The association of type D personality and depression with infertility in women

The social determinants of mental health disorders among women with infertility: a systematic review

INTRODUCTION

Infertility is associated with mental health disorders in women, even if a successful pregnancy resolves infertility. However, the link between social determinants of health (SDoH) and mental health in women with infertility is not well understood. We aimed to investigate the determinants thoroughly so that mental health screening and services can be tailored to suit women with infertility who are vulnerable to mental health disorders.

METHODOLOGY

All observational studies that included women participants of reproductive age with infertility and assessed social determinants associated with mental health disorders were searched using a combination of keywords from MEDLINE, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science databases and published in English. Two reviewers conducted screening, data extraction, quality assessment and risk of bias. The protocol was registered on PROSPERO (number CRD42022343962).

RESULTS

The systematic review included 32 studies out of 3405 screened articles from January 1st 2010 to 16th October 2023. Compared to women without infertility, the prevalence of mental health disorders, including anxiety, depression, psychological distress, and stress, is high among women with infertility, with the severity being influenced by social determinants-those with higher education, employment, higher personal or family income, private health insurance, higher social support, stronger religious beliefs, and higher spiritual well-being reported better mental health outcomes.

CONCLUSION

The study highlights the need for early detection, tailored interventions, and integrated and comprehensive support systems to address the mental health needs of women with infertility and improve their well-being.

No Baby to Bring Home: Perinatal Loss, Infertility, and Mental Illness-Overview and Recommendations for Care

PURPOSE OF REVIEW

Update readers on the state of the research on mental health, perinatal loss, and infertility with a focus on providing a comprehensive overview to empower clinicians in treating this population.

RECENT FINDINGS

Rates of psychiatric illness are increased in people that experience perinatal loss and infertility. The research remains largely below the clear need for focused screening, prevention, and treatment. Clinicians and researchers need to remain attuned to the impact of perinatal loss and infertility on the mental health of patients and families. Screening, referral, and expanded therapeutic and psychiatric resources are imperative to improving the well-being of these patients and families.

Factors Associated with Depression in Infertile Couples: A Study in Thailand

BACKGROUND

Infertility can affect a couple's mental health and marital and social relationships. The study aimed to investigate the prevalence of depression among infertile couples and their relationships with other factors.

METHODS

This study employed a cross-sectional survey. Validated tools were used to assess anxiety and depression, marital satisfaction, personality traits and sufficiency economy. The actor-partner interdependence model (APIM) was used for dyadic analysis.

RESULTS

The prevalence of depression in infertile couples was 6.7%. Aggression, extraversion and neuroticism were significantly correlated with depression, whereas the expectation of having children, marital satisfaction and sufficiency economy were negatively correlated with depression. The APIM model suggested that neuroticism and marital satisfaction were significant predictors of depression. Partner effect between the expectation of having children and depression was observed (p = 0.039).

CONCLUSIONS

Like other populations, depression in infertile couples seems to be associated with aggression, extraversion and neuroticism. However, there are specific variables related to infertility that impact the depression levels of these couples. For instance, the expectation of having children can affect the partners of infertile couples, while the role of the sufficiency economy is a new factor that has been examined for depression in this sample and requires further exploration.

Psychological distress and its associated factors among patients with chronic obstructive pulmonary disease in Hunan, China: a cross-sectional study

