ABSTRACT
Background: Fertility loss is considered as a challenging experience. This study was conducted to compare the effectiveness of antidepressant medication and psychological intervention on depression symptoms in women with infertility and sexual dysfunctions [SD]
Materials and Methods: This randomized, controlled clinical trial study was completed from December 2014 to June 2015 in Babol, Iran. Of the 485 participants, 93 were randomly assigned in a 1: 1: 1 ratio to psychosexual therapy [PST], bupropion extended-release [BUP ER] at a dose of 150 mg/d, and control [no intervention] groups. The Beck Depression Inventory [BDI] was completed at the beginning and end of the study. Duration of study was eight weeks. Statistical analyses were performed by using paired-test and analysis of covariance
Results: The mean depression score on the BDI was 22.35 +/- 8.70 in all participants. Mean BDI score decreased significantly in both treatment groups [PST: P<0.0001, BUP: P<0.002] from baseline to end of the study, whereas intra-individual changes in BDI score were not significant in the control group. The decrease in mean BDI score was greater with PST compared to BUP treatment [P<0.005] and the control group [P<0.0001]. The PST group showed greater improvement in depression levels [severe to moderate, moderate to mild] in comparison with the two other groups [P<0.001]. Drug treatment was well tolerated by the participants in the BUP group
Conclusion: PST can be a reliable alternative to BUP ER for relieving depression symptoms in an Iranian population of women with infertility and SD
ABSTRACT
Objectives: Spontaneous abortion is one of the most important complications of pregnancy with short and long adverse psychological effects on women. This study assesses the implications of a spontaneous abortion history has on women's psychiatric symptoms and pregnancy distress in subsequent pregnancy less than one years after spontaneous abortion
Methods:A case-control study was conducted on pregnant women of Babol city from September 2014 to May 2015. In this study, 100 pregnant women with spontaneous abortion history during a year ago and 100 pregnant women without spontaneous abortion history were enrolled. All the participants in two groups completed the Symptom Checklist-90-Revised [SCL-90-R], and pregnancy Distress Questionnaire [PDQ]
Results:Women with spontaneous abortion history had significantly higher mean of many subscales of SCL- 90 [depression, anxiety, somatization, obsessive-compulsiveness, interpersonal sensitivity, psychoticism, hostility, paranoid, and Global Severity Index] more than women without spontaneous abortion history. Also, women with spontaneous abortion history had significantly higher mean of two subscales of PDQ concerns about birth and the baby, concerns about emotions and relationships] and total PDQ more than women without spontaneous abortion history
Conclusion:Pregnant women with less than a year after spontaneous abortion history are at risk of psychiatric symptoms and pregnancy distress more than controls. This study supports those implications for planning the post spontaneous abortion psychological care for women, especially women who wanted to be pregnant during 12 month after spontaneous abortion
ABSTRACT
Objectives: To explore whether coping strategies and general anxiety are associated with pregnancyspecific stress [PSS] and how much of variance of PSS is explained with these variables
Methods: A cross sectional study was conducted at two teaching hospitals between November 2013 and December 2015. Total 190 pregnant women [60 women at 6-13-weeks of gestation, 60 at 13-26 weeks, and 70 at 27-40 weeks of gestation] completed the study. The participants completed three questionnaires including; Pregnancy experience scale [PES-41], Ways of Coping Questionnaire [WCQ], and State-Trait anxiety inventory [SATI]. Pearson coefficients and analysis of regression was done to assess the correlations between variables
Results: Pregnant women who experienced higher mean level of pregnancy specific-stress had significantly higher mean level of occult anxiety, overt anxiety, and total anxiety than women who did not experience PSS. Although there was a positive and significant relationship between intensity of hassles and uplifts and ways of coping, the correlation between PSS and ways of coping was not significant. The results of analysis regression showed that general anxiety during pregnancy predicted 25% of the variance of PSS [F=4.480, beta=0.159]. Also, ways of coping predicted 38% of the variance in pregnancy Hassles [F=7.033, beta=0.194]
Conclusion: The ways of coping predicted the variance of pregnancy hassles, but does not evaluate pregnancy specific-stress. To think about PSS in terms of general anxiety may help to clarify past findings and to guide future research and interventions
ABSTRACT
The infertility is associated with psychological consequence including depression, and lack of self-efficacy. The aim of this study was to compare the pharmacological and no pharmacological strategies in promotion of self-efficacy of infertile women. A randomized controlled clinical trial was conducted on 89 infertile women who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center and were randomized into three groups; cognitive behavioral therapy [CBT], antidepressant therapy with flouxetine 20 mg daily for 3 month, and a control group. All participants completed Infertility Self-efficacy Inventory [ISE] and the Beck Depression Inventory [BDI] at the beginning and end of the study. The means ISE scores among the CBT, fluoxetine, and control groups at the beginning and end of the study were 6.1 +/- 1.6 vs. 7.2 +/- 0.9, 6.4 +/- 1.4 vs. 6.9 +/- 1.3 and 6.1 +/- 1.1 vs. 5.9 +/- 1.4 respectively. Both CBT and fluoxetine increased the mean of ISE scores more than control group after intervention [p<0.0001, p=0.033; respectively], but increase in the CBT group was significantly greater than flouxetine group. Finally, there was evidence of high infertility self-efficacy for women exposed to the intervention compared with those in the control group. Also, there was an improvement in depression. Both fluoxetine and CBT decreased significantly the mean of BDI scores more than the control group; decrease in the CBT group was significantly more than that in the fluoxetine group. CBT can serve as an effective psychosocial intervention for promoting self-efficacy of infertile women