ABSTRACT
Background: Infertility has mental, social, and reproductive consequences. The aim of this study is to evaluate the effect of psychiatric intervention on the pregnancy rate of infertile couples. Methods: In an experimental and intervention-control study, 638 infertile patients who were referred to a university infertility clinic were evaluated; 140 couples (280 patients) with depression (from mild to severe) in at least one of the spouses were followed. All couples provided informed consent and were randomly numbered from 1 to 140. Those with even numbers were assigned to the psychological intervention before infertility treatment, and those with odd numbers were assigned to the psychological intervention during infertility treatment. Patients in the experimental group received 6–8 sessions of psychotherapy (individually) before beginning infertility treatment and were given Fluoxetine (antidepressant) at 20–60 mg per day during the psychotherapy period. The control group did not receive any intervention. Three questionnaires, the Beck Depression Inventory (BDI), the Stress Scale (Holmes-Rahe), and a sociodemographic questionnaire, were administered to all patients before and after treatment. The clinical pregnancy rate was compared between the two groups based on sonographic detection of gestational sac 6 weeks after the last menstrual period. The data were analysed by t test, X2 and logistic regression methods. Results: Pregnancy occurred in 33 (47.1%) couples in the treatment group and in only 5 (7.1%) couples in the control group. There was a significant difference in pregnancy rate between the treatment and control groups (X2= 28.318, P < 0.001). To determine the effectiveness of psychiatric interventions on pregnancy, a logistic regression analysis was used. In this analysis, all demographic and infertility variables were entered in a stepwise manner. The results showed that in the treatment group, Pregnancy in the treatment group was 14 times higher than the control group (95% CI 4.8 to 41.7). Furthermore, cause of infertility was an effective factor of pregnancy. The adjusted odds ratio in male factor infertility was 0.115 (95% CI 0.02 to 0.55) and in both factors (male and female) infertility was 0.142 (95% CI 0.03 to 0.76) compared with the unexplained group. In this study, no other variables had any significant effect on pregnancy. Conclusion: Based on the effectiveness of psychiatric interventions in increasing pregnancy rate, it is crucial to mandate psychiatric counselling in all fertility centres in order to diagnose and treat infertile patients with psychiatric disorders.
ABSTRACT
The present study aimed at identifying the methods and appropriate strategies for public awareness and education on preparedness in earthquakes in Tehran metropolis. This was a cross-sectional study. The study was a door-to-door survey of the 22 municipal districts in Tehran and involved a total of 1211 subjects aged 15 and above. People were asked about different methods of public information and education, as well as the types of information needed for earthquake preparedness. The important issues indicated by respondents were supervision on building construction and strengthening of buildings as well as public education. The educational tools and media that were proposed by the respondents included television, radio, posters, educational classes, newspapers and instructional pamphlets regarding earthquakes, video films and internet, respectively. The study has also shown that with the assumption of earthquake occurrence in Tehran, the most important sources for getting immediate information were the general public and TV. 70% of the respondents believed that in case of earthquake prediction, people should be informed by the media. The study findings revealed that information dissemination alone can not result in changing people's perspectives and behaviors. Appropriate methods are needed along with increasing people's understanding and raising their awareness on the earthquake damage in order to encourage them to learn and implement preventive measures. The paper also indicated that mass media have important role in public education and providing people with adequate information about disasters