Patients with chronic obstructive pulmonary disease (COPD) experience a high risk for psychological distress. Understanding what factors contributing to this risk is vital for developing effective interventions to address COPD-related psychological distress. To examine psychological distress and its associated factors in COPD patients in China. This is a cross-sectional study. Using cluster random sampling, 351 COPD patients participated in and completed a questionnaire survey from June 2021 to January 2022. Instruments used in this research included a self-designed social-demographic questionnaire, the Kessler Psychological Distress Scale (K10), the COPD Knowledge Question, the Type D Personality Scale (DS-14), the COPD Assessment Test (CAT), and modified Medical Research Council Dyspnea Score (mMRC). Multivariate linear regressions were used in the final analysis. Among 351 COPD patients, 307 (or 87.5%) had psychological distress. Our univariate analysis indicated that psychological distress scores were significantly associated with monthly household income (F = 2.861, P < 0.05), exercise frequency (F = 4.039, P < 0.01), type D personality (t = 5.843, P < 0.01), years with COPD (r_s = 0.156, P < 0.01), frequency of acute exacerbation (r_s = 0.114, P < 0.05), mMRC score (r_s = 0.301, P < 0.01), and CAT score (r_s = 0.415, P < 0.01). Our final multivariate linear regression showed that exercise frequency (coefficient = -1.012, P < 0.01) was an independent protective factor of psychological distress in COPD patients, while type D personality (coefficient = 3.463, P < 0.001), mMRC score (coefficient = 1.034, P < 0.001) and CAT score were independent risk factors (coefficient = .288, P < 0.001). No relationship was observed between psychological distress and knowledge of COPD. Psychological distress is commonly presented among COPD patients in China. Findings from this study suggest promoting and increasing frequency of exercise will be beneficial in reducing psychological distress among COPD patients. This study also highlights the importance of assessing personality type, dyspnea, and impact of COPD on daily living for preventing and managing psychological distress due to COPD. In addition, Given the high rate of psychological distress among COPD patients, policymakers should consider making mental health resources easily available and accessible to this vulnerable population.

Breastfeeding competency and its influencing factors among pregnant women in third trimester pregnancy: a cross-sectional study

Competency is closely related to the occurrence of the behavior. Breastfeeding competence is the mastery of different breastfeeding factors which intervene in breastfeeding behavior. Breastfeeding competence could improve the breastfeeding behavior. However, few studies have paid attention to the status and the influencing factors of breastfeeding competency. The breastfeeding competency of pregnant women in third trimester pregnancy has the greatest impact on breastfeeding behavior after childbirth. Therefore, the objective of this study were to investigate the breastfeeding competency level and independent risk factors for breastfeeding competency among pregnant women in third trimester pregnancy. A cross-sectional survey method and convenience sampling method was used in the study. The general information questionnaire including age, gestational week, educational background, and so on were used to investigate the general information of pregnant women and their husbands. A breastfeeding competency scale (BCS) was used to investigate the breastfeeding competency of pregnant women. The total score of the BCS ranges from 38 to 190, with higher scores indicating greater breastfeeding competency. Lower level, medium level and higher level are 38-89, 90-140 and 141-190 respectively. Type-D Scale-14 (DS14) was used to investigate the type D personality of pregnant women. A multivariable linear regression was used to examine the independent predictors of breastfeeding competency. A total of 550 questionnaires were collected and finally 525 effective questionnaires were collected. The age of 525 pregnant women is (30.24 ± 3.954) years old. The breastfeeding competency score of pregnant women was (134 ± 19.741). Multivariable linear regression analysis showed that higher breastfeeding competency in pregnant women were reported among pregnant women who gestational age ≥ 256 days (37 weeks) (B = 8.494, p < 0.001), the previous breastfeeding experience were exclusive breastfeeding (B = 17.384, p < 0.001) and partial breastfeeding (B = 16.878, p < 0.001), participating in pregnant women school 2-3 times (B = 10.968, p = 0.013) and ≥ 5 times (B = 13.731, p = 0.034). Pregnant women with lower breastfeeding competency were found in women who were judged to have type D personality (B = - 6.358, p < 0.001). The result can explain 25.8% of the variation in the total breastfeeding competency score. This should be considered an important issue by maternal and child health care in the medical system that the moderate level of breastfeeding capacity among pregnant women. Differentiated and targeted breastfeeding support and services for pregnant women should be carried out based on influencing factors of breastfeeding competency.

