Coping strategies of women with postpartum depression symptoms in rural Ethiopia: a cross-sectional community study

Background: Most women with postpartum depression (PPD) in low- and middle-income countries remain undiagnosed and untreated, despite evidence for adverse effects on the woman and her child. The aim of this study was to identify the coping strategies used by women with PPD symptoms in rural Ethiopia to inform the development of socio-culturally appropriate interventions. Methods: A population-based, cross-sectional study was conducted in a predominantly rural district in southern Ethiopia. All women with live infants between one and 12 months post-partum (n = 3147) were screened for depression symptoms using the validated Patient Health Questionnaire, 9 item version (PHQ-9). Those scoring five or more, ‘high PPD symptoms’, (n = 385) were included in this study. The Brief Coping with Problems Experienced (COPE-28) scale was used to assess coping strategies. Construct validity of the brief COPE was evaluated using confirmatory factor analysis. Results: Confirmatory factor analysis of the brief COPE scale supported the previously hypothesized three dimensions of coping (problem-focused, emotion-focused, and dysfunctional). Emotion-focused coping was the most commonly employed coping strategy by women with PPD symptoms. Urban residence was associated positively with all three dimensions of coping. Women who had attended formal education and who attributed their symptoms to a physical cause were more likely to use both problem-focused and emotion-focused coping strategies. Women with better subjective wealth and those who perceived that their husband drank too much alcohol were more likely to use emotion-focused coping. Dysfunctional coping strategies were reported by women who had a poor relationship with their husbands. Conclusions: As in high-income countries, women with PPD symptoms were most likely to use emotion-focused and dysfunctional coping strategies. Poverty and the low level of awareness of depression as an illness may additionally impede problem-solving attempts to cope. Prospective studies are needed to understand the prognostic significance of coping styles in this setting and to inform psychosocial intervention development

The impact of infertility diagnosis on psychological status of women undergoing fertility treatment

Despite the great number of studies conducted to examine the impact of infertility on the psychological status of women undergoing infertility treatment, little is known about the psychological impact of infertility when it is due to male or female factors and its role in the cause of higher levels of anxiety and stress. The aim of this cross-sectional study was to assess the impact of infertility diagnosis on infertile women's levels of anxiety, depression and fertility-related stress. The study involved 404 women undergoing fertility treatment in a public clinic in Athens. The research instruments were three self-administrated questionnaires. State and trait anxiety, infertility-related stress (personal, social and marital domain) and depression were measured. Most of the women in this sample had low levels of infertility-related stress and a low score for depression, but higher scores of state and trait anxiety than the published normative scores. Women with male factor infertility had higher levels of state anxiety (p = 0.007) and social stress (p = 0.007) than women with female, mixed and unknown infertility. Women with idiopathic infertility also had higher levels of trait anxiety (p = 0.001). Thus, the psychological status of women is strongly related to the aetiology of the infertility problem, and as a result it is necessary for women undergoing treatment for infertility to have an individualised psychological support, based on their infertility problem