Depression In Women Research Articles

Effects of a maternal psychosocial intervention on hair derived biomarkers of HPA axis function in mothers and children in rural Pakistan

ObjectiveDisruptions in the hypothalamic-pituitary-adrenal (HPA) axis are thought to be key neuroendocrine mechanisms involved in psychopathology and may have intergenerational impacts. Hair-derived HPA hormones offer a measure of long-term HPA axis activity that may be useful in assessing maternal and infant health. Building on a community-based randomized control trial of a perinatal depression intervention in Pakistan, we examine intervention effects on HPA axis activity in a subsample of mothers and infants. MethodsHPA axis activity was assessed using hair-derived cortisol, cortisone, and dehydroepiandosterone (DHEA). Hair samples were collected from mother-child dyads at one year postpartum from prenatally depressed women randomized to a cognitive-behavioral intervention (n ​= ​35 dyads) or to enhanced usual care (n ​= ​37 dyads), and from a comparison sample of women who screened negative for depression in pregnancy (n ​= ​35 dyads). ResultsThe intervention group had 38 percent (p=0.01) lower maternal cortisol levels and 45 percent (p ​< ​0.01) lower maternal cortisone compared to the EUC group. Maternal DHEA levels were higher among women in the intervention group compared to the EUC group by 29 percent (p ​= ​0.02). Intergenerational intervention effects show higher DHEA levels in infants by 43% (p ​= ​0.03). Infant cortisol and cortisone did not differ across groups. ConclusionsResults suggest that the perinatal depression intervention has effects on HPA axis activity in both mothers and children, providing evidence that treating maternal depression may impact physiological stress system functioning intergenerationally. In addition, utilizing hair-derived biomarkers of HPA-axis activity is a potentially useful clinical indicator of intervention impacts on the neuroendocrine system.

Maternal Interaction With Infants Among Women at Elevated Risk for Postpartum Depression.

Ample research links mothers’ postpartum depression (PPD) to adverse interactions with their infants. However, most studies relied on general population samples, whereas a substantial number of women are at elevated depression risk. The purpose of this study was to describe mothers’ interactions with their 6- and 12-month-old infants among women at elevated risk, although with a range of symptom severity. We also identified higher-order factors that best characterized the interactions and tested longitudinal consistency of these factors from 6 to 12 months of infant age. We leveraged data from eight projects across the United States (n = 647), using standardized depression measures and an adaptation of the NICHD Mother-Infant Interaction Scales. Overall, these depression-vulnerable mothers showed high levels of sensitivity and positive regard and low levels of intrusiveness, detachment, and negative regard with their infants. Factor analyses of maternal behaviors identified two overarching factors—“positive engagement” and “negative intrusiveness” that were comparable at 6 and 12 months of infant age. Mothers’ ability to regulate depressed mood was a key behavior that defined “positive engagement” in factor loadings. An exceptionally strong loading of intrusiveness on the second factor suggested its central importance for women at elevated depression risk. Mothers with severe depressive symptoms had significantly more “negative intrusiveness” and less “positive engagement” with their 6-month-old infants than women with moderate or fewer depressive symptoms, suggesting a potential tipping point at which symptoms may interfere with the quality of care. Results provide the foundation for further research into predictors and moderators of women’s interactions with their infant among women at elevated risk for PPD. They also indicate a need for evidence-based interventions that can support more severely depressed women in providing optimal care.