İnfertil kadınlarda kişilik özelliklerinin anksiyete ve depresyon gelişimi üzerine olan etkileri

Amaç: Bu çalışmada infertil kadınların kişilik özelliklerinin anksiyete ve depresyon gelişimi üzerine olan etkilerinin araştırılması amaçlandı. Gereç ve yöntemler: Çalışmaya, Ocak 2015-Agustos 2016 tarihleri arasında tüp bebek merkezine ve kadın doğum polikliniğine başvurmuş olan sırası ile 67 infertil ve 61 fertil kadın olmak üzere toplam 128 kişi dahil edildi. İnfertil grubu primer veya sekonder infertilitesi olup infertilite tedavisi planlanan veya başlanan kadınlar oluşturdu. Kontrol grubunu ise birden fazla sayıda çocuğu olan fertil kadınlar oluşturdu. Her iki gruba Beck Anksiyete Ölçeği (BAÖ), Beck Depresyon Ölçeği (BDÖ), Eysenck Kişilik Anketi (EKA) ve Çift Uyum Ölçeği (ÇUÖ) uygulandı. Bulgular: İnfertil ve fertil gruplar arasında yaş gruplarının dağılımı açısından anlamlı bir fark tespit edilmedi. Bununla birlikte BAÖ, BDÖ ve ÇUÖ toplam ortalama puanları infertil grupta anlamlı olarak daha yüksek tespit edildi. Kişilik ve çift uyum ölçeklerinde nörotizm, yalan, çift doyumu, çift uyumu ve sevgi alt ölçekleri ortalama puanları infertil grupta anlamlı olarak daha yüksek bulunurken; dışa-dönüklük, psikotizm ve çiftlerin bağlılığı alt ölçekleri ortalama puanları açısından iki grup arasında anlamlı bir fark izlenmedi. Korelasyon analizinde nörotizm ile anksiyete ve depresyon arasında pozitif yönde; dışa-dönüklük ile anksiyete ve depresyon arasında negatif yönde zayıf bir ilişki bulundu. Sonuç: Bu çalışmaya göre infertil kadınlarda nörotizm kişilik özelliğine sahip olanların anksiyete ve depresyon gelişimine daha yatkın olabileceği düşünülebilir.

Relationships among type-D personality, fatigue, and quality of life in infertile women

PURPOSE

The objective of the present study was to investigate the prevalence of the type D personality and identify the relationship between type D personality, fatigue and quality of life (QoL) in infertile women.

METHODS

A total of 149 infertile women were recruited between October 2020 and January 2021. The participants were assessed through self-administered questionnaires using the type- D Personality Scale-14, Fatigue Severity Scale, and Fertility QoL Instrumental Questionnaire. Data were analyzed using the independent t-test, chi-square test, Pearson's correlation coefficients, and multiple regression analysis using the SPSS/WIN 25.0 program for Windows.

RESULTS

Approximately 40.9% of infertile women were classified into the type D personality group, which showed significantly higher fatigue and lower QoL than the non-type D personality group. Fatigue was the most influential factor on the QoL of infertile women (β=-.23, p=.003), followed by the duration of infertility treatment (β=-.22, p=.003), type D personality (β=-.18, p=.025), and relationship with spouse (β=-.17, p=.024). These variables account for approximately 22% of the variance.

CONCLUSIONS

Intervention programs that consider fatigue, type D personality, relationship with spouses, and treatment duration may be useful for improving QoL in infertile women.

Factors Associated with Anxiety and Depression in Infertile Couples—Study Protocol

(1) Background: Infertility refers to the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is an important medical and social problem that causes individual distress, family conflict and emotional impact experienced by about 15% of couples worldwide. Anxiety and depression are the main psychological problems associated with infertility with many potential contributing factors which are yet to be fully elucidated. This study aims to investigate factors related to anxiety and depression among infertile couples. (2) Methods/Design: This study will employ an analytical cross-sectional survey. Sociodemographic information will be collected. Validated tools will be used to assess anxiety and depression (Outcome Inventory-21(OI-21), marital satisfaction (ENRICH Marital Satisfaction Scale, sufficiency economy (Sufficiency Economy Scale (SES) and personality traits (Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ). The Actor-Partner Interdependence Model estimated by multilevel modeling will be used for dyadic analysis. (3) Discussion: This study will provide evidence about factors associated with anxiety and depression in infertile couples. Outcomes will raise awareness about mental health problems among infertile couples and guide future research for interventions.

The level of anxiety in infertile women whose ART cycles are postponed due to the COVID-19 outbreak

AIM

This study evaluated the level of fear and anxiety related to the COVID-19 outbreak, in infertile women whose ART cycles were delayed due to the pandemic.

