Elif Ganime Aygün, Barış Sancak, Ürün Özer Ağırbaş

İnfertil Kadınlarda Özşefkat ile Anksiyete ve Depresif Belirtiler Arasındaki İlişki

Amaç: İnfertil kadınlarda fertil kadınlara göre psikiyatrik belirti gözlenme oranı daha fazladır ve depresyon ile anksiyete bu gruptaki en yaygın psikiyatrik rahatsızlıklardandır. Özşefkat; depresyon, anksiyete ve stresi öngörmekte değerli bir değişken olabilmektedir. Çalışmamız infertil kadınlarda özşefkati değerlendirmeyi ve depresyon ve anksiyete düzeyleri ile ilişkisini incelemeyi amaçlamaktadır. Yöntem: Bu kesitsel araştırmanın örneklemi 122 hastadan oluşmaktadır. İnfertilite tedavisi için kadın hastalıkları ve doğum kliniğine başvuran kadınlar ardışık olarak çalışma grubuna (N=50) dahil edilmiştir. Kontrol grubu (N=72) ise hastane çalışanları ve akrabalarından, benzer yaş ve cinsiyet gözetilerek seçilmiştir. Katılımcılar sosyodemografik veri formuna ek olarak Öz-Anlayış Ölçeği (SCS) ve Hastane Anksiyete ve Depresyon Ölçeği (HADS) formlarını doldurmuşlardır. Bulgular: Kontrol grubu ile karşılaştırıldığında, çalışma grubunda SCS skorları anlamlı olarak düşük ve HADS skoru (depresyon ve anksiyete) anlamlı olarak yüksek bulunmuştur. SCS ve HADS skorları arasında negatif korelasyon tespit edilmiştir (p < 0.001). Bu ilişki, düşük özşefkatın yüksek depresyon ve anksiyete ile bağlantılı olduğunu göstermektedir. İnfertilite tedavisinin süresi SCS ve HADS skorları ile bağlantısız bulunmuştur (p > 0.05). Sonuç: İnfertil kadınlarda depresyon ve anksiyete düzeyleri daha yüksek saptanmakta olup, özşefkat bu grupta psikolojik sağlığın korunması ile anksiyete ve depresif belirtilerin önlenmesinde etkili bir faktördür. İnfertil kadınların psikolojik iyi oluşlarını hedefleyen özşefkat temelli ya da diğer girişimler yararlı olacaktır.

Relationship of Self-Compassion with Anxiety and Depressive Symptoms in Infertile Women

Purpose: Infertile women have a higher rate of psychiatric symptoms compared to fertile women while depression and anxiety are among the most common psychiatric disorders in this group. Self-compassion might be a variable in predicting depression, anxiety and stress. The study aimed to evaluate self-compassion in infertile women and to examine its relationship with depression and anxiety levels. Methods: This cross-sectional study included a total number of 122 participants. The study group (n=50) consisted of women who applied to the gynaecology and obstetrics clinic for infertility treatment and were recruited consecutively. The control group (n=72) was recruited from hospital staff and their relatives, of the similar age and gender as the study group. The participants filled Self-Compassion Scale (SCS) and Hospital Anxiety and Depression Scale (HADS) in addition to sociodemographic data form. Results: SCS scores were significantly lower, and HADS scores (both depression and anxiety) were significantly higher in the study group, compared to the control group. There was a negative correlation between SCS and HADS scores (p < 0.001), indicating that lower self-compassion levels are associated with increased depression and anxiety. Duration of infertility treatment was not correlated with SCS and HADS scores (p > 0.05). Conclusion: Infertile women have higher levels of depression and anxiety while self-compassion is an influential factor in maintaining psychological well-being and preventing anxiety and depressive symptoms in this group. Self-compassion based or other interventions targeting psychological well-being of infertile women would be beneficial.