Cognitive-Behavioral and Personal Construct Therapies for Depression in Women with Fibromyalgia: A Randomized Controlled Trial

Background/ObjectiveFibromyalgia is a chronic pain syndrome that depressive symptoms can aggravate. The aim of the present study was to test the efficacy of Personal Construct Therapy (PCT), an approach that emphasizes identity features and interpersonal meanings as the focus of the treatment of depressive symptoms, in women with fibromyalgia. MethodWe compared PCT with Cognitive Behavioral Therapy (CBT) in a multicenter parallel randomized trial. Women with fibromyalgia and depressive symptoms (n = 106) were randomly allocated to CBT (n = 55) or PCT (n = 51) in individual and modular formats to adjust to their needs. Analysis was by linear mixed-effects models. ResultsParticipants in both conditions had significantly reduced depressive symptoms, and we found no significant difference when comparing groups both post-treatment (β = -0.47, t = -0.49, p = .63) and at follow-up (β = -1.12, t = -1.09, p = .28). Results were similar between conditions for anxiety, fibromyalgia's impact, and the distribution of clinically significant changes in depressive symptoms and pain. ConclusionsPCT and CBT seem to be equally effective in the treatment of depressive symptoms, making PCT a viable alternative treatment.

Acceptability of Behavioral Activation for Depression Among Latinas: A Mixed Methods Study

Latinxs represent the largest ethnoracial minority population in the United States. Despite having significant rates of depression, Latinxs underutilize behavioral health services. This, combined with the association between gender and depression (women have higher rates of depression than men), underscores the importance of developing an improved understanding of how Latinas view behavioral activation (BA), an empirically supported treatment for depression. In this mixed methods study, participants consisted of 77 Latinas; participants were provided with a vignette depicting a fictional character that underwent BA for depression. Participants in the quantitative study completed a measure of treatment acceptability of BA (n = 60); participants in the qualitative study completed a semistructured interview assessing their views on BA (n = 17). Latinas had generally positive attitudes about BA, although they also identified some elements that they perceived might act as barriers to treatment success. Because we were interested in the interplay of cultural factors and treatment acceptability, we also examined enculturation and acculturation as predictors of treatment acceptability—enculturation only was a significant predictor treatment acceptability. Our sample was relatively small, social desirability may have influenced our responses, and it is not known to what extent our results generalize to Latinx men. Latina women find BA to be an acceptable treatment for depression, which suggests promise with regard to clinical outcomes for depressed Latinas receiving BA. Addressing potential barriers to treatment engagement may improve outcomes for depressed Latinas receiving BA.

Interaction Effect between Physical Activity and the BDNF Val66Met Polymorphism on Depression in Women from the PISMA-ep Study.

The relationship between depression and the Val66Met polymorphism at the brain-derived neurotrophic factor gene (BDNF), has been largely studied. It has also been related to physical activity, although the results remain inconclusive. The aim of this study is to investigate the relationship between this polymorphism, depression and physical activity in a thoroughly characterised sample of community-based individuals from the PISMA-ep study. A total of 3123 participants from the PISMA-ep study were genotyped for the BDNF Val66Met polymorphism, of which 209 had depression. Our results are in line with previous studies reporting a protective effect of physical activity on depression, specifically in light intensity. Interestingly, we report a gene-environment interaction effect in which Met allele carriers of the BDNF Val66Met polymorphism who reported more hours of physical activity showed a decreased prevalence of depression. This effect was observed in the total sample (OR = 0.95, 95%CI = 0.90–0.99, p = 0.027) and was strengthened in women (OR = 0.93, 95%CI = 0.87–0.98, p = 0.019). These results highlight the potential role of physical activity as a promising therapeutic strategy for preventing and adjuvant treatment of depression and suggest molecular and genetic particularities of depression between sexes.

Antenatal depression: Efficacy of a pre-post therapy study and repercussions in motor development of children during the first 18 months postpartum. Study: “Pregnancy care, healthy baby”