MATERIALS AND METHODS

An online survey was sent to women whose ART cycles were postponed due to the COVID-19 outbreak between April and May 2020. The study population were 101 participants. The main outcome measure is to determine the levels of fear and anxiety in infertile women by using the Spielberger State-Trait Anxiety Inventory (STAI-T and STAI-S) and Fear of COVID-19 scale (FCV-19S). The relationship of the COVID-19 outbreak with the willingness to go ahead with the desire for pregnancy was also assessed.

RESULTS

The state-anxiety levels were significantly higher in women above 35 years (45.0 ± 5.2 vs. 42.2 ± 4.5, p = 0.006). Women with diminished ovarian reserve had a higher state-anxiety compared to other causes, but were not found to be significant (44.7 ± 5.2 vs. 42.5 ± 5.0, p = 0.173). Women who thought that the possibility of not being able to get pregnant was more important than being infected with the COVID-19 had higher anxiety levels than women who thought just the opposite. The diminished ovarian reserve and high duration of infertility were found to be significantly associated with higher anxiety levels (OR = 2.5, p < 0.05). The diminished ovarian reserve and previous ART failure significantly predicted the presence of clinical state-anxiety.

CONCLUSION

The state-anxiety was found to be higher in women whose cycles were postponed due to the outbreak and the presence of diminished ovarian reserve also significantly affected anxiety levels. Further research is needed to assess whether COVID-19 will have any impact on ART treatments in the next few years.

Chronotype Profile, Stress, Depression Level, and Temporomandibular Symptoms in Students with Type D Personality

Background: Despite a growing interest in the types of human circadian activity, different chronotypes and personality-related issues have been rarely studied. It has already been emphasized that ‘stress personality’ is considered a risk factor for certain psychosomatic diseases and may be a temporomandibular disorders (TMDs) predictor. Therefore, an attempt has been made to analyze the chronotypes, stress levels, stress factors, and the occurrence of depression and TMDs in students with type D personalities. People with this personality trait tend to experience negative emotions more—depression, anxiety, anger, or hostility—yet may have a negative image of themselves and report somatic complaints. Aim: The aim of this study was to analyze the importance of the chronotype profile for the level of stress perceived, as well as for the occurrence of depression and TMDs in people with type D personalities. Material and Methods: The study has been conducted on a group of 220 physical therapy students. The study group G1 consisted of 110 participants with type D personalities, the control group G2 consisted of the same number of participants without the stress personality. All participants have been analyzed for the chronotype (MEQ), stress perception (PSS10), the occurrence of depression (Beck scale-BDI), the occurrence of TMDs symptoms and have completed the stress factor assessment questionnaire during the study, followed by DS14 questionnaire—a tool for assessing the prevalence of type D personality. Results: In students with type D personalities (G1), the definitely evening and evening chronotypes have been significantly more predominant than in the control group (G2). A significantly higher number of stressors and TMDs symptoms have been observed in the respondents from the G1 group than in the control group (<0.001). Univariate logistic regression analysis showed that type D personality was strongly associated with a more frequent occurrence of all TMD symptoms. Additionally, a significant influence of the evening chronotype on the occurrence of type D personality was observed. Among the potential confounding variables, female gender and a mild and moderate degree of depression have an impact on the occurrence of type D personality (p < 0.05). In the multivariate model, adjusted with the above-mentioned factors, an increased risk of the type D personality trait was found. Conclusion: The evening chronotype and type D personality may imply greater feelings of stress, greater depression, and more frequent symptoms of TMDs in young adults.

Intensification of Type D Personality Traits and Coping Strategies of People Staying in Polish Penitentiary Institutions—Cross-Sectional Study

The aim of this study was to determine the intensity of the occurrence of stress-prone personality traits (type D) and the strategies of coping with stress in a group of people staying in Polish penitentiary institutions. This study was conducted in two penitentiary units in Lesser Poland Voivodeship. Participants consisted of 152 prisoners. In this cross-sectional study, two standardized research tools—Mini-COPE Inventory for Measurement Coping with Stress and the Type-D Scale (DS14)—were used. The presence of a stress-prone personality (type D) among persons serving a prison sentence concerned 42.11% of the respondents and did not correlate with their sex and age. The convicted persons were more often guided by ‘negative affectivity’ than by ‘social inhibition’. People staying in penitentiary units most often used the strategy of ‘active coping’ and ‘planning’. Types of coping strategies used by the respondents depended on their sex and the presence of type D personal characteristics. Increasing people’s social awareness of the issues of stress experienced by prisoners can contribute to reducing the phenomenon of the marginalization and stigmatization of incarcerated people.

