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Alavi SMA, Irani RD, Fattahi P, Pakseresht S. Effects of brief cognitive behavioral therapy on mental health in substance-related disorder: a randomized controlled trial. BMC Psychiatry 2023; 23:924. [PMID: 38066514 PMCID: PMC10709952 DOI: 10.1186/s12888-023-05413-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND & OBJECTIVES Population and aging are major contributing factors influencing the increase in substance use disorder (SUD), which in itself affects mental health, particularly anxiety and depression. Cognitive behavioral therapy (CBT) and pharmacotherapy co-treatment are considered the gold standard for the treatment of SUD. Thus, the present study has been carried out to investigate the efficacy of brief CBT on the general health of opioid users. METHODS A randomized controlled trial (RCT) was conducted with forty opioid users whose addiction was dully confirmed by a psychiatrist at the drop-in center of the Ahvaz Jundishapur University of Medical Sciences. The patients were then randomly divided into two equal groups (n = 20). The control group was treated solely using methadone maintenance therapy (MMT); however, the intervention group underwent four sessions of CBT in addition to MMT. The general health questionnaire (GHQ) consisting of 28 items (Goldberg, 1979) was applied to both groups at the beginning and end of the study. The collected data was analyzed using IBM SPSS ver. 26, and data analysis was carried out using chi-square, t-test, Mann-Whitney, and Poisson regression model. P < 0.05 was statistically significant for all the aforementioned tests. RESULTS The mean age for the control and intervention groups were 37.95 ± 7.64 and 43.85 ± 9.92, respectively (p = 0.042). There was no statistically significant difference in terms of gender and levels of education (p = 0.311 and p = 0.540). Both groups differed statistically regarding marital status and occupation (p = 0.025 and 0.002). There was no significant statistical difference in all subclasses and the total scores of GHQ-28 for both groups, except for anxiety and insomnia in the intervention group (p = 0.038). After applying a Likert scale with a 23-point cut-off score, there was no statistically significant difference in terms of psychosis after intervention in the intervention group (p = 0.077). CONCLUSION The results of the current study show that brief CBT is effective on psychiatric health, especially anxiety and sleep disorders, whereas brief CBT fails to affect the patient's depression, somatic symptoms, and social dysfunction. TRIAL REGISTRATION The Iranian Registry of Clinical Trials (IRCT) approved the study design (IRCT registration number: IRCT20190929044917N1, registration date: 13/01/2020).
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Affiliation(s)
- Seyed Mohammad Amin Alavi
- Faculty of medicine, Ahvaz Jundishapur University of Medical Sciences, Golestan Blvd, Ahvaz, 6135715794, Khuzestan, Iran.
| | | | - Payam Fattahi
- Medical Student, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sirus Pakseresht
- Department of Psychiatry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Warne E, Oxlad M, Best T. Evaluating group psychological interventions for mental health in women with infertility undertaking fertility treatment: A systematic review and meta-Analysis. Health Psychol Rev 2023; 17:377-401. [PMID: 35348050 DOI: 10.1080/17437199.2022.2058582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/22/2022] [Indexed: 11/04/2022]
Abstract
ABSTRACTWe conducted a systematic review and meta-analysis of the published literature concerning the effectiveness of group psychological interventions in improving anxiety, depression, marital dissatisfaction, fertility quality of life and stress, and pregnancy outcomes of women with infertility, participating in fertility treatment. A search of five databases yielded 1603 studies; 30 articles met inclusion criteria, and computations of effect sizes ensued (Hedges' g and Odds Ratios (OR)). The total sample comprised 2752 participants, with 1279 participants receiving group intervention and 1473 participants in the comparison group. Group psychological interventions reduced depression (Hgw = -1.277; 95% CI = [-1.739- -0.815]; p = 0.000), anxiety (Hgw = -1.136, 95% CI [-1.527- -0.744]; p = 0.000), fertility stress (Hgw = -0.250, 95% CI [-0.388- -0.122]; p = 0.000), and marital dissatisfaction (Hgw = -0.938; 95% [CI -1.455- -0.421]; p = 0.000), and pregnancy rates improved (OR = 2.422 95% CI [2.037-2.879]; p = 0.000). No improvement was observed regarding fertility quality of life (Hgw = 0. 144; 95% CI [-0.176- 0.463]; p = 0.379). Our findings highlight that participation in group psychological intervention improved the mental health, fertility stress and pregnancy rates of women with infertility.