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1. Evers JL. Female subfertility. Lancet. 2002;360:151-9. DOI: 10.1016/ S0140-6736(02)09417-5.
2. Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;21:293-308. DOI: 10.1016/j. bpobgyn.2006.12.003.
3. Greil AL. Infertility and psychological distress: a critical review of the literature. Soc Sci Med. 1997;45:1679-704. DOI: 10.1016/ s0277-9536(97)00102-0.
4. Alireza Afshani S, Abooei A, Mohamad Abdoli A. Self-compassion training and psychological well-being of infertile female. Int J Reprod Biomed. 2019;17:757-62. DOI: 10.18502/ijrm.v17i10.5300.
5. Noorbala AA, Ramezanzadeh F, Abedinia N, et al. Psychiatric disorders among infertile and fertile women. Soc Psychiatry Psychiatr Epidemiol. 2009;44:587-91. DOI: 10.1007/s00127-008-0467-1.
6. Sbaragli C, Morgante G, Goracci A, et al. Infertility and psychiatric morbidity. Fertil Steril. 2008;90:2107-11. DOI: 10.1016/j. fertnstert.2007.10.045.
7. Chen TH, Chang SP, Tsai CF, et al. Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Hum Reprod. 2004;19:2313-8. DOI: 10.1093/humrep/deh414.
8. Domar AD, Broome A, Zuttermeister PC, et al. The prevalence and predictability of depression in infertile women. Fertil Steril. 1992;58:1158-63. PMID: 1459266.
9. Volgsten H, Skoog Svanberg A, Ekselius L, et al. Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Hum Reprod. 2008;23:2056-63. DOI: 10.1093/humrep/den154.
10. Neff KD. The development and validation of a scale to measure self-compassion. Self and Identity 2003; 2:223-50. DOI: 10.1080/15298860309027.
11. Allen AB, Leary MR. Self-Compassion, stress, and coping. Soc Personal Psychol Compass. 2010;4:107-18. DOI: 10.1111/j.1751-9004.2009.00246.x.
12. Galhardo A, Cunha M, Pinto-Gouveia J. Mindfulness-Based program for infertility: efficacy study. Fertil Steril. 2013;100:1059-67. DOI: 10.1016/j.fertnstert.2013.05.036.
13. Raque-Bogdan TL, Hoffman MA. The relationship among infertility, self-compassion, and well-being for women with primary or secondary infertility. Psychology of Women Quarterly 2015;39:484- 96. DOI: 10.1177/0361684315576208.
14. Sadiq U, Rana F, Munir M. Marital quality, self-compassion and psychological distress in women with primary infertility. Sex and Disabil. 2021;1-11. DOI: 10.1007/s11195-021-09708-w.
15. Deniz ME, Kesici Ş, Sümer AS. The validity and reliability study of the Turkish version of self-compassion scale. Soc Behav Pers. 2008;36:1151-60. DOI: 10.2224/sbp.2008.36.9.1151.
16. Aydemir Ö, Güvenir T, Kuey L, et al. Validity and reliability of Turkish version of Hospital Anxiety and Depression Scale. Turk Psikiyatri Derg. 1997;8:280-7.
17. Harrison RF, O’Moore RR, O’Moore AM. Stress and fertility: some modalities of investigation and treatment in couples with unexplained infertility in Dublin. Int J Fertil. 1986;31:153-9. PMID: 2875038.
18. Edelman RJ, Golombok S. Stress and reproductive failure. J Reprod Infant Psychol. 1989;7:79-86. DOI: 10.1080/02646838908403578.
19. Wiweko B, Anggraheni U, Elvira SD, et al. Distribution of stress level among infertility patients. Middle East Fertil Soc J. 2017;22:145-8. DOI: 10.1016/j.mefs.2017.01.005.
20. Massarotti C, Gentile G, Ferreccio C, et al. Impact of infertility and infertility treatments on quality of life and levels of anxiety and depression in women undergoing in vitro fertilization. Gynecol Endocrinol. 2019;35:485-9. DOI: 10.1080/09513590.2018.1540575.
21. Matsubayashi H, Hosaka T, Izumi S, et al. Emotional distress of infertile women in Japan. Hum Reprod. 2001;16:966-9. DOI: 10.1093/ humrep/16.5.966.
22. Holley SR, Pasch LA, Bleil ME, et al. Prevalence and predictors of major depressive disorder for fertility treatment patients and their partners. Fertil Steril. 2015;103:1332-9. DOI: 10.1016/j.fertnstert.2015.02.018.
23. Pasch LA, Holley SR, Bleil ME, et al. Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services? Fertil Steril. 2016;106:209-15. e2. DOI: 10.1016/j.fertnstert.2016.03.006.
24. Chiba H, Mori E, Morioka Y, et al. Stress of female infertility: relations to length of treatment. Gynecol Obstet Invest. 1997;43:171-7. DOI: 10.1159/000291848.
25. Germer CK, Neff KD. Self-compassion in clinical practice. J Clin Psychol. 2013;69:856-67. DOI: 10.1002/jclp.22021.
26. Cunha M, Galhardo A, Pinto-Gouveia J. Experiential avoidance, self-compassion, self-judgment and coping styles in infertility. Sex Reprod Healthc. 2016;10:41-7. DOI: 10.1016/j.srhc.2016.04.001.
27. Domar AD, Seibel MM. (1990). Emotional aspects of infertility. In MM Seibel (Ed.), Infertility: A comprehensive text. Appleton & Lange; 1990. pp. 23–35.
28. de Liz TM, Strauss B. Differential efficacy of group and individual/ couple psychotherapy with infertile patients. Hum Reprod. 2005;20:1324-32. DOI: 10.1093/humrep/deh743.
29. Terzioglu F. Investigation into effectiveness of counseling on assisted reproductive techniques in Turkey. J Psychosom Obstet Gynaecol. 2001;22:133-41. DOI: 10.3109/01674820109049965.
30. Domar AD, Seibel MM, Benson H. The mind/body program for infertility: a new behavioral treatment approach for women with infertility. Fertil Steril. 1990;53:246-9. DOI: 10.1016/ s0015-0282(16)53275-0.