The Importance of Type D Personality in the Development of Temporomandibular Disorders (TMDs) and Depression in Students during the COVID-19 Pandemic

Background: a type D personality is a factor in a person’s susceptibility to general mental stress, especially during the COVID-19 pandemic. Although many studies were conducted on the relationships among stressful situations, an individual’s personality, depression, and the occurrence of various diseases, e.g., cardiovascular disease or cancer, there are no analogous data on people with temporomandibular disorders (TMDs). Aim: the assessment of TMDs and depression symptoms in students with type D personality. Material and Methods: the research was carried out with the participation of 240 physiotherapy students. The study group (G1) consisted of 120 participants with type D personalities, the control group (G2) consisted of the same number of participants, without “stress” personalities. All subjects were assessed for the occurrence of TMD symptoms, as well as for depression and anxiety symptoms, using the Beck Depression Inventory (BDI), based on the proprietary questionnaire. Results: in students with type D personality symptoms, TMDs occurred significantly more often and in greater number (p = 0.00) than in those without stress personalities. The exception was the symptom of increased muscle tension, which showed no statistical difference (p = 0.22). Among the 240 respondents, depression was found in 128 people (53.3%). In the group of students with type D personalities, depression was significantly more frequent than in the group without type D personalities (p = 0.00). In participants with depression, TMD symptoms were more common, i.e., headaches, neck, and shoulder girdle pain, TMJ acoustic symptoms, increased masticatory muscle tension, teeth clenching, and teeth grinding. There was no significant difference between the incidence of depression and TMJ pain and jaw locking. There was a significant interaction between the occurrence of headaches and acoustic symptoms and the occurrence of depression. For headache and depression interactions, the OR was >1; based on the results, we may assume that a headache depends more on the occurrence of depression rather than it being a symptom of a TMJ disorder in people with type D personalities. Conclusion: type D personality and depression may contribute to the development of TMD symptoms.

Importance of Personality Factors in Determining the Psychological Consequences of Infertility: A Systematic Review

BACKGROUND AND PURPOSE

The diagnosis of infertility not only involves biological but the psychosocial links have also been established. Individual difference variables, such as personality and temperament have been found playing prominent role in modifying the psychological and biological aspects of infertility. This systematic review aimed to examine evidence-based research on the role of personality traits in determining vulnerability to stress in infertility, understand the gender-based differences, and deliver suggestions for future researches.

METHOD

The search for studies relating to the variables was accomplished using various electronic databases. The search was kept limited to a time span of about 20 years, that is, from January 2000 to April 2020. Additional researches were collected from library source and others were retrieved by contacting experts. Studies were selected on the basis of a predetermined inclusion and exclusion criteria, and quality of the studies was also taken into account.

RESULTS

The search of studies through above methods was fruitful in identifying 23 studies including six longitudinal and prospective studies, and 17 cross-sectional studies covering both individual- and model-based personality attributes related findings. The overall quality ratings of the studies ranged from fair to good.

CONCLUSION

The review revealed that personality factors such as neuroticism, harm avoidance, and psychoticism are the potential risk factors, whereas optimism has a protective impact in the context of fertility disorders. The long-term impact of personality on infertility needs further exploration. Trait modification interventions during the treatment of infertility were also suggested in the light of previous findings.

