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Advisor(s)
Abstract(s)
A mutilação genital feminina (MGF) afeta milhões de jovens e mulheres a nível mundial. As consequências físicas da MGF têm sido extensamente abordadas na literatura, enquanto apenas uma porção aborda as consequências a nível da saúde mental. Neste trabalho, revimos sistematicamente a literatura de modo a investigar a existência de uma relação entre MGF e consequências adversas a nível da saúde mental, tais como sintomas relacionados com a depressão, ansiedade ou perturbação de stress pós-traumático (PSPT). Para tal, conduzimos uma pesquisa sistemática em múltiplas bases de dados, culminando na inclusão de 27 estudos que avaliam as sequelas psicopatológicas da prática em mulheres circuncisadas, através do uso de ferramentas previamente validadas para a avaliação da saúde mental. Utilizámos a ferramenta ROBINS-I para apreciar o risco de viés em cada um dos estudos incluídos. Seguidamente, elaborámos uma síntese narrativa e meta-análise para cada outcome, bem como uma análise de sensibilidade. Treze estudos demonstraram uma associação entre MGF e pelo menos uma consequência adversa a nível da saúde mental, com oito estudos a apresentar uma relação com sintomas depressivos, sete com sintomas de ansiedade e quatro com sintomas de PSPT. Dos cinco estudos que estudavam o impacto consoante a idade na qual ocorre MGF e o tipo de circuncisão, três detalharam um risco mais elevado para sintomas do foro psiquiátrico em mulheres que foram submetidas a MGF numa idade mais avançada, e três indicaram que o tipo III de MGF está associado a consequências mais graves. A meta-análise não revelou qualquer relação estatisticamente significativa entre MGF e qualquer um dos outcomes avaliados. São necessários mais estudos para poder inferir qual a relação entre MGF e a saúde mental das mulheres submetidas à mesma, com estudos de maior qualidade e protocolos mais uniformes, bem como maior detalhe sobre o evento em si.
Female genital mutilation (FGM/C) affects millions of women and girls across the world. The physical consequences of FGM/C have been widely documented in the existing literature, whereas only a fraction of the research on the topic focuses on its mental health consequences. In this study, we systematically reviewed the literature to investigate whether there is a relationship between FGM/C and adverse mental health outcomes, such as depressive, anxious and PTSD-related symptoms. To this end, we conducted a systematic search of multiple databases and included in this review a total of 27 studies that assess the psychopathological sequelae of this practice on circumcised women and girls, through the use of validated mental health assessment tools. We used the ROBINS-I tool for assessing the risk of bias of each included study. We then conducted a narrative synthesis and metanalyses for each outcome, as well as a sensitivity analysis. Thirteen studies revealed an association between FGM/C and at least one adverse mental health outcome, with eight studies detailing a connection with depressive symptoms, seven correlating it to anxiety symptoms and four underlining its link to post-traumatic stress disorder (PTSD). Out of five studies that assessed the impact of age at the time of FGM/C and the type of circumcision, three pointed to a higher risk for psychiatric symptoms in women who underwent FGM/C at a more advanced age and three indicate that FGM/C type III is associated with worse outcomes. The metanalysis did not reveal any statistically significant relationship between FGM/C and any of the evaluated outcomes. Further research is necessary in order to more confidently assess the relationship between FGM/C and mental health, with higher quality and more standardized protocols and assessment, as well as more detail about the procedure.
Female genital mutilation (FGM/C) affects millions of women and girls across the world. The physical consequences of FGM/C have been widely documented in the existing literature, whereas only a fraction of the research on the topic focuses on its mental health consequences. In this study, we systematically reviewed the literature to investigate whether there is a relationship between FGM/C and adverse mental health outcomes, such as depressive, anxious and PTSD-related symptoms. To this end, we conducted a systematic search of multiple databases and included in this review a total of 27 studies that assess the psychopathological sequelae of this practice on circumcised women and girls, through the use of validated mental health assessment tools. We used the ROBINS-I tool for assessing the risk of bias of each included study. We then conducted a narrative synthesis and metanalyses for each outcome, as well as a sensitivity analysis. Thirteen studies revealed an association between FGM/C and at least one adverse mental health outcome, with eight studies detailing a connection with depressive symptoms, seven correlating it to anxiety symptoms and four underlining its link to post-traumatic stress disorder (PTSD). Out of five studies that assessed the impact of age at the time of FGM/C and the type of circumcision, three pointed to a higher risk for psychiatric symptoms in women who underwent FGM/C at a more advanced age and three indicate that FGM/C type III is associated with worse outcomes. The metanalysis did not reveal any statistically significant relationship between FGM/C and any of the evaluated outcomes. Further research is necessary in order to more confidently assess the relationship between FGM/C and mental health, with higher quality and more standardized protocols and assessment, as well as more detail about the procedure.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Keywords
Mutilação genital feminina Saúde mental Depressão Ansiedade Perturbação de stress pós-traumático Psiquiatria Psicologia médica