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Introduction: Infertility and depression are major problems of today&aposs societies. Although depression is one of the most prevalent diseases in primary care practice, consult for receiving help is carried out much less than true prevalence of the disease. Therefore gathering information about prevalence and risk factors of depression is very valuable. Beck Depression Inventory (BDI) which is a screening tool for depression can be used in Iranian patients because of availability of a validated translation. The objective of this study was to estimate the prevalence of depression in infertile subjects in an infertility center.

Materials and Methods: In this study, 681 infertile women were evaluated in Shariati Hospital, Tehran. Demographic information’s including age, duration, type and cause of infertility, level of education, previous treatments and smoking habits were recorded. BDI was completed by patients and score was estimated. Score of 16 and higher was assumed positive.

Results: There was no relationship between age and prevalence of positive BDI score, but prevalence of positive BDI score was higher in infertilities of longer duration, infertilities caused by both male and female factors and in patients with low level of education and history of previous treatment or surgical therapy.

Conclusion: Infertile patients are at risk of depression. Rate of consulting with psychiatrists and getting help is low in our country due to cultural aspects, so screening of high risk subgroups in infertile patients and referring them to psychiatrist would be very helpful.

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Background & Aim: Postpartum depression is mood disorder that affected 10-15% of women during 6 months after delivery. This study was designed to investigate preventive effect of supportive activities during prenatal on postpartum depression.

Methods & Materials: This research is clinical trial study and the samples were 440 pregnant women in Lahijan and Astanea in eastern of Gilan .The sampling was simple randomization for 2 groups. One group presented in education classes and others received current prenatal care. Between 4 to 8 weeks after delivery their Beck depression inventory (BDI) score was evaluated among two groups. Data analysis has been done by SPSS statistical software.

Results: Prevalence depression (cases who have Beck score more than 16) in study group was 6.5% versus 18.6% in control group. Mean BDI score in study group was 7.08 versus 8.69.

Conclusion: Participated to education classes during pregnancy decrease the postpartum depression.

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Background & Aim: Postpartum depression is a severe and pervasive sadness with labile mood that affect 8-15% women after delivery. It can negatively impress mother-infant bonding. There are a lot of factors which make women vulnerable to postpartum depression so that controlling them can prevent from the postpartum depression incidence. Several researches have shown an association between serum cholesterol reduction and depression. The aim of present study is to determine relation between postpartum depression with total serum cholesterol changes before and after child birth in Lahijanian women in years 2006-2007.

Methods & Materials: This research sought a descriptive-analytical design. Samples consisted of healthy Primigravidia women (101 persons) with normal labor, normal delivery at term, married, and a medium to high socio-educational level, without history of a depressive disorder, and metabolic disorders or hyperlipidemia. The excluded were the women with maternal or fetal complication before delivery, having problem with accepting infant gender, fetal death and being depressed during pregnancy. All women were visited in two stages: 3 weeks before the expected delivery and also 6 weeks after delivery. On both visits the Beck depression inventory and serum cholesterol registration questionnaire were completed. Data were collected using a questionnaire which had three sections: demographic characteristics, the Beck depression inventory and laboratory tests. Data were analysed using descriptive and inferential statistics (Spearman correlation coefficient and t-test) by SPSS computer software.

Results: Findings indicated that serum cholesterol declined considerably in the postpartum period, also it was shown that there was a significant correlation between reduced serum cholesterol and postpartum depression (r=-0.331, P<0.001).

Conclusion: Serum cholesterol reduction has a relation with postpartum depression.

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  Background & Aim: Reducing maternal anxiety has a critical role in maternal and fetal mental and physical health. This study aimed to assess the effect of two anxiety reducing techniques including relaxation and maternal-fetal attachment training on anxiety in third trimester and postpartum depression among primipara women.