AimsTo evaluate the efficacy of brief psychotherapeutic interventions of cognitive behavioral therapy to treat antenatal depression and verify the association between interventions and motor development of infants at 3 and 18 months of age. MethodsPre-post-intervention study nested a randomized clinical trial, both of which are extracts from a population-based cohort study of a southern Brazilian city. The major depressive episode was measured through Mini Plus, the severity of depressive symptoms by BDI-II and motor development using Bayley-III and AIMS. The follow-ups occurred during the gestational period (T2) and at 3 (T3) and 18 months (T4) after delivery. ResultsData were analyzed from 336 women in the control group (not intervened) and 108 from the group of depressed women who received intervention for antenatal depression. The effectiveness of the interventions for a major depressive episode was around 80% for both models in the two follow-up stages (3 and 18 months postpartum). In addition, the children whose mothers received intervention presented 3.7 (95% CI 0.7–6.6) points higher in Bayley-III at 3 months old when compared to the children in the control group (p = 0.01). There was no difference between the two psychotherapy models tested, both being equally effective (p > 0.05). ConclusionsWe found that the brief psychotherapeutic interventions of cognitive behavioral therapy for gestational depression were effective in causing remission of the condition both in the short and long term, besides indirectly causing benefits also to the children, with regard to their motor development.

Risk factors of perinatal depression in women: a systematic review and meta-analysis

BackgroundPerinatal depression in women is associated with high morbidity and mortality, and has attracted increasing attention. The investigation of risk factors of perinatal depression in women may contribute to the early identification of depressed or depression-prone women in clinical practice.Material and MethodsA computerized systematic literature search was made in Cochrane Library, PubMed, Web of Science, and EMBASE from January 2009 to October 2021. All included articles were published in English, which evaluated factors influencing perinatal depression in women. Based on the recommendations of the Cochrane Collaboration protocols, Review Manager 5.3 was used as a statistical platform.ResultsThirty-one studies with an overall sample size of 79,043 women were included in the review. Educational level (P = 0.0001, odds ratio [OR]: 1.40, 95% CI: [1.18,1.67]), economic status of families (P = 0.0001, OR: 1.69, 95%CI: [1.29,2.22]), history of mental illness (P < 0.00001, OR: 0.29, 95% CI: [0.18, 0.47]), domestic violence (P < 0.00001, OR: 0.24, 95% CI: [0.17,0.34]), perinatal smoking or drinking (P = 0.005, OR: 0.63; 95% CI [0.45, 0.87]; P = 0.008, OR: 0.43, 95% CI, [0.23 to 0.80]; respectively), and multiparity(P = 0.0003, OR: 0.74, 95% CI: [0.63, 0.87]) were correlated with perinatal depression in women. The stability of our pooled results was verified by sensitivity analysis and publication bias was not observed based on funnel plot results.ConclusionLower educational level, poor economic status of families, history of mental illness, domestic violence, perinatal smoking or drinking, and multiparity serve as risk factors of perinatal depression in women.

Social Support Buffers the Effects of Prenatal Depressed Mood: A Mixed-Methods Study.

BACKGROUND: Women use various coping strategies to deal with stress and depression. These strategies are shaped by social contexts over the life course and may attenuate and/or exacerbate the physiologic effects of depression. AIMS: The purpose of this study was to determine whether coping strategies (active, disengaged, or social support coping) moderate depression-related diurnal cortisol dysregulation and to explore how social context influences women's use of coping. METHODS: This was a mixed-methods study of pregnant women (N = 65) during mid-pregnancy. Cortisol was measured in saliva collected during the waking hours of the day. Participants completed the Edinburgh Depression Scale and the Brief COPE. A subset of the sample participated in semistructured qualitative interviews (n = 20). RESULTS: Social support coping, but not active or disengaged coping, moderated end-of-day cortisol levels. Among depressed women, higher use of social support was associated with lower and more dynamic (i.e., less flat) diurnal cortisol rhythms. The qualitative findings revealed how complex social dynamics related to financial insecurity, lack of mutuality, and social identity affected women's use of and access to social support. CONCLUSION: These findings support theories of the stress-buffering effects of social support. Future research is needed to examine how social determinants affect access to social support, and how early life social experiences condition women's adaptive formation of social support coping strategies over the life course. Clinically, these findings underscore the value of relationship-centered nursing care for depressed women.

