:
Les données provenaient de la National Comorbidity Survey Replication (n = 3310 femmes de 18 ans et plus). L'entrevue diagnostique composite internationale de l'Organisation mondiale de la santé a servi à évaluer les troubles mentaux selon le Manuel diagnostique et statistique des troubles mentaux, 4e édition, l'avortement au cours de la vie. Des analyses de régression logistique multiple ont été employées pour examiner les associations entre l'avortement et les troubles de l'humeur, d'anxiété, d'utilisation de substances, l'alimentation, et les troubles de comportement perturbateur, ainsi que l'idéation suicidaire et les tentatives de suicide au cours de la vie. Nous avons calculé le pourcentage de répondantes dont les troubles mentaux sont apparus après le premier avortement. Le rôle de la violence a aussi été exploré. Les fractions attribuables dans la population ont été calculées pour les associations significatives entre l'avortement et les troubles mentaux.
Résultats:
Après ajustement pour les données sociodémographiques, l'avortement était associé à une probabilité accrue de troubles mentaux graves — troubles de l'humeur (rapport de cotes ajusté [RCA] allant de 1,75 à 1,91), troubles anxieux (RCA allant de 1,87 à 1,91), troubles d'utilisation de substances (RCA allant de 3,14 à 4,99), ainsi qu'idéation suicidaire et tentatives de suicide (RCA allant de 1,97 à 2,18). L'ajustement pour la violence affaiblissait certaines de ces associations. Pour tous les troubles examinés, moins de la moitié des femmes déclaraient que leur trouble mental avait débuté après le premier avortement. Les fractions attribuables dans la population allaient de 5,8 % (idéation suicidaire) à 24,7 % (toxicomanie).
Conclusions:
Notre étude confirme une forte association entre l'avortement et les troubles mentaux. Les mécanismes possibles de cette association sont discutés.
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Article first published online: April 1, 2010
Issue published: April 2010
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PubMed: 20416147
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