  Methods & Materials: In this clinical trial, 126 pregnant women were randomly selected and divided into three groups including relaxation training, maternal-fetal attachment skills training, and control group. The participants completed a demographic questionnaire, the Spillberger and Beck questionnaires and written consents at baseline. The participants completed the questionnaires after the intervention too. The one way ANOVA and paired t-test were used to analyze the data. 

  Results: At baseline, the mean total anxiety, state and trait anxiety and depression scores were not significantly different between the groups. The ANOVA showed differences in the mean score of anxiety after the intervention (P=0.03) in the intervention groups. There were statistically significant differences between the attachment and control groups (P=0.01) and the relaxation and control groups (P<0.001) in terms of the mean score of state anxiety. The ANOVA showed a reduction in the mean score of state anxiety after intervention in the attachment (P=0.02) and relaxation groups (P=0.01). There was significant difference after the intervention in the mean score of maternal depression (P=0.002) between the attachment and relaxation groups with the control group (P=0.01, P=0.01 respectively). 

  Conclusion: A ttachment and relaxation trainings can reduce maternal anxiety and post-partum depression. Pregnancy visit is an important opportunity to screen maternal anxiety and prevent post-partum depression using simple and non-expensive training programs.

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  Background & Aim: Hysterectomy is the second most common major surgery among women of reproductive age. Studies have suggested that women do not usually receive adequate information regarding hysterectomy before the surgery. Depression is a common psychiatric condition diagnosed after hysterectomy. The aim of this study was to assess the impact of pre-hysterectomy counseling on depression among women.

  Methods & Materials : In this clinical trial, 100 women who had undergone hysterectomy for non-malignant conditionswere selected from two hospitals (women’s’ hospital and Imam Khomeini hospital) and completed the informed consent forms. Participants were randomly divided into two intervention and control groups. In the intervention group, we implemented the supportive counseling within two sessions. Depression was assessed 1-2 weeks before the surgery and two monthsafter the surgery. Data were gathered using the 30-item SAMA questionnaire (modified BECK questionnaire in Iran)for depression and a demographic questionnaire. The two groups were assessed using the Wilcoxon rank-sum test, Mann Whitney U test and paired-t test. Data were analyzed in the SPSS-14.0. The p-value less than 0.05 was considered significant forall tests.

  Results: Mann Whitney U test showed no significant difference between the control and intervention groups in the mean score of depression (p<0.001). In the intervention group, the mean score of depression was 44.46 ± 6.7 at baseline and 20.86 ± 5.9 after the intervention.

  Conclusion : Pre-hysterectomy counseling should be provided for women in order to reduce negative psychological consequences.

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  Background & Aim: Depression is common among nursing and midwifery students. Problem-solving is a short-term intervention that can be used to treat psychological problems. This study was carried out to evaluate the effect of problem-solving skills training on depression scores among nursing and midwifery students .

  Methods & Materials: This was a clinical trial. Nursing and Midwifery st udents (n=900) studying at Tabriz and Urmia universities were recruited in the study during 2 010-2011. The Beck Depression Scale was administered in both schools. Ninety two students who achieved a score above 10 in the Beck Depression Scale were selected. One school was randomly allocated to the intervention group and the other one was allocated to the control group. Students in the intervention group received six sessions of problem-solving skills training within three weeks. T he questionnaire was completed by the participants in both schools after the intervention. Data were analyzed using the independent t-test . 

  Results: After the intervention, the Beck Depression Inventory score in the intervention group decreased from 18.60 to 13.41 (P<0.01). There were no differences in the control group before and after the intervention (P<0.01) .

  Conclusion: The problem-solving skills training program reduced depression scores. Providing information and using the problem-solving skills training are recommended .

  

 

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Background & Aim: Mother-Child bonding is an emotional aspect of relationship between mother and baby that affects children's psychological development. This study was performed to determine the predictors of mother-child bonding.

