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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

91 women were asked to complete a standardized multiple choice questionnaire (modified from the Edinburgh Postnatal Depression Scale) to screen for anxiety and depression before and after legal abortion in early pregnancy achieved either by use of mifepristone in combination with a prostaglandin (PG) (n=54) or by vacuum aspiration under general anesthesia (n=37). Before abortion, over 60% in both groups had high scores (compatible with psychiatric morbidity), but after abortion, there was a significant and equal fall in scores by so that by 1 month, 10% of either group had high scores. There were no differences between the 2 groups. Both abortion methods were acceptable to the majority of women, although only 75% of the medical group indicated they would use the same method if a future termination was ever required, as compared with 94% of the surgical group. However, in 13 women who had experienced both methods, the medical approach was preferred by 10 (77%). Thus, medical abortion is acceptable to the majority of women and is associated with the same low rate of shortterm psychiatric morbidity as had previously been recorded with surgical methods of termination, despite greater patient involvement and awareness of the abortion process.
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PMID:Psychiatric morbidity and acceptability following medical and surgical methods of induced abortion. 177 72

A discussion of unconscious psychological resistance to contraception is illustrated by the case of a woman with a 10-year history of use of oral contraceptives and IUDs marked by repeated development of side effects and changes of formulation culminating in a serious depression after tubal ligation at age 35. The woman's postligation complaints of abdominal pain resistant to analgesic treatment were the expression of a serious depressive syndrome that responded poorly to antidepressants. The request for contraception normally contains 2 propositions: the individual desires to have sexual relations, and the individual does not wish to procreate. The logical connection between these 2 propositions at the conscious level is absent at the level of the unconscious, where there is no logic or possibility of reasoning. Forgetting a pill is a relatively minor form of resistance to contraception. Other symptoms, such as pain, vertigo, nausea, nervousness, insomnia, and anxiety with the pill or unexplained pain, repeated local infections, or anxiety and depression with the IUD may be manifestations of the psychological modifications inevitably caused by the psychic symbolism of the contraceptive. The difficulty experienced by certain women in accepting in their unconscious the 2 propositions about contraception causes the symptoms to be produced. Unconscious motives for resistance to contraception may include a woman's dependence on the potential for maternity for her sexual identity, or anxiety at the degree of sexual freedom offered by the contraceptive method. The unconscious elements related to resistance are sometimes open to modification. A study of women undergoing abortion at a center in Rennes indication that 91% failed to use an effective method of contraception at the time of the pregnancy, but that 1 year later 76% had accepted a method. Only 12% at risk of undesired pregnancy were not using a method. A large part of the increased usage was probably explained by contraceptive information provided at the time of the abortion, but the very fact of the abortion may have helped some of the women resolve their feelings of ambivalence about contraception. But 53% of the contraceptive acceptors complained of side effects, mainly anxiety, decreased sexual pleasure, weight gain and menstrual problems. It appears that an abortion may influence the decision to use a method without greatly changing the resistance to contraception. The practitioner wishing to assess the potential tolerance or resistance of a woman to contraception should take the time to discuss her feelings about contraception, menstruation (which signifies absence of pregnancy and thus maternity), and her sexual and emotional life. the dialogue can continue in subsequent visits if the women had complaints about side effects.
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PMID:[Resistance to contraception]. 219 28

Prior to their having a 1st trimester abortion, women's perceptions of social support from their partner, family, and friends and self-efficacy for coping were assessed. Depression, mood, physical complaints, and anticipation of negative consequences were measured after the 30-min recovery period. As predicted, perceived social support enhanced adjustment indirectly through its effects on self-efficacy. Women who perceived high support from their family, friends, and partners had higher self-efficacy for coping. Higher self-efficacy, in turn, predicted better adjustment on the psychological measures but not on the physical complaint measure. No direct path between social support and adjustment was observed. In addition, women who told close others of their abortion but perceived them as less than completely supportive had poorer postabortion psychological adjustment than either women who did not tell or women who told and perceived complete support.
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PMID:Perceived social support, self-efficacy, and adjustment to abortion. 223 Dec 79

