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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
Rivista di Medicina Interna e Farmacologia
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2016 Novembre;175(11):465-85
Analysis of distal and proximal risk factors for mental health, in women aged from 10 to 24 years and residing in Lombardy, at first hospitalization for an induced abortion or normal delivery in the years 2007-2012
Claudio FINICELLI 1, Mariarosaria CAFIERO 2, Giuseppe L. FORMICOLA 3, Fulvio FINICELLI 4
1 Private Practictioner of Perinatal and Adolescent Clinical Psychology, Rho (MI), Italy; 2 University of Naples Federico II, Naples, Italy; 3 I Faculty of Medicine and Surgery, University of Naples Federico II, Naples, Italy; 4 Faculty of Medicine and Surgery, University of Caserta, Caserta, Italy
BACKGROUND: Examining the risk factors for subsequent mental health sequelae in female adolescents hospitalized for induced abortion, the composition of mental disorders present in patients, the interaction between reproductive and mental health.
METHODS: The study, from an observational, descriptive and analytical point of view, examines data contained in the hospital discharge records (Schede di Dimissione Ospedaliera, SDO) of adolescents hospitalized for a first induced abortion (n. 19991) or for a first normal delivery (n. 22342). Within the SDOs of the two groups, included in the Epidemiologic and Economic Atlas of Hospital Activities in Lombardy (Atlante Lombardo Epidemiologico ed Economico dell’Attività Ospedaliera, ALEE-AO vers. 9.0), the records bearing the diagnosis of mental disorder in medical history or at hospital discharge have been isolated by ICD 9CM codes. The measures used were: number of evaluated patients per ten thousand, crude age-specific index, Odds Ratio with 95% CI, Fischer’s test.
RESULTS: An increased presence of such risk factors was detected in abortion group, as mental disorders in medical history or at discharge, low age at gestational event. The gestational outcome did not appear to be significant in itself after case-control analysis. The distribution of disorders in this group is characterized by the predominance of drug dependence over episodic mood disorders, by the predominance of mental disorders detected at discharge over those diagnosed in history, and by the predominance of cases in patients aged 15-19 over 20-24 and 10-14 age groups.
CONCLUSIONS: The results highlight the need to detect during a gestational event in adolescence the presence of risk factors for mental health sequelae that may persist or recur at prolonged time intervals. The findings point towards the need for preventive interventions both appropriate to the complexity of the interaction between the different expressions of adolescent distress and characterized by the integration of services for reproductive and mental health.