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Affiliation(s)
- Emma Warne
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Melissa Oxlad
- School of Psychology, The University of Adelaide, Adelaide, Australia
- CQU, School of Health, Medical and Applied Science, NeuroHealth Lab, Appleton Institute, Brisbane, Australia
| | - Talitha Best
- CQU, School of Health, Medical and Applied Science, NeuroHealth Lab, Appleton Institute, Brisbane, Australia
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Majidzadeh S, Mirghafourvand M, Farvareshi M, Yavarikia P. The effect of cognitive behavioral therapy on depression and anxiety of women with polycystic ovary syndrome: a randomized controlled trial. BMC Psychiatry 2023; 23:332. [PMID: 37170227 PMCID: PMC10174601 DOI: 10.1186/s12888-023-04814-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/24/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Women's mental health has a significant impact on the health of society. Due to the prevalence of mental health problems in women with PCOS, this study aimed to determine the effect of cognitive behavioral therapy on depression and anxiety (primary outcomes) and quality of life (secondary outcomes) in women with polycystic ovary syndrome. METHODS This randomized controlled trial was performed on 84 patients with PCOS referred to Al-Zahra Hospital in Tabriz-Iran, 2021. Participants were randomly assigned to intervention (n = 42) and control (n = 42) groups. Counseling with cognitive behavioral therapy was provided in 8 sessions of 60-90 min weekly in groups with 5 to 7 people in each group for the intervention group. Spielberger State-Trait Anxiety, Beck Depression, and Quality of Life Questionnaire for women with polycystic ovary syndrome (PCOSQ) were used to collect data. Independent t-test and ANCOVA were used to compare the outcomes between the two groups. RESULTS After the intervention, based on ANCOVA test with adjusting the baseline values, mean scores of depression (mean difference (MD): -18.6; 95% confidence interval (95% CI): -19.4 to -17.8: P < 0.001), trait anxiety (MD: -15.0; 95% CI: -16.0 to -13.9; P < 0.001), and state anxiety (MD: -15.3; 95% CI: -16.2 to -14.3; P < 0.001), were significantly lower in the intervention group compared to the control group. The mean score of quality of life (MD: 19.25; 95% CI: 17.66 to 20.84; P < 0.001) was significantly higher in the intervention group compared to the control group. CONCLUSION This study showed that CBT was effective in reducing depression and anxiety and improving the quality of life. Therefore it is recommended that health care providers use this approach to improve the mental health and quality of life of women with PCOS. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT): IRCT20110826007418N7. Date of registration: 25/10/2021. URL: https://en.irct.ir/trial/57348 ; Date of first registration: 25/10/2021.
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Affiliation(s)
- Sheida Majidzadeh
- Department of midwifery, Student Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Farvareshi
- Clinical Psychologist, Razi Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Yavarikia
- Department of midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Rahimi R, Hasanpour S, Mirghafourvand M, Esmaeilpour K. Effect of Hope-oriented group counseling on mental health of infertile women with failed IVF cycles: a randomized controlled trial. BMC Psychiatry 2021; 21:286. [PMID: 34078307 PMCID: PMC8171030 DOI: 10.1186/s12888-021-03280-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/13/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Considering the prevalence of infertility in the community and the consequences of failure of infertility treatments on women's mental health, interventions that can control stress, anxiety and depression in infertile women with a history of IVF failure will be very helpful. This study aimed to determine the effects of hope-oriented group counseling on mental health (primary outcome) and quality of life (QoL) (secondary outcome) of women with failed IVF cycles. METHOD This randomized controlled trial was conducted on 60 women with failed IVF cycles visiting Infertility Clinic at Al-Zahra Teaching Hospital of Tabriz- Iran. Participants were allocated to the intervention group (n = 30) and control group (n = 30) based on a randomized block design. Hope-oriented group counseling was provided to the intervention group in six 45-60 min sessions (once a week). The control group only received routine care to undergo another IVF cycle. The Depression Anxiety Stress Scale-21 (DASS-21) and the SF-12 Quality of Life Scale were filled out by interviewing the participants before the intervention and one week and one month after the intervention. After intervention 26 participants in each group were included in the analysis. RESULTS There was no significant difference between the intervention and control groups in the socio-demographic profile of participants (P > 0.05). The post-intervention mean score of stress (adjusted mean difference = - 1.7, 95% confidence interval: - 3.2 to - 0.3, P = 0.018) and depression (adjusted mean difference = - 1.3, 95% confidence interval: - 4.7 to - 1.5, P < 0.001) was significantly lower in the intervention group compared to the control. Although the mean anxiety score was lower in the intervention group compared to the control, the difference between them was not statistically significant (adjusted mean difference = - 1.1, 95% confidence interval: - 2.6 to 0.4, P = 0.153). The mean score of QoL was significantly higher in the intervention group than that of the control group (adjusted mean difference = 6.9, 95% confidence interval: 5.1 to 8.8, P < 0.001). CONCLUSION Hope-oriented group counseling was effective in reducing stress and depression and improving QoL in women with failed IVF cycles. It is recommended to use this counseling approach, along with other methods, to improve the mental health of women with failed IVF cycles. TRIAL REGISTRATION TCT Registration Number: TCTR 20191017003 , registered on October 17, 2019.