Methods & Materials: This cross-sectional study was performed on 270 mothers 8 to 10 weeks postpartum referred to eighteen health centers of Tabriz, 2014-2015. Data were collected using the obstetric and socio-demographic characteristics questionnaire, the Postpartum Bonding Questionnaire, the Edinburgh Postnatal Depression Scale and the Spielberger State-Trait Anxiety Inventory. The statistical tests including Pearson correlation, Independent t, one-way ANOVA and multivariate linear regression were used for data analysis through SPSS v.21. The significance level was considered as P<0.05.

Results: The mean (SD) of mother-child bonding score was 46.2±8.4, with achievable scores range from 0 to 125. 85.2% of mothers had a mother-child bonding disorder. The most frequent disorder pertained to the dimension of impaired mother-child bonding and the least frequent disorder was anxiety about child care. Variables of depression, state anxiety and unwanted pregnancy were among the predictors of mother-child bonding.

Conclusion: The study shows that anxiety, depression, and unwanted pregnancy are the determinants affecting mother-child bonding. Thus, the screening of mothers for the early identification and treatment of anxiety and depression, and also the reduction of unwanted pregnancy rate using purposeful family planning counseling can improve the mother-child bonding, resulting in improved children's growth and development.

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Background & Aim: Quality of life indicates the level of individual’s satisfaction or dissatisfaction with the different aspects of life and has specific characteristics at each stage of life. The quality of life in the elderly may be influenced by death anxiety and depression. The aim of this study was to evaluate the relationship of depression and death anxiety to the quality of life among the elderly population.

Methods & Materials: This study was a cross-sectional research conducted on 294 elderly living in Saghez in 2016. Samples were selected through convenience sampling. The 12-Item Short Form Health Survey (SF-12), Geriatric Depression Scale (GDS) and Death Anxiety Scale were used to gather the data. Data were analyzed using descriptive statistics, the Kolmogorov-Smirnov test, Pearson correlation coefficient and linear regression by Enter method. The level of significance was considered P<0.05.

Results: The mean (and standard deviation) scores for the quality of life, depression and death anxiety among the studied elderly were respectively 33.22±7.81, 4.92±3.82 and 33.63±7.40. There was a significant relationship between depression and the quality of life (P<0.0001) but there was no significant relationship between the quality of life and death anxiety.

Conclusion: Depression is a common problem among the elderly and related to their quality of life. When assessing the quality of life in the elderly, paying attention to their depression is necessary. Appropriate diagnosis and management of depression can improve the quality of life in the elderly.

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Background & Aim: Depression is common among cardiac patients, especially patients with heart failure and leads to a poor prognosis. This study aimed to assess the effect of exercise on depressive symptoms in patients with heart failure, attending the Cardiac Rehabilitation Center.
Methods & Materials: In this clinical trial, 60 patients with NYHA class II and III heart failure who referred to the Cardiac Rehabilitation Center of Shafa Hospital affiliated to Kerman University of Medical Sciences in 2015 were randomly assigned into two groups of 30 patients. Subjects in the intervention group participated in a supervised 8-week exercise program, 3 days per week, while those in the control group only received standard routine care. Data were collected before and after the intervention by the demographic form and the Personal Health Questionnaire Depression Scale (PHQ-8). Data analysis was done by Chi-Square, Wilcoxon, Mann-Whitney U and Nonparametric ANCOVA tests using the SPSS version 21 and R software.
Results: The two groups were homogeneous in terms of depression score before the intervention. The median and interquartile range of the score of depression were 10 (5.25) in the control group and 8.5 (9.25) in the intervention group which showed a significant difference (P=0.042). By adjusting the variables of the duration of the disease and the pre-test scores of depression symptoms by non-parametric covariance test, the difference between the two groups was also significant.
Conclusion: Exercise can reduce depressive symptoms in patients with heart failure.
Clinical trial registry: IRCT201605107844N10
 

