Factors associated with poor quality of life among Iranian infertile women undergoing IVF

Infertility is a medical and social condition and has a considerable impact on a person’s quality of life (QoL). The aim of the study was to determine the QoL of women with fertility problem, and identify factors associated with poor QoL. This cross-sectional study included 155 women with fertility problems undergoing IVF in a referral fertility center in Tehran, Iran. The Fertility Quality of Life, the Hospital Anxiety and Depression Scale and demographic and fertility information questionnaire were administered to all women. The mean total QoL score was 62.57 ± 16.89. Multivariate analysis showed that the anxiety (β = ?1.59, p < 0.001) and depression (β = ?2.09, p < 0.001) had a negative impact on QoL. Cause of infertility and failure in previous treatment were also significant factors of poorer QoL. The findings indicate that the QoL was worse in women with high depression and anxiety level, failure in previous treatment and unknown cause of infertility. Thus, a comprehensive approach, including psychosocial interventions and support, is absolutely essential to improve the QoL in these women.     

The effects of anxiety and depression on in vitro fertilisation outcomes of infertile Chinese women

The object was to assess anxiety and depression during in vitro fertilisation (IVF) treatment and determine IVF-related psychological factors in infertile Chinese women. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate anxiety and depression among 842 patients, respectively. A univariate analysis was used to compare variables among three SAS groups and three SDS groups. Anxiety and depression were both represented in 21.3% of the cases. Patients <35 years tended to be more anxious. In women <35 years, the SDS scores were higher with lower educational backgrounds and female or couple’s infertility, while the SAS scores were higher in female or couple’s infertility. In older ones, the SDS scores were higher in those with lower educational backgrounds and longer time for infertility, while the SAS scores were higher in those with lower educational backgrounds. In SAS groups 1–3, the embryo availability was 5.0 (3.0–8.0), 5.0 (3.0–8.0), and 3.0 (2.0–4.5) (p = .013); and the fertilisation rate was 91.9, 90.4, and 81.8% (p < .001), respectively. We concluded that infertile women experience anxiety and depression during IVF treatment, especially in women <35 years. Younger women with female infertility would be more anxious and depressive while higher education can protect them from depression. In older ones, they would experience more depressive with longer time for infertility and be less anxious and depressive with higher education. Anxiety affects the fertilisation rate and embryo availability.     

Hurricane Katrina's impact on the mental health of adolescent female offenders

Abstract

Exposure to multiple traumatic events and high rates of mental health problems are common among juvenile offenders. This study draws on Conservation of Resources (COR) stress theory to examine the impact of a specific trauma, Hurricane Katrina, relative to other adverse life events, on the mental health of female adolescent offenders in Mississippi. Teenage girls (N=258, 69% African American) were recruited from four juvenile detention centers and the state training school. Participants were interviewed about the occurrence and timing of adverse life events and hurricane-related experiences and completed a self-administered mental health assessment. Hierarchical linear regression models were used to identify predictors of anxiety and depression. Pre-hurricane family stressors, pre-hurricane traumatic events, hurricane-related property damage, and receipt of hurricane-related financial assistance significantly predicted symptoms of anxiety and depression. Findings support COR theory. Family stressors had the greatest influence on symptoms of anxiety and depression, highlighting the need for family based services that address the multiple, inter-related problems and challenges in the lives of female juvenile offenders.     

Psychosocial correlates of eczema in a non-treatment-seeking population

Data from the Vietnam Experience Study were used to examine psychosocial correlates of eczema. Based upon the results of dermatologic examinations, three groups of male veterans were identified: (a) subjects with eczema (n = 80), (b) subjects with tinea (n = 282), and (c) subjects with no medical diagnosis (n = 176). These three groups were compared on measures of anxiety, depression, hostility, and social support. The Diagnostic Interview Schedule (Version III-A) was used to determine diagnoses of anxiety and depression and level of social support. MMPI Scales 2 and 7, the Wiggins content scale of Depression, and the Cook-Medley Hostility Scale were used to assess anxiety, depression, and hostility. Eczema subjects did not differ from tinea or no-disease control groups on dependent measures. These results are contrasted with previous studies of treatment-seeking patients, which showed greater prevalence of anxiety and depression among individuals with eczema. Directions for future research are suggested.This paper is taken from the first author's dissertation.     

