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      Infertilidade: associação com transtornos mentais comuns e a importância do apoio social Translated title: Infertility: association with common mental disorders and the role of social support

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          Abstract

          INTRODUÇÃO: O diagnóstico da infertilidade pode ser devastador na vida de um casal. Muitas mulheres inférteis percebem a situação como estigmatizante, causadora de sofrimento psíquico e isolamento social. O estudo objetivou determinar as variáveis econômicas, demográficas, interpessoais, sociais e também a prevalência de transtornos mentais comuns na população de mulheres atendidas nos ambulatórios de referência de esterilidade do Hospital Agamenon Magalhães, Centro Integrado de Saúde Amaury de Medeiros e Instituto Materno Infantil de Pernambuco e encaminhadas ao Ambulatório de Saúde Mental em Reprodução Humana do Hospital Universitário Oswaldo Cruz. MÉTODO: A pesquisa foi transversal, durante o ano de 2007, com um total de 60 pacientes, que responderam a dois questionários auto-aplicáveis: o Self-Reporting Questionnaire-20 (SRQ-20) e outro, formulado pela pesquisadora. RESULTADOS: Das 60 mulheres pesquisadas, 55% tinham 31 anos ou mais. A prevalência total dos transtornos mentais comuns foi de 53,3%, sendo que a ocorrência de transtornos mentais comuns foi bem mais elevada entre as que tinham 31 anos ou mais do que entre as que tinham até 30 anos (66,7 versus 37%). As que evitavam situações sociais que podiam causar desconforto emocional apresentaram maior incidência de transtornos mentais comuns. CONCLUSÕES: A prevalência dos transtornos mentais comuns e sua associação com enfrentamento social embasam a necessidade de atendimento interdisciplinar, incluindo profissionais de saúde mental. Nossos dados confirmam a importância do apoio social e da inclusão dos parceiros no processo de avaliação da infertilidade.

          Translated abstract

          INTRODUCTION: A diagnosis of infertility may be devastating for a couple. Many infertile women perceive the situation as stigmatizing, a cause of psychic distress and social isolation. This study aimed at determining the economic, demographic, interpersonal, social and work variables and also the prevalence of common mental disorders in a population of women seen in reference hospitals for infertility (Hospital Agamenon Magalhães, Amaury de Medeiros Integrated Health Center and Instituto Materno Infantil de Pernambuco), and referred to the Mental Health in Human Reproduction Outpatient Clinic at Hospital Universitário Oswaldo Cruz. METHOD: This was a cross-sectional study conducted in 2007 with a total of 60 patients, who answered two self-reporting questionnaires: the Self-Reporting Questionnaire-20 (SRQ-20) and a questionnaire designed by the researcher. RESULTS: Of the 60 women studied, 44% were aged 31 or older. The overall prevalence of common mental disorders was 53.3%. It was much more common in women aged 31 or older than in those aged 30 or less (66.7 vs. 37.0%). The patients who avoided social situations that could cause emotional discomfort presented a higher rate of common mental disorders. CONCLUSIONS: The prevalence of common mental disorders and their association with social coping underlies the need for an interdisciplinary approach, including mental health professionals. Our data confirm the importance of social support and the inclusion of the male partner in the infertility evaluation process.

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          International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care.

          INTRODUCTION The purpose of the present study was to review existing population surveys on the prevalence of infertility and proportion of couples seeking medical help for fertility problems. METHODS Population surveys, reporting the prevalence of infertility and proportion of couples seeking help in more and less developed countries, were reviewed. RESULTS Estimates on the prevalence of infertility came from 25 population surveys sampling 172 413 women. The 12-month prevalence rate ranged from 3.5% to 16.7% in more developed nations and from 6.9% to 9.3% in less-developed nations, with an estimated overall median prevalence of 9%. In 17 studies sampling 6410 women, the proportion of couples seeking medial care was, on average, 56.1% (range 42-76.3%) in more developed countries and 51.2% (range 27-74.1%) in less developed countries. The proportion of people actually receiving care was substantially less, 22.4%. Based on these estimates and on the current world population, 72.4 million women are currently infertile; of these, 40.5 million are currently seeking infertility medical care. CONCLUSIONS The current evidence indicates a 9% prevalence of infertility (of 12 months) with 56% of couples seeking medical care. These estimates are lower than those typically cited and are remarkably similar between more and less developed countries.
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            Infertility and psychological distress: a critical review of the literature.

            This essay reviews the literature on the social psychological impact of infertility, paying special attention to the relationship between gender and the infertility experience. It is convenient to divide the literature into articles which explore the possibility that infertility may have psychological causes (Psychogenic Hypothesis) and those which examine the psychological consequences of infertility (Psychological Consequences Hypothesis). The psychogenic hypothesis is now rejected by most researchers, but a related hypothesis, which states that stress may be a causal factor in infertility, is worthy of exploration. The descriptive literature on the psychological consequences of infertility presents infertility as a devastating experience, especially for women. Attempts to test the psychological consequences hypothesis have produced more equivocal results. In general, studies which look for psychopathology have not found significant differences between the infertile and others. Studies which employ measures of stress and self-esteem have found significant differences. The psychological consequences literature is characterized by a number of flaws, including over sampling of women, small sample size, non-representative samples, failure to study those who have not sought treatment, primitive statistical techniques, and an over-reliance on self-reports. Studies on infertility and psychological distress need to take into consideration both the duration of infertility and the duration of treatment. Finding an appropriate set of "controls" is a particularly intractable problem for this area of research. In general, the psychological distress literature shows little regard for the social construction of infertility. By taking what should be understood as a characteristic of a social situation and transforming it into an individual trait, the literature presents what is essentially a medical model of the psycho-social impact of infertility. Most researchers conclude that infertility is a more stressful experience for women than it is for men. Most studies have found that the relationship between gender and infertility distress is not affected by which partner has the reproductive impairment. Future research needs to be better informed by theoretical considerations. Scholars need to pay more attention to the way the experience of infertility is conditioned by social structural realities. New ways need to be developed for better taking into account the processual nature of the infertility experience. Efforts need to be make to include under-studied portions of the infertile population. Finally, more effort needs to be made to better integrate the empirical study of the experience of infertility with important social policy questions.
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              Um amor conquistador: o mito do amor materno

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rprs
                Revista de Psiquiatria do Rio Grande do Sul
                Rev. psiquiatr. Rio Gd. Sul
                Sociedade de Psiquiatria do Rio Grande do Sul (Porto Alegre )
                0101-8108
                December 2008
                : 30
                : 3
                : 201-210
                Affiliations
                [1 ] Universidade Federal de Pernambuco Brazil
                [2 ] Universidade Federal de Pernambuco Brazil
                [3 ] Universidade de Pernambuco Brazil
                Article
                S0101-81082008000400009
                10.1590/S0101-81082008000400009
                a792fa3c-8d0c-41e9-850c-976c1f1c6b65

                http://creativecommons.org/licenses/by/4.0/

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                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0101-8108&lng=en
                Categories
                ACOUSTICS
                PSYCHIATRY

                Clinical Psychology & Psychiatry,Acoustics
                Infertility,mental disorders,prevalence,social support,stigma,Infertilidade,transtornos mentais,prevalência,apoio social,estigma

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