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Background & Aim: Diagnosis of cancer can cause emotional problems such as stress, anxiety, depression and incompatibility with the disease in the patient and his/her family, leading to adverse consequences in the improvement process and an increase in the complications of the disease. Considering the importance of this topic, the study was conducted to investigate the effect of Roy’s adaptation model-based care plan on the severity of depression, anxiety and stress in patients with colorectal cancer hospitalized in the treatment and educational centers of Urmia.
Methods & Materials: In this randomized clinical trial study, 36 patients with colorectal cancer (at the third or fourth stage of disease) hospitalized in the treatment and educational centers of Urmia were selected by a convenience sampling and were assigned to the intervention group or control group in 2016. Data collection tools were a form for assessing the Roy’s adaptation model and the depression, anxiety, and stress scale (DASS-21). The Roy’s adaptation model-based care plan was administered to the intervention group. Data analysis was performed using the SPSS software version 18 and t test and Chi-square test.
Results: The study results showed before the intervention, the mean scores of depression, anxiety and stress were 12.7±4.5, 13.9±4.8, 16.4±4.7 for the control group and were 15.7±4.5, 13.0±4.6, 12.6±4.2 for the intervention group, respectively. There was no statistically significant difference between the two groups (P<0.05). However, after the intervention, the mean scores of the studied variables increased in the control group (13.7±4.8, 13.93±4.9, 17.16±4.4) and decreased in the intervention group (10.46±3.1, 11.00±3.4, 13.8±5.2). There was a significant difference between the two groups (P<0.05).
Conclusion: Due to the severity of depression, anxiety, and stress among cancer patients, more cost-effective and non-pharmacological methods such as the Roy’s adaptation model, can be useful to control these complications and create a less stressful environment for these patients.
Clinical trial registry: IRCT20160220026662N5
 

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Background & Aim: Postpartum depression disorder is a common psychosocial disorder with negative consequences for the mother and child. On the other hand, attention training technique can be more effective than other techniques for intervention in the cognitive-attention syndrome. Therefore, the present study was conducted to determine the effectiveness of attention training technique on the symptoms of depression, anxiety and metacognitive beliefs in patients with postpartum depression.
Methods & Materials: This study was conducted in a single-case experimental design using a multiple baseline design in eight sessions during one-, three- and six-month follow-ups on two patients, referred to the psychology and psychiatry unit of Tabriz Red Crescent in 2018. The Beck Depression Inventory, the Beck Anxiety Inventory and Metacognitive Beliefs Questionnaire were used to collect the data. Data analysis was performed using the Excel software as a graphical analysis and then based on the percentage of improvement, effect size and clinical significance.
Results: At the end of treatment, a significant reduction was observed in the symptoms of depression (61% remission), anxiety (48% remission) and metacognitive beliefs (83% remission) in patients with postpartum depression.
Conclusion: The results of this study showed that attention training technique can be effective in the treatment of patients with postpartum depression. However, further studies are needed in this area.
Clinical trial registry: IRCT20171227038096N1
 

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Background & Aim: Addiction as a crisis and a chronic long-term disorder can lead to mental health symptoms in the users and their family members, the most common of which are stress, anxiety and depression. The aim of the study was to determine the effect of a quality of life intervention on the psychological reactions in family caregivers of addicts.
Methods & Materials: This study is a clinical trial. The research population included the family caregivers of addicts admitted to Baharan psychiatric hospital in 2018. The sample consisted of 80 subjects who were randomly divided into intervention and control groups. The caregivers in the intervention group received eight sessions of group counseling based on quality of life therapy and based on specified content, every other day. Eight weeks after the intervention, the data were collected using the DASS-21, and were analyzed by the SPSS software version 21 using paired t test, independent t test, Chi-square and Covariance.
Results: After the quality of life intervention, the mean scores of stress, anxiety and depression in family caregivers in the intervention group (11.50±4.36, 11.05±3.49, 10.57±4.67) were significantly lower than those of in the control group (14.67±4.93, 14.02±4.33, 13.40±4.77) (P<0.01). There were no significant differences in these variables between the two groups before the intervention.
Conclusion: Counseling based on quality of life therapy in this study had a positive and significant effect on reducing the severity of psychological reactions in family caregivers of addicts. Therefore, health care providers are recommended to use this counseling approach along with addiction treatment programs to increase the welfare and psychological well-being of family caregivers.
Clinical trial registry: IRCT20160924029954N11
 