Associations Between Maternal Mental Health and Child Emotional and Behavioral Problems: Does Prenatal Mental Health Matter?

This study examined associations between elevated symptoms of prenatal depression or anxiety and offspring emotional and behavioral problems during mid to late childhood taking into account the impact of later maternal mental health symptoms. The sample consisted of 2,891 women and their children (49 % male) from a prospective, community-based study, the Avon Longitudinal Study of Parents and Children. Women completed measures of depressive (Edinburgh Postnatal Depression Scale) and anxious (Crown Crisp Experiential Index) symptoms at regular intervals beginning in pregnancy. Mothers and teachers assessed offspring emotional and behavioral problems using the Strengths and Difficulties Questionnaire when children were 10–11 years old. Multivariable regression models were fit to address study hypotheses. Exposure to elevated symptoms of maternal depression during pregnancy was associated with increased total offspring emotional and behavioral problems, even after controlling for later maternal mental health problems and a range of sociodemographic and psychosocial characteristics, according to mothers’ but not teachers’ reports. Similarly, children exposed to elevated symptoms of maternal anxiety during pregnancy were reported to have increased total emotional and behavioral problems by mothers but not by teachers. We found support for modest associations between elevated symptoms of maternal depression and anxiety during the prenatal period and certain domains of offspring emotional and behavioral problems in mid to late childhood above and beyond the impact of later maternal mental health problems. These findings highlight the need for additional clinical and research attention to the prenatal period and to both maternal depression and anxiety.     

The Before Baby Relationship Checkup: A Couples-Based Intervention to Reduce Relationship Risk Factors for Perinatal Mood and Anxiety Disorders

Relationship conflict and lack of partner support are risk factors for perinatal mood and anxiety disorders. An intervention to strengthen couples’ relationships before birth may reduce relationship risk factors for perinatal mood and anxiety disorders, though no research has explored this to date. The aims of this Stage 1 open-series non-experimental proof of concept study were to adapt the ‘Marriage Checkup’, an evidence-based intervention for relationship distress, as a preventative intervention for perinatal mood and anxiety disorders and to assess its feasibility and acceptability. Pregnant women receiving care at a university-based obstetric practice, and their partners, were recruited. Ten couples participated in the Before Baby Relationship Checkup, a personalized relationship health service offered in the obstetric clinic. Quantitative and qualitative data gathered suggests the intervention is feasible to implement in an obstetric setting, and acceptable to perinatal couples. Specific adaptations to the Marriage Checkup for perinatal couples are warranted and further testing is needed to evaluate efficacy.

     

Quality-of-life after penile prosthesis placed at radical prostatectomy

Abstract

The clinical and psychosocial effects of immediate penile prosthesis implantation at the time of radical prostatectomy (RP) were investigated in 97 consecutive patients and 68 partners. Prosthesis recipients reported more frequent sexual contact, fewer marital problems and slightly fewer sexual functioning problems than the RP-alone patients. There were no group differences on any sociodemographic characteristics, on disease recurrence, on physical and psychosocial functioning, or on reported depression. Patients who chose the prosthesis did, however, evidence less of a link between depression and functional limitations and between depression and marital problems. They also had lower levels of agreement with their partners in reporting their own depression, as compared to the patients who opted for RP surgery alone. We conclude that the penile prosthesis was associated with an increased frequency of sexual contact, a reduction in reported marital problems, and stylistic differences between the two patient groups in dealing with affect.     

