Lowenstein Lior, Deutcsh Michael, Gruberg Rakefet, Solt Ido, Yagil Yaron, Nevo Ori, Bloch Miki
Department of Obstetrics and Gynecology, the Rappaport Technion Faculty of Medicine, Rambam Medical Center, POB 9602, Haifa 31096, Israel.
Gen Hosp Psychiatry. 2006 Jan-Feb;28(1):43-7. doi: 10.1016/j.genhosppsych.2005.07.006.
The purpose of this study is to compare the baseline psychological distress and symptom profile of women undergoing either medical (with mifepristone) or surgical pregnancy termination and the psychological outcome 2 weeks after the procedure.
Women (n = 200) given free choice of pregnancy termination method, either medical or surgical, were assessed before pregnancy termination by a demographic questionnaire including questions regarding the choice of the method of pregnancy termination, the Brief Symptom Inventory (BSI), the Spielberger State Anxiety questionnaire and the Rotter Locus of Control Scale. Two weeks after the procedure, the BSI and Spielberger questionnaires were repeated.
Women with a smaller number of past pregnancies tended to choose the medical procedure. Reasons for choosing the medical procedure were fear of surgery, anesthesia and of future fertility difficulties. Prior to the procedure, the "medical group" had significantly higher levels of obsessive-compulsive symptoms, guilt and BSI general symptom index score, and a trend for higher interpersonal sensitivity and paranoid ideation. Postprocedure, both groups showed significant decline in anxiety levels and did not differ on most symptom parameters.
Women who chose to have a medical termination are marginally more symptomatic before the procedure than women choosing surgical termination. However, both methods of pregnancy termination resulted in significant reduction in preabortion psychological distress level.
本研究旨在比较接受药物流产(使用米非司酮)或手术流产的女性的基线心理困扰和症状特征,以及流产术后2周的心理结局。
200名可自由选择药物流产或手术流产方式的女性,在流产前通过一份人口统计学调查问卷进行评估,该问卷包括关于流产方式选择的问题、简明症状量表(BSI)、斯皮尔伯格状态焦虑问卷和罗特控制点量表。流产术后2周,再次进行BSI和斯皮尔伯格问卷评估。
既往怀孕次数较少的女性倾向于选择药物流产。选择药物流产的原因是害怕手术、麻醉以及未来生育困难。在流产前,“药物流产组”的强迫症状、内疚感和BSI总体症状指数得分显著更高,人际敏感性和偏执观念也有升高趋势。流产术后,两组的焦虑水平均显著下降,且在大多数症状参数上无差异。
选择药物流产的女性在流产前的症状略多于选择手术流产的女性。然而,两种流产方式均导致流产前心理困扰水平显著降低。