 

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Background & Aim: The important aspects of maternal postpartum adjustment are readiness in caring for the family, newly-added member and self as well as return to pre-pregnancy functional status. The aim of the study was to determine the predictors of postpartum maternal functioning.
Methods & Materials: This cross-sectional study was conducted on 422 newly delivered mothers attended the healthcare centers of Bonab in 2016 using the cluster random sampling method. Data were collected through a socio-demographic characteristics form, the Edinburgh postpartum depression scale, and the functional status questionnaire. The multivariate linear regression model on the SPSS software version 21 was used to determine the predictors of functional status.
Results: Mean (SD) of the functional status total score was 2.3 (0.24). The maximum and the minimum scores were in the subdomains “infant care” [3.64 (0.32)], and “social activities and society” [1.43 (0.41)], respectively. There was a significant inverse correlation between postpartum depression and total score of functional status, self-care and social activities and society subscales. According to the general linear model, postpartum depression, spouse’s age and job, economic status, mother’s education level and the number of pregnancy were the predictors of mothers’ functional status during postpartum period.
Conclusion: Postpartum depression and some socio-demographic characteristics are among the variables influencing maternal functional status. Therefore, the early diagnosis and treatment of postpartum depression and consideration of the mothers’ socio-demographic characteristics, can improve maternal functional status and result in better maternal postpartum adjustment.
 

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Background & Aim: Diagnosis of cancer causes deep emotional problems such as depression in a patient with cancer. Laughter yoga involves laughter exercises that may be effective in treating depression in patients undergoing chemotherapy. The aim of the study was to determine the effect of laughter yoga on depression in cancer patients undergoing chemotherapy.
Methods & Materials: This two-group randomized clinical trial was conducted on 69 cancer patients undergoing chemotherapy at Reza Medical Center in Mashhad in 2018. Patients were randomly divided into intervention or control groups. For the intervention group, before chemotherapy a 20-30 minute laughter yoga session was performed daily for four days. The control group received routine self-care training. Depression was assessed using the Beck Depression Inventory before and after the laughter yoga sessions. Data were analyzed using Chi-square, independent t-test, Fisher’s exact test, and paired
t-test through the SPSS software version 20.
Results: Women made up 67% (n=46) of the participants in the study. The mean age of patients in the intervention group was 49.0±9.6 years and in the control group 45.2±12.6 years. The mean score of depression in the post-test in the intervention group (7.50±6.04) was significantly lower than that of in the control group (12.54±7.53) (P<0.005). In within-group comparison, there was a significant decrease in the depression score in the intervention group (P<0.001).
Conclusion: Laughter yoga improved depression in the patients undergoing chemotherapy. Thus, its use is recommended for these patients.
Clinical trial registry: IRCT20180429039463N1

 

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Background & Aim: Eating disorders manifest numerous psychological and social consequences for both individuals and society. The present study was conducted to investigate the effectiveness of cognitive-behavioral therapy in alleviating COVID-19-related anxiety, fear of negative evaluation, and depression among women diagnosed with Anorexia Nervosa.
Methods & Materials: This study employed a quasi-experimental pre-test-post-test design with a control group. The research population consisted of women diagnosed with anorexia nervosa in Tehran in 2022. Thirty participants were selected through convenience sampling from psychological clinics in the 6th and 8th districts of Tehran, and were randomly assigned to either the intervention group (n=15) or the control group (n=15). Questionnaires assessing eating attitudes, COVID-19-related anxiety, fear of negative evaluation, and depression were administered to both groups. The intervention group received a total of eight 90-minute sessions of cognitive-behavioral therapy, while the control group did not receive any intervention. The collected data were subsequently analyzed using multivariate analysis of covariance through the SPSS software version 24.
Results: The results of the study showed that cognitive-behavioral therapy led to a significant reduction in mental anxiety related to COVID-19 (P<0.001, F=36.41), physical anxiety related to COVID-19 (P<0.001, F=39.15), fear of negative evaluation (P<0.001, F=41.92), and depression (P<0.001, F=47.48) in women diagnosed with anorexia nervosa (P<0.001).
Conclusion: Cognitive-behavioral therapy demonstrated efficacy in alleviating psychological disorders among women diagnosed with anorexia nervosa. Given the potentially severe impairment of mental health experienced by numerous individuals with anorexia nervosa, it is imperative to implement measures for identifying and providing psychological interventions to vulnerable groups.

