背景:复发性妊娠丢失(RPL)和不孕症与严重的精神并发症有关。
本研究旨在探讨认知行为疗法(CBT)与舍曲林治疗抑郁症的效果。焦虑,
与常规护理相比,患有RPL的抑郁症不育妇女的不育压力。
材料与方法:采用三臂随机对照试验对60例抑郁症性不育患者进行
巴博尔市不孕症中心的人口,伊朗,他们被随机分为三个
组:舍曲林药物治疗(n=20),CBT心理治疗(n=20),和常规护理作为对照组
(n=20)。心理治疗的参与者在10周内接受了CBT课程(每次90分钟)。
药物治疗组的参与者每天服用50mg舍曲林,持续22周。使用贝克抑郁量表(BDI-II)评估结果
,生育问题清单(FPI),和状态特质焦虑
试验开始时的库存表格Y(STAI-Y),审判后10周,和三个月的随访。
使用社会科学统计软件包(SPSS)软件,数据进行了分析。
结果:在试验后,CBT显著减轻了抑郁症状,效果大小中等
(g=0.11,95%CI:-0.03至-0.50)。舍曲林显示,与对照组相比,状态焦虑评分降低更多
,试验后效果较大(g=-1.04,95%CI:-1.70至
-0.38)。与舍曲林相比,CBT降低了FPI的总分,一个大的,随访
向上试验[95%CI=-0.03(-0.65,-0.58)]。CBT和舍曲林在降低
抑郁和不孕症压力方面均优于对照组。
结论:CBT和舍曲林对患有RPL的抑郁性不孕妇女的抑郁和不孕症应激降低。具有CBT的显著fi不能优势。舍曲林在减少焦虑方面优于CBT(注册号:
IRCT201304045931N3)。
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 significant advantage of CBT. Sertraline was superior to CBT in reduction of anxiety (registration number:
IRCT201304045931N3).