Overanxious disorder: An examination of developmental differences

Differences between a clinical sample of younger (ages 5 to 11) and older (ages 12 to 19) children meeting DSM-III criteria for overanxious disorder (OAD) were examined. Younger and older children were compared in terms of (1) the rates of OAD diagnoses occurring in the two age groups, (2) sociodemographic characteristics, (3) symptom expression, (4) association with other forms of maladjustment, and (5) self-reported anxiety and depression. The prevalence of OAD diagnoses and sociodemographic characteristics did not differ. Although younger and older OAD children showed similar rates of most specific DSM-III OAD symptoms, older children presented with a higher total number of overanxious symptoms than younger children. Older children more frequently exhibited a concurrent major depression or simple phobia, whereas younger OAD children more commonly had coexisting separation anxiety or attention deficit disorders. Older OAD children reported significantly higher levels of anxiety and depression on self-report measures. Findings indicated that the expression of OAD varies by developmental level.     

MATERNITY LEAVE AND WOMEN'S MENTAL HEALTH

The Wisconsin Maternity Leave and Health Study addresses an important policy issue, parental leave, by investigating the work status, maternity leave, and mental health of 570 women. In the longitudinal design, the women, all of whom were living with a husband or partner, were interviewed during the fifth month of pregnancy, 1 month postpartum, and 4 months postpartum. At 4 months postpartum, full-time workers, part-time workers, and homemakers did not differ in depression or anger, but full-time workers showed elevated anxiety compared with the other two groups. In multiple regression analyses, length of leave interacted significantly with marital concerns when predicting depression; women who took a short leave (6 weeks or less) and were high on marital concerns had the highest depression scores. Short maternity leave can be conceptualized as a risk factor that, when combined with other risk factors such as marital concerns, places women at greater risk for depression.     

Depression and anxiety among war-widows of Nepal: a post-civil war cross-sectional study

Thousands of Nepalese women were widowed as a consequence of a decade (1996–2006) long civil war in Nepal. These women are at grave risk of mental health problems due to both traumatic experiences and violation of natural order of widowhood. The present study explores the depression and anxiety among war-widows. In 2012, a cross-sectional study was designed to interview 358 war-widows using validitated Beck Depression Inventory and Beck Anxiety Inventory in four districts of Nepal – Bardiya, Surkhet, Sindhupalchowk and Kavrepalanchowk with history of high conflict intensity. The prevalence of depression and anxiety was 53% and 63% respectively. Financial stress was significantly associated with depression (2.67, 95% CI: 1.40–5.07) and anxiety (2.37, 95% CI: 1.19–4.72). High autonomy of women as compared to low autonomy, high social support as compared to low social support and literacy as opposed to illiteracy was associated with less likelihood of depression and anxiety. Our results suggest high magnitude of depression and anxiety among war-widows in Nepal. Future policy efforts should be directed at providing mental health services to identify mental health issues among conflict affected individuals with focus on education, employment and activities to promote social support and autonomy at community.     

Emotional Reactions and Attitudes Prior to In Vitro Fertilization: An Inter-Spouse Study

In this study, spouse's emotional responses and attitudes to in vitro fertilization (IVF) treatment were examined. The participants were 113 childless couples who suffered from infertility of unknown or mechanical (women) cause. Both partners were evaluated prior to IVF treatment. Incompatible emotional responses and attitudes to the treatment between the partners usually reflected the men reporting less distress and worries than women. Women had significantly higher state and trait anxiety and depression scores than normative levels, irrespective of whether they were successful in conceiving. Husbands of conceiving women scored higher on depression than husbands of nonconceiving women. The nonconceiving husbands had depression and trait anxiety scores significantly lower than the normative level. In addition, high emotional responses to the treatment, especially in men, were positively associated with treatment success. Recommendations for family assessment and counseling are suggested on the basis of these results.     