Psychological Impact of Infertility. Directions for the Development of Interventions

Introduction: Infertility represents a major health problem that oftentimes is experienced as a crisis situation. Because it interposes with achieving an important life goal, that of having children, its implications on the psycho-emotional level are robust. Purpose: The present article aimed at exploring the multidimensional effects of infertility on mental health, as well as suitable psychological intervention strategies for patients both at an individual and couple level. Methodology: An extensive literature review was conducted to select the most relevant information. Articles included were searched in PubMed, Google Scholar and other similar databases within a seven years interval (2014-2021) to assure the up-to-date quality of the paper. The main criteria of inclusion were: studies about the consequences of infertility on mental health, epidemiology, risk and protective factors, psychological models for infertility, psychological evaluation, established instruments, psycho-social and therapeutic interventions, intervention protocols used in public health for infertility patients. Results and Discussion: Infertility is often experienced as a crisis situation, in which the most common consequences are visible at the level of mood disorders (e.g. anxiety, depression, marked distress) and at the social level (stigma, divorce, social isolation, financial difficulties). Psychological counseling is needed throughout medical treatment and therapeutic interventions (e.g. cognitive-behavioral therapy) have shown favorable results in managing the emotional balance of the individual/couple and reducing the risk of psychopathology. Conclusions: Research highlights the beneficial effects of psychological interventions on reducing levels of stress related to infertility, anxiety and depressive symptoms and on improving the quality of life and couple dynamics

Effects of Self-Esteem on the Associations Between Infertility-Related Stress and Psychological Distress Among Infertile Chinese Women: A Cross-Sectional Study

Background

Anxiety and depression are the most common psychological causes of distress in infertile women. Our study aimed to evaluate the prevalence of depression and anxiety and investigate the effects of self-esteem on the association of infertility-related stress with depression and anxiety among infertile women.

Methods

This study was conducted between December 2017 and May 2018. Questionnaires containing Fertility Problem Inventory (FPI), Rosenberg self-esteem scale (RSES) and Hospital Anxiety and Depression Scale (HADS) were distributed among 536 female infertility patients in Shenyang, China. Hierarchical linear regression analyses were used to examine the mediating and moderating role of self-esteem. Baron and Kenny’s technique, asymptotic, and resampling strategies were used to confirm the mediating role of self-esteem on the associations between infertility-related stress with depression and anxiety.

Results

The prevalence of depression and anxiety was 27.9% and 42.2% among Chinese female infertility patients, respectively. Infertility-related stress was positively associated with depression and anxiety, whereas self-esteem was negatively associated with depression and anxiety. Additionally, the effects of infertility-related stress on depression and anxiety gradually decreased along with an increase in self-esteem. Meanwhile, self-esteem partially mediated the associations between infertility-related stress with depression and anxiety.

Conclusion

A high prevalence of psychological distress was found among infertile women. Self-esteem mediated and moderated the effects of infertility-related stress on depression and anxiety. Additionally, infertility-related stress and self-esteem were associated with psychological distress, which explained why infertile women had a higher prevalence of depression and anxiety. Therefore, interventions that focus on self-esteem may be effective and should be used as a resource to combat mental health problems.

Factors associated with infertility distress of infertile women: a cross-sectional study

BACKGROUND

Women undergoing infertility treatment may suffer infertility distress.

OBJECTIVE

The aim of this study was to determine factors associated with infertility distress in women with infertility problems.

MATERIALS AND METHODS

Women (N = 368) who received infertility treatment and agreed to participate in the study constituted the sample of this cross-sectional descriptive study. The participants filled out the "Descriptive Information Form on Women with Infertility" and the "Infertility Distress Scale (IDS)". The data analysis of the study was performed using the Statistical Package for Social Sciences (SPSS-20.0). The statistical significance was accepted to be p < .05.

RESULTS

It was found out that the mean IDS score of women was 37.4 ± 9.96 (min: 21-max: 80). A significant difference was found between women's educational level, employment status, difficulty in taking time off work, economic situation, the person who paid for treatment expenses and cause of infertility and mean IDS scores (p < .05). No significant relationship was found between women's social security, family type, having children and previous infertility treatment and mean IDS scores (p > .05). A positive and statistically significant linear relationship was found between the IDS score and marriage duration, desiring time for a baby and duration of infertility treatment (p < .05).

CONCLUSIONS

The study revealed that the infertility distress level increased as the marriage duration, desiring time for a baby and the duration of infertility treatment of women admitted to the infertility clinic increased. Infertile women should be provided with care and support by considering these variables.