Two-thousand cases (500 women and 500 men with sterilization; 500 women and 500 men without sterilization) in two counties and two cities in Sichuan, China, were investigated between 15 September 1992 and 30 April 1993. Information was obtained about their age, parity, marriage, contraceptives, social behavior, and present psychological characteristics. CES-D, SAS, and E.P.Q. scales were used to assess the depressive symptomatology, anxiety, and personality of the subjects. The results revealed that sterilization psychologically affected the depressive symptoms and anxiety under the neutral personality. In addition, depressive symptoms and anxiety were related to the subjects' age, educational level, income, operative doctors' attitudes to sterilization acceptors, and subjects' understanding of the sterilization.
PIP: A comparative study conducted in two counties and two cities in China's Sichuan province indicated that surgical sterilization may have long-term psychological effects. Subjects included 500 men 40-44 years of age and 500 women 35-39 years of age who underwent vasectomy or tubectomy 5 years prior to the study; 500 non-sterilized men and 500 non-sterilized women from the same site, in the same age groups, and with the same number of children were recruited as controls. Three scales measuring personality, anxiety, and depression were administered. All eight indicators of depression were significantly higher among sterilized men and women. The risk for depression was 2.34 times greater after tubal ligation and 3.97 times greater after vasectomy. Similarly, all 10 indicators of anxiety were significantly higher among sterilized subjects. The risk for anxiety was 2.88 times greater after tubal ligation and 4.79 times greater after vasectomy. The subjects' personality type did not affect their psychological disorders. In general, sterilization acceptors of relatively older ages, higher levels of education, and higher incomes were more likely to report depression and anxiety. Depression and anxiety were also associated with a lack of adequate rest after the sterilization procedure and poor communication skills on the part of the sterilization provider. These findings suggest a need for careful pre-sterilization counseling and education as well as the option of psychotherapy for those who have undergone the procedure.