India's 1962 Medical Termination of Pregnancy Act allows abortions to be performed up to 20 weeks of gestation on medical, humanitarian, or eugenic grounds. Of the 406 million abortions that occur in India each year, 2.3 are induced. Women who obtain an induced abortion tend to be 21.30 years old, married, have at least 2 living children, are of relatively low educational status, are from the middle or lower socioeconomic strata, and are nonusers of contraception. Thus, abortion in India comprises a major method of fertility control; up to 80% of abortion patients were not using contraception. This phenomenon is extremely costly; an abortion costs about Rs 350, while 1 couple-year of contraceptive protection averages Rs 60. Induced abortion also carries psychological costs. Although the majority of abortion acceptors experience relief after the procedure, guilt, depression, and social and occupational sequelae are not uncommon. Moreover, women with adverse psychological reactions to abortion are at risk of nonuse of contraception and a repeat pregnancy. Women most at risk of an adverse psychological reaction to abortion are those who are unmarried, adolescents, strongly religious, and are undergoing the procedure against their wishes. While access to abortion should be protected in India, greater attention should be given to the factors that make it necessary, including illiteracy, nonavailability or lack of knowledge of contraceptive methods, inadequate follow-up of contraceptive acceptors, and poor motivation.
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PMID:The other side of abortion. 233 52

This prospective population study attempted to investigate the effects of smoking, alcohol, and caffeine consumption and socioeconomic factors and psychosocial stress on birthweight. A consecutive series of 1860 white women booking for delivery at a district general hospital in inner London were asked to participate. 136 refused and 211 failed to complete the study for other reasons (relocation, abortion, subsequent refusal), leaving a sample of 1513. Women who spoke no English, booked after 24 weeks, had insulin-dependent diabetes, or had a multiple pregnancy were excluded. Data were obtained by research interviewers at booking (general health questionnaire, modified Paykel's interview, and Eysenck personality questionnaire), at 17, 28, and 36 weeks' gestation, and from the structured antenatal and obstetric record. Variables assessed included smoking, alcohol consumption, caffeine consumption, and over 40 indicators of socioeconomic status and psychosocial stress, including social class, tenure of accomodation, educational status, employment status, income, anxiety and depression, stressful life events, social stress, social support, personality, and attitudes to pregnancy. Birthweight was adjusted for gestation and for maternal height, parity, and baby's sex. Smoking was the single most important factor (5% reduction in corrected birthweight). Passive smoking was not significant (0.5% reduction). After smoking was controlled for, alcohol had an effect only in smokers and the effects of caffeine became significant. Only 4 of the socioeconomic and stress factors significantly reduced birthweight and these became nonsignificant after smoking was controlled for. Social and psychological factors have little or no direct effect on birthweight corrected for gestational age (fetal growth), and the main environmental cause of its variation in this population was smoking.
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PMID:Effects on birth weight of smoking, alcohol, caffeine, socioeconomic factors, and psychosocial stress. 249 59

Late sequelae 16 months or more after laparoscopic sterilization by Falope rings (380) or electrocautery (243) were analyzed by mailed questionnaires, telephone interviews and medical records. The sterilizations were done from January 1980-June 1985 at a free-standing surgical clinic; patients were aged 22-48; 259 procedures were post- abortal, 364 were interval; 89% were by general anesthesia. The survey emphasized satisfaction or dissatisfaction with the procedure, altered menstrual pattern requiring D & C, psychological consequences and continuation of yearly gynecological care. 18% expressed regret, 7 because of having an abortion at the time, 1 because of the death of her child, and 6 because of remarriage. 2 women reported that their decision at the time was not definite, despite counseling. 2 failures resulted in pregnancy (0.3%). 4.8% required a D & C for abnormal menstrual bleeding. 13 of these 30 had prior history of menstrual disorders. 8.2% reported psychological problems, 33 were seen by a psychiatrist; 3 were in psychological care. Medical factors associated with the psychological problems were concomitant abortion in 5, and severe meno-metrorrhagia and depression 3. 16.9% failed to continue routine gynecological care. There was no apparent association of any of these findings with type of procedure or anesthesia. It was concluded that counseling should touch on all these topics more thoroughly before sterilization.
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PMID:Late sequelae following laparoscopic female sterilization. 256 9