 

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Background & Aim: The utilization of emotional expression methods, including narrative counseling and written emotional expression, has been shown to be efficacious in mitigating the intensity of diverse psychological issues such as depression and acute stress, particularly following traumatic events. Additionally, emergency cesarean section is commonly acknowledged as a traumatic event that may lead to psychological challenges for the mother. The purpose of this research was to compare the effectiveness of emotional expression through writing and narration in reducing post-traumatic stress and postpartum depression among women undergoing emergency cesarean section.
Methods & Materials: This quasi-experimental study was conducted in Zahedan, involving a total of 120 women who underwent emergency cesarean section and were admitted to Ali Ibn Abi Talib (AS) hospital during the period of 2021-2022. The participants were selected using convenience sampling and were randomly divided into three groups: written emotional expression, narration and control, with each group consisting of 40 participants. The intervention consisted of one face-to-face session and two non-face-to-face sessions. Data collection involved the use of the Edinburgh Depression Questionnaire and PTSD assessments, administered before and six weeks after the intervention across all three groups. The data were analyzed using SPSS version 24, employing descriptive and inferential tests such as ANOVA and Tukey's post hoc analysis.
Results: The results showed a significant decrease in the average scores of post-traumatic stress and postpartum depression in the written emotional expression and narration groups, compared to the control group, after the intervention (P<0.05). However, before the intervention, there were no significant differences observed among the three groups (P>0.05). Furthermore, a higher mean difference was observed in both post-traumatic stress and postpartum depression scores before and after the intervention in the written emotional expression group, compared to the narration group, indicating a greater effect of written emotional expression (P<0.001).
Conclusion: Based on the research findings, highlighting the positive effect of both narration and written emotional expression, it is recommended to incorporate these techniques as supplementary components within comprehensive educational and care programs for women experiencing traumatic childbirth.

 

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Background & Aim: Post-treatment follow-up care for breast cancer is crucial in reducing mortality rates, minimizing treatment costs, and enhancing patients' quality of life. This study aims to identify the psychosocial factors affecting post-treatment follow-up care in breast cancer patients.
Methods & Materials: This descriptive-analytical study involved 180 breast cancer patients from Babol and other cities of western Mazandaran province. Participants were selected using a simple random sampling method between 2021 and 2022. Data were collected through personal information questionnaires, the Zigmond Hospital Anxiety and Depression Scale, the Psychological Distress Thermometer, the Fear of Cancer Recurrence Scale, and a post-treatment breast cancer follow-up care checklist. Data analysis was conducted using SPSS version 18, employing descriptive and inferential statistical methods.
Results: The average age of the participants was 51.49 years (SD=12.01). The mean and standard deviation scores for depression, anxiety, and psychological distress were 6.16±2.71, 10.70±4.13, and 5.98±2.54, respectively. The results showed that individuals with higher levels of anxiety, depression, psychological distress, and fear of recurrence are less likely to engage in follow-up care (P<0.05).
Conclusion: The results suggest that health policymakers should address the psychological challenges faced by breast cancer patients. Specifically, providing insurance coverage for the screening and treatment of mental health problems may improve mental well-being, encourage self-care behaviors, and promote overall health.