The Institute of Public Health, University of Copenhagen, DK-1014 Copenhagen K, Denmark.
Hum Reprod. 2009 Nov;24(11):2810-20. doi: 10.1093/humrep/dep257. Epub 2009 Jul 22.
The present study investigates anticipated support and perceived appreciation as well as perceived negative aspects of social relations as determinants of the incidence of severe depressive symptoms among women and men in unsuccessful fertility treatment.
A prospective cohort study of consecutively recruited, new couples in fertility treatment completed questionnaires immediately before initiating treatment (T1) and at 1-year follow-up (T2) (response rates 80%, 88%). The study population included 695 participants (355 women and 340 men) who had no severe depressive symptoms at T1, who had no child together at T1 and whose treatment had failed. We measured severe depressive symptoms with Mental Health Inventory 5 from Short-Form 36, functional aspects of general social relations and of infertility-specific social relations.
Fifteen per cent of women and 6% of men in unsuccessful treatment reported severe depressive symptoms at T2. Among men, low emotional support, low appreciation and high excessive demands from the partner were significant determinants of the incidence of severe depressive symptoms. Among women and men, low appreciation from the family, many conflicts and high excessive demands from family, friends and neighbours were significant determinants of severe depressive symptoms. The analyses were controlled for gender. Duration of infertility, infertility diagnosis and socio-economic position did not confound the associations.
More women than men report severe depressive symptoms after 1 year of unsuccessful treatment. It is important to be aware of the possible negative impact of relational strain among fertility patients in unsuccessful treatment.
本研究调查了预期支持和感知赞赏，以及感知到的社会关系的负面方面，作为女性和男性在不成功的生育治疗中发生严重抑郁症状的决定因素。
一项前瞻性队列研究，连续招募新的生育治疗夫妇，在开始治疗前（T1）和 1 年随访时（T2）完成问卷（响应率 80%，88%）。研究人群包括 695 名参与者（355 名女性和 340 名男性），他们在 T1 时没有严重的抑郁症状，在 T1 时没有共同的孩子，并且治疗失败。我们使用 Mental Health Inventory 5 从 Short-Form 36 中测量严重抑郁症状，评估一般社会关系和生育特定社会关系的功能方面。
在不成功的治疗中，15%的女性和 6%的男性报告在 T2 时出现严重的抑郁症状。在男性中，低情感支持、低赞赏和高来自伴侣的过度需求是严重抑郁症状发生的显著决定因素。在女性和男性中，来自家庭的低赞赏、许多冲突和来自家庭、朋友和邻居的高过度需求是严重抑郁症状的显著决定因素。这些分析控制了性别。不孕持续时间、不孕诊断和社会经济地位并没有混淆这些关联。
在不成功的治疗后 1 年，报告严重抑郁症状的女性多于男性。在不成功的生育治疗中，要意识到患者之间关系紧张可能产生的负面影响，这一点很重要。