“Social Separation” Among Women Under 40 Years of Age Diagnosed with Breast Cancer and Carrying a BRCA1 or BRCA2 Mutation

We conducted an exploratory, qualitative study investigating experiences of women who had developed breast cancer under the age of 40 and who were identified as BRCA1 or BRCA2 mutation carriers. These germline mutation carriers face an increased lifetime risk of a second primary breast cancer and an increased risk for a primary ovarian cancer. Thirteen women who fit this criteria participated in three focus groups conducted at a major cancer center in the UK during Spring 2003. We asked broad, open-ended questions that allowed for a wide range of responses about their cancer and genetic testing experiences, physical and psycho-social concerns, family and partner reactions and their need for social support. The women expressed feelings of devastation, loneliness, feeling different and isolation, ambivalence about having to support family members, worries about partner’s anxiety and depression, and anxiety about talking to family members, especially children. These feelings were stronger after the cancer diagnosis and compounded by the genetic test results that occurred at a later time. We also found that, at least temporarily, the women experienced what we call “social separation”—emotional distance from, or dissonance with groups they interact with or are part of, e.g., family and friends, frequently leading to a reduction in communication or a change in previously unstated, but accepted normal interaction. We concentrate on a few characteristics of social separation—feelings of aloneness, isolation and separation, use of silence and verbal discretion, the relationship between estrangement and kinship interaction and norm disruption, and are looking at social patterns of interpersonal relationships that may occur when risk and illness statuses are new and framing and feeling rules have not as yet been clearly developed due to a cultural lag.     

The Compatibility of Ideal and Real Romantic Partner Characteristics,Attachment to Partner and Relationship Satisfaction Among Indian Women

This study examined the compatibility between the characteristics of ideal and real romantic partners, attachment to partner (defined by two categories—avoidance and anxiety) and relationship satisfaction of (N = 272) women involved in close heterosexual relationships. As hypothesized, higher compatibility of ideal and real romantic partner characteristics was related to lower levels of avoidance and anxiety and higher levels of relationship satisfaction. This study also revealed that the three-factor model for ideal partner (partner warmth-trustworthiness, vitality-attractiveness, and status-resources), designed by Fletcher, Simpson et al. (1999) was not fully suitable to Indian women; there were five major dimensions, which defined what women used as standards to evaluate ideal partners. The study showed that: older women more than younger ones desired external and family—related attributes of ideal partner. The results suggest that ideals may be very important for satisfying relationships and secure connection with the romantic partner. The cultural differences in evaluative dimensions for ideal partner needs further investigation.     

Discovery of a Partner Affair and Major Depressive Episode in a Probability Sample of Married or Cohabiting Adults

Prior research has found that humiliating marital events are associated with depression. Building on this research, the current study investigated the association between one specific humiliating marital event—discovering that one's partner had an affair—and past‐year major depressive episode (MDE) in a probability sample of married or cohabiting men and women who were at high risk for depression based on the criterion that they scored below the midpoint on a measure of marital satisfaction (N = 227). Results indicate that (i) women were more likely than men to report discovering their partner had an affair in the prior 12 months; (ii) discovering a partner affair was associated with a higher prevalence of past‐year MDE and a lower level of marital adjustment; and (iii) the association between discovering a partner affair and MDE remained statistically significant when holding constant demographic variables and marital adjustment. These results support continued investigation into the impact that finding out about an affair has on the mental health of the person discovering a partner affair.     

Perceived dyadic coping,anxiety, depression and satisfaction with life of women diagnosed with fibromyalgia

Women diagnosed with fibromyalgia face a wide range of challenges impacting multiple aspects of their lives, such as their relationship with their partner. This study aims to examine how women diagnosed with fibromyalgia manage stress in their own couple and to investigate the role of dyadic coping in anxiety and depression symptoms, and in life satisfaction. Seventy-three women diagnosed with fibromyalgia and 73 matched women filled questionnaires to examine dyadic coping, anxiety and depression symptoms, and life satisfaction. Results show that women diagnosed with fibromyalgia perceived themselves and their partner as using more negative dyadic coping, more delegated dyadic coping and less common dyadic coping. Moreover, negative dyadic coping predicted higher anxiety symptoms and poorer life satisfaction. Overall, our findings highlight the importance of dyadic stress management in understanding psychological adjustment better in women diagnosed with fibromyalgia and the need to develop better-adapted interventions to support them effectively.     

