Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.
Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
Riv Psichiatr. 2018 Nov-Dec;53(6):324-330. doi: 10.1708/3084.30766.
The aim of this work was to identify risk predictors of a negative psychological outcome among personal, situational and systemic characteristics of women who choose to interrupt a pregnancy by elective (e.g., not feeling ready for giving birth) or therapeutic means (e.g., fetal abnormalities).
A prospective study on two cohorts were conducted and focused on a group of women: the first recurred to elective abortion (VTP) (n=20) and the second recurred to therapeutic abortion (TTP) (n=30). The psychological distress was measured before and after abortion through the administration of two psychometric tests: SCL-90-r and CES-D. Dependent samples t-test was used to evaluate the tendency of the two cohorts' mean scores before and after abortion; repeated measures analysis of variance (ANOVA) was used to analyze the variance of mean scores of subgroups isolated for variables of interest before and after abortion.
After the termination of pregnancy, in VTP a significant decrease between t-0 and t-1 mean score (p<0.05) was observed in all SCL-90-r's global scores and subscales: GSI (p=0.036), PST (p=.031), PSDI (p=0.004), SOM (p=0.009), DEP (p=0.032), ANX (p=0.036) and even in CES-D score of DEP (p=0.017) and SOM (p=0.011) subscales. In TTP a relevant decrease was found in SCL-90's SOM (p=0.023) and ANX, (p=0.016) subscales and in CES-D total score (p=0.020), POS (p=0.014) and SOM (p=0.09)subscales. In VTP group presence of partner support and absence of relational problems resulted as protective factors from a worse outcome.
The results of this study suggest that, following an induced abortion, women experienced a significant improvement in the mood state compared to the period before the event; poor partner support and relational problems related with the abortion emerged as risk factors for a significantly worse psychological outcome compared to other causes interruption of pregnancy.
本研究旨在识别因个人、情境和系统因素选择人工流产（例如，还没准备好分娩）或治疗性流产（例如，胎儿畸形）的女性中，哪些是导致负面心理结果的风险因素。
对两个队列进行前瞻性研究，主要关注一组女性：第一组因选择性流产（VTP）（n=20），第二组因治疗性流产（TTP）（n=30）而再次流产。通过两种心理测试（SCL-90-r 和 CES-D）在流产前后测量心理困扰。采用独立样本 t 检验评估两组流产前后的平均分变化趋势；采用重复测量方差分析（ANOVA）分析流产前后各感兴趣变量的亚组平均分的方差。
在终止妊娠后，VTP 组的所有 SCL-90-r 总分和子量表（GSI、PST、PSDI、SOM、DEP、ANX）的 t-0 与 t-1 平均分（p<0.05）均显著降低，甚至 CES-D 中 DEP（p=0.032）和 SOM（p=0.036）子量表的得分也显著降低。TTP 组 SCL-90 的 SOM（p=0.023）和 ANX 子量表和 CES-D 的总分（p=0.020）、POS（p=0.014）和 SOM（p=0.09）子量表的得分均有明显降低。VTP 组中伴侣支持和无关系问题被认为是避免不良结局的保护因素。
本研究结果表明，与事件发生前相比，人工流产后女性的情绪状态显著改善；与其他原因导致的妊娠中断相比，较差的伴侣支持和与流产相关的关系问题是导致心理结局显著恶化的风险因素。
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