Abstract
Purpose: Gender-specific differences exist between male and female infertility patients' mental health, the meaning of infertility in their lives, and the coping strategies used. This systematic review examines whether gender-specific aspects are addressed in psychological intervention studies for infertility and whether infertile women and men benefit equally from such interventions. Methods: Databases were searched to identify relevant articles published between 1978 and 2007 (384 articles). The review included both controlled and uncontrolled psychological intervention studies examining results for infertile women and men separately. Outcome measures (depressive symptoms, anxiety, and mental distress) and gender-specific baseline characteristics (mental distress at pre-assessment, cause of infertility, and medical treatment) were collected. A total of twelve studies were finally included. Results: In 10 of 12 studies, women exhibited higher levels of mental distress than men. Gender-specific aspects were not addressed in the psychological interventions. Examining the efficacy of psychological interventions revealed that women exhibited stronger positive mental health effects in 2 of the 12 studies. Conclusion: Psychological distress before psychological treatment seems more pronounced in women than in men. Therefore psychological interventions for infertile couples should take gender-specific aspects into account. More research is needed to address the gender-specific aspects regarding psychological interventions for infertility.
Zusammenfassung
Fragestellung: Geschlechtsspezifische Unterschiede zeigen sich bei infertilen Frauen und Männern in der psychischen Gesundheit, in der Bedeutung der Infertilität für deren Leben und in den verwendeten Bewältigungsstrategien. Mittels einer systematischen Übersichtsarbeit wurde untersucht, inwiefern geschlechtsspezifische Aspekte in psychologischen Interventionsstudien zur Infertilität berücksichtigt werden und ob infertile Frauen und Männer gleichermaßen von solchen Interventionen profitieren. Methoden: In verschiedenen Datenbanken wurde nach relevanten Artikeln (384 Artikel), die zwischen 1978 und 2007 publiziert wurden, gesucht. Eingeschlossen wurden kontrollierte und nicht kontrollierte psychologische Interventionsstudien, bei denen die Resultate für infertile Frauen und Männer separat ausgewertet wurden. Als Ergebnismaße wurden depressive Symptome, Angst und psychischer Stress und als geschlechtsspezifische Charakteristika die Variablen psychischer Stress zu Beginn, Grund der Infertilität und medizinische Behandlung erfasst. Insgesamt konnten abschließend 12 Studien eingeschlossen werden. Resultate: In 10 von 12 Studien wiesen Frauen ein höheres Level an psychischem Stress auf als Männer. In keiner der vorliegenden Interventionsstudien wurden geschlechtsspezifische Aspekte berücksichtigt. In Bezug auf die Wirksamkeit psychologischer Interventionen zeigten sich in 2 von 12 Studien größere Verbesserungen des psychischen Befindens bei infertilen Frauen als bei infertilen Männern. Schlussfolgerung: Psychischer Stress vor der psychologischen Behandlung ist bei Frauen ausgeprägter als bei Männern. Deshalb sollten geschlechtsspezifische Aspekte in psychologischen Interventionen für infertile Paare berücksichtigt werden. Mehr Forschung zu geschlechtsspezifischen Aspekten ist dafür notwendig.
Key words
infertility - gender - psychological intervention - review - mental health
Schlüsselwörter
Infertilität - Geschlecht - psychologische Intervention - Review - psychische Gesundheit
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K. Hämmerli
University of Bern
Institute of Psychology
Department of Clinical Psychology and Psychotherapy
Gesellschaftsstraße 49
3012 Bern
Switzerland
eMail: katja.haemmerli@ptp.unibe.ch