Cognitive biases in processing infant emotion by women with depression,anxiety and post-traumatic stress disorder in pregnancy or after birth: A systematic review

Perinatal psychological problems such as post-natal depression are associated with poor mother–baby interaction, but the reason for this is not clear. One explanation is that mothers with negative mood have biased processing of infant emotion. This review aimed to synthesise research on processing of infant emotion by pregnant or post-natal women with anxiety, depression or post-traumatic stress disorder (PTSD). Systematic searches were carried out on 11 electronic databases using terms related to negative affect, childbirth and perception of emotion. Fourteen studies were identified which looked at the effect of depression, anxiety and PTSD on interpretation of infant emotional expressions (k = 10), or reaction times when asked to ignore emotional expressions (k = 4). Results suggest mothers with depression and anxiety are more likely to identify negative emotions (i.e., sadness) and less accurate at identifying positive emotions (i.e., happiness) in infant faces. Additionally, women with depression may disengage faster from positive and negative infant emotional expressions. Very few studies examined PTSD (k = 2), but results suggest biases towards specific infant emotions may be influenced by characteristics of the traumatic event. The implications of this research for mother–infant interaction are explored.     

A Case-Control Study of Psychosocial and Aerobic Exercise Factors in Women With Symptoms of Depression

The study is an examination of specific aspects of psychosocial constructs and health-promoting behavior that may be related to symptoms of depression. The authors used a case-control design to investigate possible differences between provisional social support, hardiness dimensions, and exercise behavior and related perceptions in a sample of 94 White, middle-aged women with and without symptoms of depression. The results indicated that women with symptoms of depression have significantly fewer (p < .001) specific forms of social support resources (i.e., reassurance of worth, social integration, guidance, and attachment) and significantly lower (p < .0001) perceptions of control and commitment in their lives. The results also indicated no difference in perceptions and behaviors related to physical activity between women with and without symptoms of depression. Those results suggest that provisional social support, as well as specific dimensions of hardiness, should be the focus of interventions for women with symptoms of depression.     

Assessment of HIV counselling and social care services in a London hospital

The use of, and satisfaction with, counselling and social care services was investigated among HIV-infected clients attending HIV specialist climes at Guy's Hospital and Southwark Social Services, London. A survey of 71 clients with HIV infection was carried out using a self-administered questionnaire. The greatest demand was for advice about income support, housing, counselling for the HIV test, counselling for depression or anxiety, psychological support for coping with HIV, help with sleeping problems, mobility allowance, and help with furniture/household appliances. Overall, 57% thought the service was good or excellent; 66% of respondents thought they would use the services in the future. Over nine in ten clients had used the psychosocial support services at some stage since their HIV diagnosis, although only two-thirds anticipated that they would have need of these services in the future. The psychosocial support service will need to remain responsive to the shift in demand for this service, as well as the changing needs of clients who use it.     

Explaining Delay in Care Seeking for Breast Cancer Symptoms1

From a theory of care-seeking behavior, this study answered two questions: Do psychosocial variables (anxiety, utility, norm, and habit) and objective, facilitating conditions (e. g., regular practitioner) influence care-seeking delay with a breast symptom directly, or are psychosocial influences moderated by facilitating conditions? Do demographic or clinical factors explain delay, controlling for psychosocial variables and facilitating conditions? Women with breast cancer symptoms (N= 106) completed questionnaire measures. Delay was measured by the days between symptom detection and first contact with the health system. Norm and having a regular practitioner were related inversely to delay. The influence of anxiety was moderated by having a regular practitioner. Among women lacking a practitioner, anxiety was related inversely to delay; among women with a practitioner, anxiety was not related to delay. Controlling for psychosocial variables and facilitating conditions, women of color delayed longer than did Caucasians. Findings can guide research and theory about care seeking.