Talk:Abortion and mental health

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New study

Factual Error found in Regard to the Royal College of Psychiatrists

The paragraph about the UK Royal College of Psychiatrists stated that this organizations review comcluded that there is no link between mental health and abortion. This is a factual error. The truth is that the review concluded that the evidence is inconclusive. Ste11aeres (talk) 20:23, 13 February 2013 (UTC)

No, that's simply not true. The UK RCP report is here. The authors conclude: When a woman has an unwanted pregnancy, rates of mental health problems will be largely unaffected whether she has an abortion or goes on to give birth. (p. 125) In other words, unwanted pregnancies are risk factors for psychological distress, but whether those pregnancies end in abortion or in live birth does not change that risk. Their conclusions were not ambiguous or inconclusive; perhaps you could explain why you view it as such? MastCell Talk 04:24, 14 February 2013 (UTC)

Fergusson et al.

PMID 23553240 concluded that "There is no available evidence to suggest that abortion has therapeutic effects in reducing the mental health risks of unwanted or unintended pregnancy. There is suggestive evidence that abortion may be associated with small to moderate increases in risks of some mental health problems." Having looked over this article I find it quite skimpy, as it does not even mention reviews and meta-analyses (with only one exception). I feel that we ought to add mention of this recently published review, which actually looked at the NCCMH data the editors of this page are so in love with, as well as some others, for instance, This one was also by Fergusson et al. Jinkinson (talk) 17:32, 12 July 2013 (UTC)

I'm not quite following... which paper are you suggesting we mention? MastCell Talk 17:39, 12 July 2013 (UTC)
(edit conflict) I think Jinkinson means Fergusson 2013 (PMID 23553240).

Fergusson's contributions to this literature has been discussed a number of times on this page (search the archives for his name), so the article ought to be understood in the lens of Fergusson's previous work. I think it might be best to just wait for the response of the broader scientific community before including it. The first response (PMID 23803898) already appears to be quite critical, and I don't think anyone else has addressed it yet. NW (Talk) 17:42, 12 July 2013 (UTC)

Yeah, that is what I meant, NW. It seems David M. Fergusson, who is pro-choice and an atheist, has a long history of publishing research alleging that abortion causes mental health problems. I suppose we could (but don't have to) add mention of some of his studies while pointing out that they have been slammed by the Guttmacher Institute, as well as by the Family Planning division of New South Wales. Jinkinson (talk) 18:20, 13 July 2013 (UTC)

Recent review of scientific studies on the question

The following account of a recent review of research papers has been reverted immediately after it was added:

Of research papers published between 1995 and 2011, thirteen found that abortion constituted a clear risk of mental problems as compared to childbirth, five found no difference, and one found that childbearing had worse results. In the case of unplanned pregnancies, four found abortion involved greater risk than continuing to childbirth, three found no difference. Three studies found that abortion gave rise to a greater risk than a miscarriage, four found no difference, and two found that the miscarriage group showed greater short-term anxiety and depression but that the abortion group had greater long-term anxiety and depression. A review of these papers, which appeared in the July 2013 number of Psychiatry and Clinical Neurosciences, concluded that childbirth brings lesser risk of mental disorders than any form of fetal loss, and that some studies show that abortion brings a higher risk than miscarriage; it also considered that further research is needed (Abstract of the study "Abortion and subsequent mental health: Review of the literature" by Carlo V. Bellieni and Giuseppe Buonocore in Psychiatry and Clinical Neurosciences, Volume 67, Issue 5, pages 301–310 (July 2013) ).</ref>

The revert (on the grounds: "I have read the article (not just the abstract) and see that unlike serious systematic reviews, it does not do any quality analysis of the studies in question") seems to be based on nothing better than the idea that an editor's personal opinion carries more weight than a reliable(?) published source that summarizes in the form of an abstract the content of the study. The deleted account follows closely the published information. Esoglou (talk) 17:11, 27 July 2013 (UTC)

Since neither the reverter nor anyone else has questioned the reliability of the cited source, I have restored the deleted information, making it yet clearer that it is only a report of the conclusions of the review, not a statement of judgement by Wikipedia on the actual facts. Esoglou (talk) 17:54, 28 July 2013 (UTC)
The reliably based information about what the review of evidence says has again been deleted, this time without even a pretence of an explanation. I'll wait until the day after tomorrow before restoring it, in order to give the reverters more time to explain their action. Esoglou (talk) 19:48, 28 July 2013 (UTC)
I agree with those who have reverted your edit. While I can't speak for them, I'll explain my view. A number of major expert bodies have summarized existing evidence on this subject. All of them have reached a similar conclusion: that induced abortion does not cause mental-health problems. You have selected a single review article which reached a different conclusion, and highlighted that article in the lead. On what basis did you choose to highlight this specific review (as opposed to any of the other numerous narrative reviews, systematic reviews, and meta-analyses published on the subject)? We as editors should not be in the business of trying to "debunk" or undermine reputable expert opinion, which in this case is quite clear. I think that your edit violated our policy on undue weight, by citing a single article as equivalent (or superior) to the views of multiple expert medical and scientific bodies.