Gestational Exposure to Antidepressant Drugs and Neurodevelopment: An Examination of Language, Mathematics, Intelligence, and Other Cognitive Outcomes.

During the past decade, nearly a dozen small and large, prospective and retrospective observational studies examined cognitive neurodevelopmental outcomes in childhood after gestational exposure to antidepressant drugs. Many of the studies found that exposure was associated with poorer outcomes on measures of language, cognition, intellectual skills, and academic performance, but, in most instances, the association appeared to be more related to maternal depression during pregnancy and other confounds than to antidepressant use during pregnancy. A large new population-based observational study specifically examined language and mathematics performance in serial, nationally standardized tests. The study found that, in fully adjusted analyses, in children and adolescents aged 9-15 years, a history of gestational exposure to antidepressant drugs was associated with a small (by about 2 out of 100 points) but statistically significantly poorer performance in mathematics but not in language. The findings were consistent though attenuated in a large number of important and appropriate sensitivity analyses, some of which adjusted for confounding in additional ways. The body of literature reviewed suggests that prenatal antidepressant exposure is indeed associated with cognitive neurodevelopmental deficits and that the deficits are attenuated or eliminated by adjustment for maternal depression and other confounds. It is suggested that the deficits that remain despite adjustment may be due to residual confounding from unmeasured behavioral and internal environment variables associated with untreated maternal depression. Thus, prenatal antidepressant exposure may merely be a marker rather than the cause of cognitive neurodevelopmental deficits. Whereas the literature in the field does not drive a case for withholding antidepressants from depressed pregnant women, decision-making must remain a shared process.

A comparison of symptoms of bipolar and unipolar depression in postpartum women

BackgroundDistinguishing postpartum women with bipolar from unipolar depression remains challenging, particularly in obstetrical and primary care settings. The post-birth period carries the highest lifetime risk for the onset or recurrence of Bipolar Disorder (BD). Characterization of differences between unipolar and bipolar depression symptom presentation and severity is critical to differentiate the two disorders. MethodsWe performed a secondary analysis of a study of 10,000 women screened by phone with the Edinburgh Postnatal Depression Scale at 4–6 weeks post-birth. Screen-positive mothers completed the Structured Clinical Interview for DSM-4 and those diagnosed with BD and unipolar Major Depressive Disorder (UD) were included. Depressive symptoms were assessed with the 29-item Structured Interview Guide for the Hamilton Rating Scale for Depression (SIGH-ADS). ResultsThe sample consisted of 728 women with UD and 272 women with BD. Women with BD had significantly elevated levels of depression severity due to the higher scores on 8 of the 29 SIGH-ADS symptoms. Compared to UD, women with BD had significantly higher rates of comorbid anxiety disorders and were twice as likely to report sexual and/or physical abuse. LimitationsOnly women who screened positive for depression were included in this analysis. Postpartum women with unstable living situations, who were hospitalized or did not respond to contact attempts did not contribute data. ConclusionsSeverity of specific symptom constellations may be a useful guide for interviewing postpartum depressed women along with the presence of anxiety disorder comorbidity and physical and/or sexual abuse.

Psychological intervention in women with Mayer-Rokitansky-Küster-Hauser syndrome after artificial vaginoplasty: a prospective study.