The causal impact of attributions and coping self-efficacy on adjustment to abortion was examined. Two hundred and eighty-three women were randomly assigned prior to their abortion to 1 of 3 counseling interventions: 1 designed to alter attributions for unwanted pregnancy (ATT-INT), 1 designed to raise coping expectations (EXP-INT), or a control (standard counseling) group. Depression, mood, anticipated consequences, and physical complaints were assessed postabortion. Women in the ATT-INT or EXP-INT group were better adjusted immediately postabortion than women in the control group. The EXP-INT group was also less depressed than the ATT-INT group. Three individual difference factors were also related to better adjustment: high coping self-efficacy, low self-character blame, and low other-blame. Self-efficacy also predicted adjustment 3 weeks postabortion. Implications for theories of adjustment to major life events, therapeutic interventions to assist coping with such events, and public policy on abortion are discussed.
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PMID:Self-blame, self-efficacy, and adjustment to abortion. 261 59

Sixty-seven women were interviewed four weeks after spontaneous abortion. As determined by the Present State Examination, 32 of these women were psychiatric cases. This rate is four times higher than in the general population of women. In each case the diagnosis was depressive disorder, a finding confirmed by scores on three depression rating scales. Many women showed typical features of grief. Depressive symptoms were significantly associated with a history of previous spontaneous abortion, and less so with childlessness.
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PMID:The psychiatric consequences of spontaneous abortion. 262 Feb 7

Women are at higher risk than men to develop depressive episodes during the reproductive years. Furthermore, women are vulnerable to depressions associated with oral contraceptives, abortion, the premenstrual period, the puerperium, and menopause. The phenomenology and the biologic mechanisms involved in these illnesses perhaps should be viewed in the context of other manifestations of the link between depression and female reproductive functions. For example, women are especially vulnerable to a rapid cycling form of affective illness and to hypothyroidism, an associated factor for this form of affective disorder. The postpartum period is also associated with impaired thyroid function, and there are reports of the induction of rapid cycles of mood following the termination of pregnancy. Thus, alterations in thyroid hormones may be a feature of both postpartum and rapid cycling forms of affective disorder in women. A previous history of a postpartum depression places a woman at a high risk for the development of a subsequent puerperal episode. Also, difficulties during pregnancy may predispose a woman to the development of other reproductive-related depressions. The role reproductive hormones play in this possible sensitization phenomenon needs to be examined in order to understand the relationship of depression to the female reproductive cycle.
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PMID:Reproductive factors affecting the course of affective illness in women. 265 9

Adolescent mothers and their offspring are a high risk group both physically and emotionally. Poverty, malnutrition, complications of pregnancy, and emotional problems such as depression, drug, and alcohol use, are all risks for the mother. Children are also at greater risk of physical, cognitive, and emotional problems. Therefore, it is important to identify factors which influence the outcome of adolescent mothers and their children in order to suggest interventions which will more positively affect the physical and psychological health of this increasing population. Hechtman draws the following conclusions: 1) There is no single cause for the rising rate of adolescent pregnancy, but rather a combination of factors. These can generally be grouped under biological factors, societal factors, personal attitude/needs, ignorance/misunderstanding concerning sexual matters, and problems inherent in modern contraceptive methods. 2) The consequences of pregnancy on the adolescent are multiple and can be divided into health, economic, and emotional outcomes. 3) The effects on the child who results from the adolescent pregnancy can be subdivided under physical health, cognitive, behavioral and emotional effects. 4) Early sex education programs which combine education with family planning or counselling, and readily available inexpensive contraception and abortion would do much to decrease the prevalence of adolescent pregnancy.
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PMID:Teenage mothers and their children: risks and problems: a review. 267 Jan 80


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