Yet Another Flawed Study/REPLY

Dear Editor: Both the American Psychiatric Association1 and the American Psychological Association,2 after exhaustive reviews and analysis of the literature, have concluded that there is no credible evidence that abortion causes psychiatric disorders. Ms Natalie P Mota, Dr Margaret Burnett, and Dr Jitender Sareen in their April 2010 article3 recognize the methodological challenges in studying the mental health effects of abortion, but, despite their protestations, commit precisely the same errors that have invalidated all other studies4 concluding that abortion does cause mental health problems. The errors include, but are not limited to, the following: their study is retrospective and uses a group that has been identified as having a lifetime history of a mental disorder; the timing of the abortion and the onset of a mental health disorder are not clear, owing to issues of memory that may be faulty and to the lack of verifying data; the authors are not clear whether a mental or substance abuse disorder precedes the abortion and is the reason for seeking an abortion or is the consequence of the abortion, despite the fact that studies have clearly shown that the clearest predictor of postabortion problems is a preexisting mental disorder2'4; elective abortions are not distinguished from terminations for genetic reasons, 2 very different groups; and most importantly, they were unable to determine the wantedness of the pregnancy. This addition of another invalid study to the literature linking abortion to mental health problems is very likely to be used by antichoice groups to support proposed public policy changes, limiting and complicating access to abortion, thereby interfering in the doctor-patient relationship and causing additional harm to women already suffering from the stress of unwanted pregnancies and the circumstances that led to them. References 1. American Psychiatric Association Committee on Women. Abortion and Women's Reproductive Health Care Rights Position Statement Approved by the Board of Trustees, American Psychiatric Association, May 2009. Am J Psychiatry. 2010;167:6. 2. American Psychological Association Task Force on Mental Health and Abortion. Report of the Task Force on Mental Health and Abortion. Washington (DC): American Psychological Association; 2008. 3. Mota NP, Burnett M, Sareen J. Associations between abortion, mental disorders, and suicidal behaviour in a nationally representative sample. Can J Psychiatry. …