Introduction and hypothesisThe negative psychological impact on women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is long-lasting, resulting from not only the disease itself, but also the cumbersome and painful treatment process. However, little is known about the postoperative psychological status of these patients and related interventions to improve mental health. Here, in our study, we postulated that mental disorders exist in MRKH patients with a surgical neovagina and that psychological intervention will be helpful.MethodsThirty MRKH women who had undergone vaginoplasty were enrolled. All patients had received psychological interventions since February 2020. Depression and anxiety questionnaires prior to and 2 weeks after the final intervention were recorded.ResultsBefore intervention, among 30 MRKH patients after artificial vaginoplasty, the median depression score was 6.00 (25th/75th percentile, 0.00/7.00), and the median anxiety score was 4.00 (25th/75th percentile, 1.00/7.00). After intervention, women’s depression (p < 0.001) and anxiety (p < 0.001) scores significantly decreased. The median depression score was 0.00 (25th/75th percentile, 0.00/3.00), and the median anxiety score was 1.00 (25th/75th percentile, 0.00/3.25). Furthermore, stratified analysis found that the depression (p = 0.029) and anxiety (p = 0.019) scores both improved when intervention was performed within 12 months postoperatively.ConclusionsMRKH patients are at a great risk of depression and anxiety problems after artificial vaginoplasty. Early psychological intervention can alleviate these symptoms. Ongoing psychological support was needed to eliminate emotional burden during MRKH treatment, and further study is sorely needed to identify its appropriate timing and method.

Therapy based on positive self-defining memories for older women with depressive disorder and associated ruminations: a pilot study.

Depressive disorders hinder the retrieval of positive memories, which is the mechanism strategically used by healthy subjects to cope with negative feelings. An adjustment to this strategy to deal with depression affecting elderly women presenting ruminative responses could be obtained by materialising a number of positive self-defining memories. This innovative cognitive therapeutic method should lead to a decrease in the rumination rate and an improvement in depressive disorders for ageing women. Our study, which included 14 depressed women over the age of 65 who presented with ruminative responses, was divided into two groups according to the severity of their depressive disorder (moderate or severe). Participants collected positive self-defining memories in a notebook over three sessions, which was used independently over the three following weeks. The results show a significant decrease in rumination, regardless of the disorder severity. A significant improvement in the depressive disorder was observed in the elderly women with moderate depressive disorder but stagnated after the support phase. These data highlight the interest of this therapeutic method for the treatment of patients suffering from moderate depression, while further studies will be required to adjust it for severely affected patients.

Independent predictors of depressive symptoms and social isolation on 2-year all-cause mortality among the Korean elderly in a population-based cohort study: gender differences.

OBJECTIVESThis study examined whether depressive symptoms and social isolation were independent predictors of 2-year all-cause mortality among the elderly using data from a population-based cohort study.METHODSIn total, 1,033 participants (320 men and 713 women) older than 60 years of age participated in this study. Depressive symptoms, social isolation status, and socio-demographic and health-related covariates were assessed at baseline. The primary outcome measure was 2-year all-cause mortality. Data were collected through in-person interviews by trained interviewers. The GENMOD procedure was used to calculate relative risks (RRs).RESULTSOf the 1,033 participants, 102 (40 men and 62 women) died within the follow-up period of 2 years. During the 2-year follow-up period, 17.8% of depressed men and 12.3% of depressed women died, and 29.8% of socially isolated men and 14.9% of socially isolated women died. Social isolation was an independent predictor of mortality in elderly men (adjusted relative risk [aRR], 4.6, 95% confidence interval [CI], 2.0 to 10.2), while depressive symptoms were an independent predictor of mortality in elderly women (aRR, 2.0; 95% CI, 1.2 to 3.6) when controlling for potential confounding factors. However, the depressive symptoms detected using the geriatric depression scale were not associated with mortality in men, and social isolation was not associated with mortality in women.CONCLUSIONSThe effects of depressive symptoms and social isolation on 2-year all-cause mortality within an elderly population differed according to gender. Gender-specific community-based interventions must be developed to potentially reduce 2-year all-cause mortality among the elderly.