Finally, while this is a more subjective issue, I agree with NuclearWarfare that the methodology of the article you cited was rather unimpressive, particularly compared to some of the rigorous work that's been done on this subject. In fact, I think it illustrates the finding by Charles et al. that the lower a study's methodologic quality, the more likely it is to report negative consequences of abortion. But that's a separate concern; the main justification in my view for reverting your edit was the violation of WP:WEIGHT. MastCell Talk 19:49, 28 July 2013 (UTC)

Hi Esoglou; I missed your talk page post in my watchlist yesterday; in future, perhaps using the new notifications system, could you inform me about the discussion if I appear to not be responding? As for the substance of your comment, I have nothing more to add beyond what MastCell has said. NW (Talk) 20:33, 28 July 2013 (UTC)
As explained by MastCell above, WP:WEIGHT is the primary issue. — ArtifexMayhem (talk) 21:42, 28 July 2013 (UTC)
Thank you all for your comments. I am new here, and will not stay long. But I do think that what the latest issue of a scientific journal that seems to have a certain prestige reports as a review of all the scientific papers published between 1995 and 2011 deserves a mention in the same context as some of those papers. It deals specifically not only with cases of unplanned pregnancy but also with the mental health effects of abortion as compared with miscarriage. So I don't see on what valid grounds it is being excised. However, since three Wikipedia editors want it excluded and nobody (apart from me) defends its mentioning, I will not restore it. Esoglou (talk) 07:58, 29 July 2013 (UTC)

I would like to get your opinion on this review

This review has been brought up before, but after searching the archives I could not find a specific rebuttal to it, so I was hoping if I posted a link here, someone would tell me why it is not even mentioned in the article. I am bringing it up because I want to know what the science says, and this review concluded that "...induced abortion increased the risks for...mood disorders substantial enough to provoke attempts of self-harm." I realize that Johns Hopkins is pretty prestigious, but it isn't gospel. Jinkinson (talk) 18:22, 28 July 2013 (UTC)

Only yesterday did I come to this article. So I don't understand why the 2003 study was not mentioned. There must be some reason other than the difficulty that, unlike the 1990 and the 2008 reports that are mentioned, information about it is not sourced to publications with the names Family Planning Perspectives or Contraception: An International Reproductive Health Journal. Esoglou (talk) 19:50, 28 July 2013 (UTC)
I think the paper isn't cited because it's 10 years old, and a huge amount of evidence has subsequently been published which renders its conclusions outdated (see WP:MEDDATE). The 1990 APA panel is mentioned because it's notable in a historical context. Also, the 1990 APA findings were published in a little journal called Science (as PMID 2181664), not in Family Planning Perspectives or Contraception, so your imputation of motive is not only lazy but also ignorant. The 2008 APA findings are clearly notable, as they express the current position of a major expert body on the subject. MastCell Talk 19:57, 28 July 2013 (UTC)
Is it necessary to mention that I set aside ("There must be some reason other than ...") as a reason the choice of citations for the 2008 and 1990 reports (I should indeed have specified which 2008 report) in footnotes 4 and 9? At least you did advance a reason for omitting the 2003 study: it is five years older than the mentioned 2008 papers (which in their turn are five years older than the unmentioned 2013 report). By the way, the article says nothing of the inconclusive judgement of the APA 2008 report on abortions other than a first. Esoglou (talk) 08:01, 29 July 2013 (UTC)
Actually, it does: "The [APA] panel noted a lack of quality data on the effect of multiple abortions. Additionally, the same factors which predispose a woman to multiple unwanted pregnancies may also predipose her to mental health difficulties; therefore, they declined to draw a firm conclusion on multiple abortions." MastCell Talk 18:47, 29 July 2013 (UTC)
What I said was intended in reference to the lead. I should not have written "the article". You are right. I apologize. Esoglou (talk) 06:24, 30 July 2013 (UTC)
No worries. MastCell Talk 21:21, 30 July 2013 (UTC)

recent edits

I removed the references to Fergusson and Belleini because after rewording them, they seemed a lot more tenuous than the Cochrane and J. Clin Psych references later in the paragraph. There were some WP:PEACOCK words in there too, and I note that the editor who inserted them has also been inserting Belleini et al references into a number of other neonatology (and other) articles. These particular ones did pass MEDRS, but as i noted in my reversion, i think that there is a weight issue here, and the Fergusson and Belleini studies are much less useful; the methodology of the Belleini article actually looked pretty shaky based on the abstract, though i did not read the entire article yet. -- UseTheCommandLine ~/talk ]# ▄ 22:24, 30 August 2013 (UTC)

I can agree that there is a weight issue here, but these 2 reviews are independend and their limits are not greater than those of previous reviews. I do not understand why they cannot be quoted here. Principina. 1 September 2013

I notice that quite a number of your edits so far have been the insertion of references to articles by Bellieni, et al, sometimes with no obvious compelling reason. While that could be a coincidence, my experience is that it's usually someone connected with the authors. If that's the case, you may want to review our policies on conflict of interest as well as our policies on citation spam and self-citation (which are sometimes conflated).
As for the Bellieni paper itself, it comes back to undue weight for me. Perhaps it could be acceptable with less effusive language or in an external links section, but I'm still rather skeptical. Since it was just published, and thereby has fewer opportunities to be cited than even the Cochrane paper, I'm inclined to wait a bit anyway, but open to other arguments. -- UseTheCommandLine ~/talk ]# ▄ 23:55, 1 September 2013 (UTC)
I have the same concerns about self-citation. More broadly, we've tried to move away from detailed descriptions of individual studies to a broader overview of current medical opinion on the subject. A lot of literature has been published on this subject, of greatly varying quality. We've generally tried to wait until specific studies have been appraised by reputable expert bodies (the APS, the Royal College of Psychiatry, Cochrane, etc) before incorporating them, in order to head off long talk-page debates about study methodology. Thus, I'd favor waiting to incorporate this particular article until it's clear how much weight it will be assigned by the relevant expert community. MastCell Talk 23:09, 2 September 2013 (UTC)