Referrals of patients with adjustment disorder to a consultation-liaison psychiatry service over a 10-year-period

Abstract

The goal of this retrospective cohort study was to analyze the relationship between induced abortion and the incidence of depression, anxiety disorder, adjustment disorder, and somatoform disorder in Germany.Women who had undergone induced abortions for the first time in 281 gynecological practices in Germany between January 2007 and December 2016 were included (index date). Women with live births were matched (1:1) to those with induced abortion by age, index year, and physician. The main outcome of the study was the incidence of depression, anxiety disorder, adjustment disorder, and somatoform disorder as a function of induced abortion. Survival analyses and Cox regression models were used to investigate the association between induced abortion and psychiatric disorders.This study included 17581 women who had had an induced abortion and 17581 women who had had a live birth. Within 10 years of the index date, 6.7% of the participants with induced abortions and 5.4% of those with live births were diagnosed with depression (log-rank p-value = 0.003). The respective figures were 3.4% and 2.7% for anxiety disorder (log-rank p-value = 0.255), 6.2% and 5.6% for adjustment disorder (log-rank p-value = 0.116), and 19.3% and 13.3% for somatoform disorder (log-rank p-value<0.001). Induced abortion was significantly associated with depression (hazard ratio [HR] = 1.34), adjustment disorder (HR = 1.45) and somatoform disorder (HR = 1.56), but not with anxiety disorder (HR = 1.17).There was a positive association between induced abortion and several psychiatric disorders in Germany. Further analyses are recommended to assess how induced abortion can have such a negative impact on mental health.