Effects of Depression on Processing and Evaluation of Sexual Stimuli in Women

BackgroundSexual dysfunctions are commonly associated with depression by which women are particularly affected. AimIn the following study, we looked at which stage–early attention-related processes or later evaluation-related processes–of the processing of sexual stimuli deviations occur in depressed individuals. MethodsWe examined 96 women who either suffered from a major depressive disorder, or had recovered from it, and a healthy control group. The early level of attention processes was represented by reaction time tasks (dot probe, line orientation, picture categorization). In addition, implicit approach and avoidance behavior was tested by the Approach-Avoidance Task. Later evaluation of the visual material was determined with the help of a questionnaire for recording automatic negative thoughts regarding sexuality. OutcomesReaction times and explicit ratings as well as the Becks Depression Inventory (BDI II), the Trait Sexual Motivation Questionnaire (TSMQ), the Sexual Modes Questionnaire (SMQ) and a screening for sexual dysfunction were used. ResultsDepressed women did not differ significantly from healthy women in their attention processes and approach-avoidance behavior. However, there were clear differences in explicit assessment and automatic thoughts about sexual stimuli. Women who had recovered from depression lay between the 2 groups. Clinical ImplicationsThe results indicated that the therapy of sexual dysfunction in depressed patients should focus more on automatic thoughts than on attention processes. Strengths & LimitationsThis study is the first to experimentally research the attention processes of depression towards sexual stimuli. However, participants were only tested on one occasion so that change of attention processes and evaluation of sexual stimuli over the course of a depression could not be assessed. ConclusionOur novel findings demonstrate the role of attention processes in sexual dysfunctions of depressed women and suggest potential mechanisms that may underlie the observed correlation between depression and sexual dysfunction.Baranowski AM, Noll A-K, Golder S, et al. Effects of Depression on Processing and Evaluation of Sexual Stimuli in Women. J Sex Med 2022;19:441–451.

Effect of Antenatal Depression on Fetal Growth Outcomes at the Jos University Teaching Hospital Jos, Plateau State, Nigeria

Background: Depression is the most prevalent psychiatric disorder in pregnancy and it is associated with psychosocial and obstetric factors. Studies have shown that pregnancy does not prevent women from becoming depressed; rather, it may be a time when depression occurs for the first time in some women. Antenatal depression has been identified as a risk factor for post natal depression, adverse obstetric outcomes, poorer neonatal outcomes and higher growth retardation in infants. Purpose: This study aimed to determine the fetal growth outcomes among depressed pregnant women in their third trimester attending antenatal clinic at the Jos University Teaching Hospital (JUTH), Jos, Plateau State, Nigeria. Method: A prospective cohort study design was used to assess 514 women who consented to the study (256 cases and 258 controls). A socio-demographic questionnaire was given to the women to fill out the study entry. Edinburgh Post Natal Depression Scale (EPDS) was used to screen for depression and MINI neuropsychiatric interviews were used to diagnose depression in those women found to be at risk of depression using the EPDS. Ultrasonography was used to determine the fetal weight in the third trimester of pregnancy. The birth weight of the babies born to the women was obtained from the birth register in the labor ward and the fetal growth rate was calculated from the estimated fetal weight on ultrasound scan in late pregnancy and the birth weight of babies. Result: The mean fetal weight in the third trimester for non-depressed women was slightly higher than in depressed women though the difference was not statistically significant (P = 0.431). The difference in the mean calculated fetal growth rate for fetuses of non-depressed women in the third trimester was statistically significantly higher than in depressed women (p = 0.000). Depressed women also had babies with lower birth weight than non-depressed women and the difference was statistically significant (p = 0.00).

Structural Analysis of Social Behavior: Using Cluster Analysis to Examine Intrapsychic Personality Traits Associated With Depression in Women With Breast Cancer.