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Affiliation(s)
- Roya Rahimi
- grid.412888.f0000 0001 2174 8913Student Research Committee, Department of Midwifery, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Hasanpour
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Artesh Street, Tabriz, Iran.
| | - Mojgan. Mirghafourvand
- grid.412888.f0000 0001 2174 8913Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khalil Esmaeilpour
- grid.412831.d0000 0001 1172 3536Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
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Golshani F, Hasanpour S, Mirghafourvand M, Esmaeilpour K. Effect of cognitive behavioral therapy-based counseling on perceived stress in pregnant women with history of primary infertility: a controlled randomized clinical trial. BMC Psychiatry 2021; 21:278. [PMID: 34059016 PMCID: PMC8167953 DOI: 10.1186/s12888-021-03283-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 05/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given the prevalence of infertility and consequences of stress, anxiety, and depression during pregnancy and after childbirth, this study aimed to determine the effect of group cognitive behavioral therapy (CBT)-based counseling on perceived stress (primary outcome), anxiety, depression, and quality of life (QoL) of pregnant women with a history of primary infertility. METHOD This controlled randomized clinical trial was conducted on 56 pregnant women with a history of primary infertility referred to Infertility Clinic of Al-Zahra Teaching Hospital of Tabriz. The participants were divided into the intervention (n = 28) and control (n = 28) groups using block randomization. The intervention group received group CBT-based counseling after the 14th week of the pregnancy: six in-person sessions and two telephone sessions once per week. The control group received routine care. The Perceived Stress Scale (PSS), Edinburgh Postnatal Depression Scale (EPDS), Van den Bergh's Pregnancy-Related Anxiety Questionnaire (PRAQ), and Quality of Life in Pregnancy (Gravidarum) (QOL-GRAV) were completed through interviews before and 4 weeks after the intervention by the researcher. RESULTS There was not any between-group difference in socio-demographic characteristics, except the gestational age and husband educational level (p > 0.05). Both of these variables were adjusted in ANCOVA. After the intervention, the mean scores of perceived stress (mean difference: - 7.3; confidence interval: 95%, from - 0.9 to - 5.6; p < 0.001) and anxiety (mean difference:-14.7; confidence interval: 95%. from - 20.6 to - 8.8; p < 0.001) were significantly lower in the intervention group. The mean depression score in the intervention group was lower than the control; however, this between-group difference was not significant (mean difference: - 1.95; confidence interval: 95% from - 3.9 to 0.2; p = 0.052). The mean score of quality of life in pregnancy was significantly higher in the intervention group than the control (mean difference: - 5.4; confidence interval: 95% from 3.4 to 7.4; p < 0.001). CONCLUSION CBT counseling can affect the perceived stress, anxiety, and quality of life of pregnant women with a history of primary infertility. As a result, this counseling approach is recommended along with other counseling approaches to improve the mental health of pregnant women with a history of infertility. TRIAL REGISTRATION IRCT Registration Number: IRCT20111219008459N12 , registered on 10/11/ 2018.
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Affiliation(s)
- Farideh Golshani
- Student Research Committee Department of Midwifery, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Hasanpour
- Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Rezamahaleh FA, Khadivzadeh T, Asgharinekah SM, Esmaeili H. Comparison of the effect of two methods of counseling (face to face and telephone) on awareness and attitude toward adoption in infertile couples. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:337. [PMID: 33575373 PMCID: PMC7871960 DOI: 10.4103/jehp.jehp_588_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/24/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Many infertile people have heard about adoption, but little is known about the true meaning of adoption and how it is accepted. Giving the right information about adoption is effective in making the right decision for couples. As a result, there is a need to intervene and provide training to improve community attitudes and increase adoption among infertile people. Therefore, the present study aimed to determine the effect of two counseling methods (face-to-face and telephone) on awareness and attitude toward adoption in infertile couples. MATERIALS AND METHODS The present study is a randomized quasi-experimental study of two groups in the Milad Infertility Center of Mashhad on 34 (each group of 17 couples) infertile couples with the criteria to enter the study. Couples were randomly assigned to two telephone and face-to-face counseling groups, and each individual's awareness and attitudes toward adoption were completed separately before and after counseling. The average number of face-to-face sessions for face-to-face counseling was three 60-min sessions and six 30-min sessions for telephone counseling. RESULTS Based on the results of t-test, there was a statistically significant difference between the average score of awareness of adoption before and after the intervention (2 weeks after the last counseling session), in infertile couples in face-to-face training group and in telephone training group (P < 0.0001). The score of the attitude toward adoption before counseling in the face-to-face counseling group was 60.55 ± 5.5, which reached 66.76 ± 4.7 after counseling. Based on the results of the T-pair test, this difference was significant (P < 0.0001). In addition, in the telephone counseling group, the score of attitude toward adoption increased from 59.53. 7.4 to 67.73 ± 7.5, which was a significant difference in terms of t-pair test. The mean score of attitudes toward adoption was not statistically significant in the two groups (P = 0.653). CONCLUSION The results of this study showed that both counseling methods (face to face and telephone) increase the level of awareness and attitude of couples about adoption, but neither method was superior to the other.
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Affiliation(s)
- Fateme Ahmadi Rezamahaleh
- MSc of Counselin in Midwifery, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talat Khadivzadeh
- Associate Professor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohsen Asgharinekah
- Associate Professor, Department of Educational and Counseling Psychology, Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Habibollah Esmaeili
- PH.D in Biostatistics, Professor, Social Department of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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