Trajectories and predictors of anxiety and depression amongst infertile women during their first IVF/ICSI treatment cycle
Trajectories and predictors of anxiety and depression amongst infertile women during their first IVF/ICSI treatment cycle
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DOI：
10.1016/j.jpsychores.2021.110357
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发表时间：
2021-01-25
影响因子：
4.7
通讯作者：
Fang, Mei
中科院分区：
文献类型：
--
作者：
Li, Guopeng;Jiang, Zhenhua;Fang, Mei
目的：本研究旨在确定不孕妇女在第一个 IVF 治疗周期期间的焦虑和抑郁轨迹，并检验所确定的轨迹是否与基线心理预测因素（即生育相关压力、心理弹性和疾病感知）相关。方法：采用中国版焦虑自评量表（SAS）和抑郁自评量表（SDS）在四个不同时间点（首次 IVF/ICSI 预约当天）进行纵向前瞻性研究，评估焦虑和抑郁情况（基线/T1）、卵巢刺激第一天（T2）、卵母细胞取出前一天（T3）和新鲜胚胎移植当天（T4）。对从 202 名不孕女性获得的数据进行了最终分析。进行潜在阶级增长混合模型来识别焦虑和抑郁轨迹。进行多项逻辑回归来研究轨迹成员资格的预测因素。结果：在不孕女性的第一个 IVF/ICSI 治疗周期中，确定了三种不同的调整轨迹。共有 40.1% 和 37.6% 的女性分别表现出正常水平的焦虑和抑郁（弹性轨迹），45.0% 和 43.1% 的女性有恢复轨迹，14.9% 和 19.3% 的女性有慢性焦虑和抑郁轨迹。非弹性轨迹与相对较短的不孕持续时间、较高的生育相关压力和较低的弹性有关。结论：结果表明，有可能在第一次 IVF/ICSI 预约当天识别出处于慢性或恢复轨迹的女性，因此应针对这些个体实施量身定制的预防策略，整合削弱压力评估和增强弹性的成分。
Purpose: This study aimed to identify anxiety and depression trajectories of infertile women during first IVF treatment cycle and to examine whether the identified trajectories were associated with baseline psychological predictors, namely fertility-related stress, resilience, and illness perception.Methods: A longitudinal prospective study was conducted to assess anxiety and depression using the Chinese version of Self-Rating Anxiety Scale (SAS) and Self-Rating depression Scale (SDS) at four different time points: the day of first IVF/ICSI appointment (baseline/T1), the first day of ovarian stimulation (T2), the one day before oocyte retrieval (T3), and the day of fresh embryo transfer (T4). Final analysis was done on data obtained from 202 infertile women. Latent class growth mixed modeling was carried out to identify anxiety and depression trajectories. Multinomial logistic regressions were conducted to investigate predictors of trajectory membership.Results: Three different adjustment trajectories were identified amongst infertile women during their first IVF/ICSI treatment cycle. A total of 40.1 and 37.6% of women showed normal levels of anxiety and depression (resilient trajectories), respectively, 45.0 and 43.1% of women had recovery trajectories, and 14.9 and 19.3% of women had chronic anxiety and depression trajectories. Non-resilient trajectories were associated with relatively shorter duration of infertility, higher fertility-related stress, and lower resilience.Conclusion: The results imply that it is possible to identify women in chronic or recovery trajectories on the day of first IVF/ICSI appointment, so that tailored prevention strategies integrated components that attenuate stress appraisal and strengthen resilience should be implemented to target those individuals.