BackgroundThis study aimed to investigate personality traits associated with depression in breast cancer women (BCW).MethodsSample: 236 BCW recently diagnosed (early stages). Tests: SASB-Structural-Analysis of Social-Behavior; IPAT-CDQ-Depression. Statistical analysis: cluster K-Means analysis to explore SASB personality-traits considering the 8 SASB clusters (Cl); CDQ scores dichotomized by 50th percentile cutoff (high/low); Pearson’s chi square test to compare CDQ levels and SASB traits.ResultsCluster analysis results supported two distinguishable SASB personality traits (for all SASB Cl-Scales P < .001) classified as “Love and Autonomy” (62.2%) and “Control and Hate” (37.8%). Patients with Love/Autonomy traits are spontaneous, accept their deepest feelings and desire to be close to other people (Cl1, Cl2, Cl3, Cl4). They show a medium value of self-control and a low tendency to self-abusive and self-critical behaviors (Cl5, Cl6). They pay attention to themselves and to their needs at emotional and physical levels also if may be occasionally engaged in self-destructive behaviors (Cl7, Cl8). Women with Control/Hate traits are not spontaneous and do not always express emotions (C1, Cl2, Cl3, Cl4) and flexibility in their relationship with others (Cl5, Cl6). In stressful situations, they may ignore the option of choices for self-growth and neglect their needs and those of others (Cl7, Cl8). BCWs with Control/Hate traits scored higher in depression (P <.001) than those with the Love/Autonomy profile.ConclusionsHealthcare professionals should be aware of these personality traits and their association with depression to identify the psychologically most vulnerable BCW and improve the care they provide them. The psychotherapeutic intervention should be planned to face on the personality problems.

Pharmacotherapy or Psychotherapy? Selective Treatment Depression in The Infertile Women with Recurrent Pregnancy Loss: A Triple-Arm Randomized Controlled Trial.

Background:Recurrent pregnancy loss (RPL) and infertility are associated with significant psychiatric complications. The study aimed to investigate the effectiveness of cognitive behavioral therapy (CBT) and sertraline in the treatment of in depression, anxiety, and infertility stress of depressed infertile women with RPL in comparison with usual care.Materials and Methods:A triple-arm randomized controlled trial was carried out on the 60 depressed infertile women with RPL, a population of Infertility Center of Babol city, Iran, who were randomly assigned into three groups: pharmacotherapy with sertraline (n=20), psychotherapy with CBT (n=20), and a usual care as control group (n=20). The participants of psychotherapy received CBT sessions (90 minutes each) over 10 weeks. The participants in the pharmacotherapy group took 50 mg/day sertraline daily for 22 weeks. Outcomes were assessed using the Beck Depression Inventory (BDI-II), fertility problem inventory (FPI), and State-Trait Anxiety Inventory Form Y (STAI-Y) at the beginning of the trial, 10-weeks post-trial, and three months of follow-up. Using statistical package for the social sciences (SPSS) software, data were analyzed.Results:CBT considerably reduced the depression symptoms more than sertraline with a moderate effect size at the post-trial (g=0.11, 95% CI: -0.03 to -0.50). Sertraline showed reduced the scores of state-anxiety more considerably in comparison with control group by a large effect size of post-trial (g=-1.04, 95% CI: -1.70 to -0.38). CBT reduced the total scores of FPI more considerably than sertraline, with a large, small size at follow up-trial [95% CI=-0.03(-0.65, -0.58)]. Both CBT and sertraline were superior to the control group in reducing depression and infertility stress.Conclusion:Depression and infertility stress diminished under CBT and sertraline in depressed infertile women with RPL, with a signi.cant advantage of CBT. Sertraline was superior to CBT in reduction of anxiety (registration number: IRCT201304045931N3).

Investigating the effect of transcranial direct electrical stimulation (tDCS) and neuro-verbal programming (NLP) on reducing women's depression, anxiety and stress

