The Role of Psychological Factors in the Outcome of In Vitro Fertilization in Women with Primary Infertility.

INTRODUCTION: Infertility is a multidimensional developmental crisis of the individual, couple, family and the population as a whole. This study concentrates on the psychological aspects of infertility treatment by in vitro fertilization (IVF). The aim of this study was to examine a connection between certain psychological factors - anxiety, depression, motivation for parenthood, styles of coping with stress - and the outcome of IVF. SUBJECTS AND METHODS: The study included 100 primarily infertile women aged 23-38 years, who underwent IVF procedure for the first time, at the Department of Gynaecology and Obstetrics of University Hospital Centre Zagreb. Regarding the outcome of IVF, they were divided into two groups, those with positive outcome (N=50), and those with negative outcome of IVF (N=50). We have applied: general data questionnaire, Parenthood motivation scale, COPE Inventory, and Depression, Anxiety, Stress Scales - 21. RESULTS: The dimension of motivation for parenthood Relationship and the styles of coping with stress Seeking emotional support, Planning and Active coping proved to be statistically significant predictors of IVF outcome. By increasing the results on the relationship, seeking emotional support and planning subscales, the likelihood of negative outcome was increased. By increasing the results on the active coping subscale, the likelihood of positive outcome was increased. Anxiety and depression symptoms did not prove to be statistically significant predictors of the IVF outcome. CONCLUSION: The role of psychological factors is important for understanding the diagnosis and treatment of infertility. They also provide the basis for creating guidelines for specific preventive and educational programs and for special forms of psychological counselling for individuals facing infertility.

Emotional dysregulation and attachment dimensions in female patients with bulimia nervosa.

BACKGROUND: The aim of this study was to examine whether there is a difference in the dimensions of attachment and difference in emotional regulation between the group of female patients suffering from bulimia nervosa (BN) and the control group. We also wanted to examine whether emotional regulation has a mediating role in the relationship between dimensions of attachment and severity of BN symptoms. SUBJECTS AND METHODS: The study included a total of 100 female participants from 15 to 25 years of age (M=20.40, SD=3.26). The clinical group consisted of 50 patients suffering from BN, and the control group consisted of 50 healthy female subjects. RESULTS: Female patients suffering from BN achieved higher scores in the dimensions of anxiety (t98=-5.12, p=0.00) and avoidance (t98=-4.30, p=0.00). Dimension of attachment related anxiety (ß=0.44, p=0.00) proved to be a statistically significant predictor of BN symptoms. Subjects of the clinical group also achieved significantly higher (t98=7.41, p=0.00) emotional dysregulation than participants of the control group. We also found that the mediation effect of emotional regulation on the association between anxiety and BN symptoms was statistically significant (z'=4.43, p=0.00). CONCLUSIONS: Patients suffering from BN showed significantly higher levels of attachment related anxiety and avoidance as well as significantly higher level of difficulties in emotional regulation than healthy controls. Attachment anxiety proved to be a significant predictor of symptoms BN, suggesting that the attachment related anxiety is stronger correlate of BN symptoms than avoidance, and may represent a risk factor for more severe BN symptoms. It was also found that the relationship between attachment related anxiety and BN symptoms were mediated by emotional regulation.

Satisfaction with psychiatric in-patient care as rated by patients at discharge from hospitals in 11 countries.

PURPOSE: There is disregard in the scientific literature for the evaluation of psychiatric in-patient care as rated directly by patients. In this context, we aimed to explore satisfaction of people treated in mental health in-patient facilities. The project was a part of the Young Psychiatrist Program by the Association for the Improvement of Mental Health Programmes. METHODS: This is an international multicentre cross-sectional study conducted in 25 hospitals across 11 countries. The research team at each study site approached a consecutive target sample of 30 discharged patients to measure their satisfaction using the five-item study-specific questionnaire. Individual and institution level correlates of 'low satisfaction' were examined by comparisons of binary and multivariate associations in multilevel regression models. RESULTS: A final study sample consisted of 673 participants. Total satisfaction scores were highly skewed towards the upper end of the scale, with a median total score of 44 (interquartile range 38-48) out of 50. After taking clustering into account, the only independent correlates of low satisfaction were schizophrenia diagnosis and low psychiatrist to patient ratio. CONCLUSION: Further studies on patients' satisfaction should additionally pay attention to treatment expectations formed by the previous experience of treatment, service-related knowledge, stigma and patients' disempowerment, and power imbalance.