Aim: The present study was conducted with the aim of investigating the effect of transcranial direct electrical stimulation (tDCS) and neuro-verbal programming (NLP) on reducing the level of depression, anxiety and stress of women referring to comprehensive health service centers in Zahedan. Method: pre-test-post-test research design. With experimental groups (transcranial direct electrical stimulation (tDCS) and neuro-verbal programming (NLP)) and a control group. The statistical population consisted of all women with three disorders of depression, anxiety and stress who referred to mental health experts of comprehensive health service centers in Zahedan city, from which a sample of 45 people was selected by simple random sampling method, so 30 people were in the experimental groups. The first intervention was 10 sessions of direct electrical and cranial stimulation (tDCS), the second group was given 8 weeks of neuro-verbal programming (NLP), while 15 people in the control group were not given any training. After completing the Depression Anxiety Stress Scale-21 (DASS-21) questionnaire, data was collected and then analyzed using SPSS version 23 software. Results: The results of the multivariate covariance analysis showed that the mean scores of depression (F=23.47, P=0.001), anxiety (F=65.46, P=0.001) and stress (38.30) There is a significant decrease between the pre- and post-test scores of the treatment groups. Conclusion: The results of Tukey's post-hoc test showed that the mean direct intracranial electrical stimulation (TDCS) is lower than neuro-verbal programming (NLP) in reducing the level of depression, anxiety and stress.

A Comparison of the Effectiveness of Mentalization-Based Therapy (MBT) and Affect Phobia Therapy (APT) in Reducing Depressive Symptoms in Women with Borderline Personality Disorder

Aim: The present study aimed to determine the effectiveness of Mentalization-based therapy (MBT) in comparison with Affect Phobia Therapy (APT) in reducing depressive symptoms in women with borderline personality disorders. Methods: The study had a quasi-experimental method with a pretest-posttest design and follow-up with a control group. The statistical population consisted of 120 women with borderline personality disorder symptoms who visited counseling centers in Qom from August and October 2020. After screening with the Goldberg Depression Questionnaire (1971) and interviews according to DSM-5 criteria, 60 women were selected by purposive sampling and were randomly assigned to two experimental groups and a control group (20 per group). The first experimental group received mentalization-based therapy by Batman and Funagi (2016), and the second experimental group received affect phobia therapy by McCullough in eight 90-minute sessions, one session per week, and the control group was placed on a waiting list. Data were analyzed using repeated-measures analysis of variance (ANOVA). Results: The results indicated the effects of mentalization-based therapy intervention (F=18.41, P=0.001) with an effect size of 0.36, and affect phobia therapy intervention (F=20.35, P=0.001) with an effect size of 0.38 on women's depression, and the stability of the effects at the follow-up stage. Conclusion: The affect phobia therapy along with medication can be used for patients with depression.

Association of own and spousal intra- and extra-familial adverse childhood experiences with cognitive function and the role of depression in middle-aged and older Chinese women

ObjectiveTo explore the associations of own and spousal intra- and extra-familial adverse childhood experiences (ACEs) with cognitive function and the role of depression in women. MethodsData were from the China Health and Retirement Longitudinal Study. ACEs included 11 intra-familial and 3 extra-familial domains. Principal component analysis was used to divide ACEs into mild, moderate, severe, and most severe. Depression was assessed using CESD-10 (cutoff≥10). Global cognition included episodic memory and mental intactness, with values ranging from 0 to 31. Adjusted multiple generalized linear regression models (GLM) were used to investigate the associations of own or spousal ACEs with women's cognitive function and the role of their depression in general women in Analysis 1 and married women in Analysis 2, respectively. ResultsAmong 4613 women aged 59.0 (52.0–65.0) in Analysis 1, depression mediated 12.3%, 14.6%, and 9.5% the effects of most severe overall ACEs on global cognition, episodic memory, and mental intactness. In Analysis 2, most severe spousal overall ACEs were associated with women's mental intactness, with β (95% CI) of −0.120 (−0.217 to −0.023), which was mediated by women's depression by 19.8%. Furthermore, most severe spousal extra-familial ACEs were associated with women's global cognition, episodic memory, and mental intactness (β = −0.210, 95% CI -0.297 to −0.123; β = −0.150, 95% CI -0.241 to −0.060; β = −0.211, 95% CI -0.302 to −0.121), which was 7.6%, 9.4%, and 6.0% mediated by their depression. ConclusionDepression mediated the effects of own and spousal extra-familial (not intra-familial) ACEs on women's cognitive function.