Using CBT for Depression: A Case Study of a Patient with Depressive Disorder Due to a Medical Condition (Infertility)
Keywords:depressive disorder, infertility, cognitive restructuring, clinical framing, CBT, mental health
Introduction: Infertility increases the risk for psychopathology more often in women, who can develop symptoms in mood disorders and chronic stress. Depression is one frequent psychological consequence of this medical condition and if it’s not being addressed accordingly, depressive symptoms can lead to delays in the onset of medical treatment, impairments in its outcomes and, likewise, poses a risk on the patient's mental health.
Purpose: The purpose of this case study was to disseminate a specific example of how infertility affects mental health, offering a multidisciplinary approach from both traditional CBT and health psychology. In addition to this, the case study presents important cultural aspects regarding psychotherapeutic process and access to health care.
Methodology: This is a descriptive and explanatory case study where multiple quantitative data sources have been used such as self-reported inventories: The Fertility Problem Inventory (FPI), Beck Depression Inventory (BDI) and The Coping Inventory for Stressful Situations (CISS), in addition to a semi-structured clinical interview.
Results: Results showed an improvement in mood, acquisition of a more adaptive thinking style, healthy coping mechanisms and self-help strategies to support the patient post-therapy. The contribution of cultural orientation and wellbeing-centered recommendations are being discussed.
Conclusion: The improvement of healthcare services relies on such presentations of case studies that can shift the focus in new directions of good clinical practices.
Abdollahpour, S., Taghipourb, A., Vahed, S., & Roudsarid, R. (2021). The efficacy of cognitive behavioral therapy on stress, anxiety and depression of infertile couples: a systematic review and meta-analysis. Journal of Obstetrics and Gynaecology. doi:https://doi.org/10.1080/01443615.2021.1904217 DOI: https://doi.org/10.1080/01443615.2021.1904217
Abramson, L., Seligman, M., & Teasdale, J. (1978). Learned helplessness in humans: critique and reformulation. Journal of Abnormal Psychology, 87(1), 49-74. DOI: https://doi.org/10.1037/0021-843X.87.1.49
Al-Homaidan, H. (2011). Depression among women with primary infertility attending an infertility clinic in Riyadh, Kingdom of Saudi Arabia: rate, severity, and contributing factors. International Journal of Health Sciences , 5(2), 108-115.
American Psychiatric Association, A. (2013). Diagnostic and Statistical Manual of Mental Disorders (fifth ed.). Arlington, VA: American Psychiatric Publishing. DOI: https://doi.org/10.1176/appi.books.9780890425596
Awoyinka, M., & Ohaeri, B. (2014). Depression and coping strategies among women with infertility attending three gynaecological clinics in Ibadan. The Journal of Biomedical Research, 13(2), 48-60.
Beck, A. (1976). Cognitive Therapy and the Emotional Disorders. New York: International University Press.
Beck, A., & Dozois, D. (2008). Cognitive Schemas, Beliefs and Assumptions. In K. Dobson, & D. Dozois (Eds.), Risk Factors in Depression (pp. 121-143). Academic Press. DOI: https://doi.org/10.1016/B978-0-08-045078-0.00006-X
Biehl, R., Boecking, B., Brueggemann, P., Grosse, R., & Mazurek, B. (2020). Personality Traits, Perceived Stress, and Tinnitus-Related Distress in Patients With Chronic Tinnitus: Support for a Vulnerability-Stress Model. Frontieres in Psychology. DOI: https://doi.org/10.3389/fpsyg.2019.03093
Burholt, V., Dobbs, C. and Victor, C. (2017). Social support networks of older migrants
in England and Wales: The role of collectivist culture. Ageing & Society, 38(7).
Colodro-Conde, L., Couvy-Duchesne, B., Zhu, G., Coventry, W., Byrne, E., Gordon, S., . . . Martin, N. (2018). A direct test of the diathesis–stress model for depression. Molecular Psychiatry, 1590–1596. DOI: https://doi.org/10.1038/mp.2017.130
Costa, R. (2020). Regression (Defense Mechanism). In V. Zeigler-Hill, & T. Shackelford (Eds.), Encyclopedia of Personality and Individual Differences. Cham: Springer. doi:https://doi.org/10.1007/978-3-319-24612-3_1422 DOI: https://doi.org/10.1007/978-3-319-24612-3_1422
Choudhary M, Halder S. (2019). Cognitive behavior therapy in management of psychosocial factors in female infertility. Journal of Psychosocial Research, 14(1). DOI: https://doi.org/10.32381/JPR.2019.14.01.6
Chu, K., Zhang, Q., Han, H., Xu, C., Pang, W., Ma, Y., Li, W. (2017). A systematic review and meta-analysis of nonpharmacological adjuvant interventions for patients undergoing assisted reproductive technology treatment. International Journal of Gynecology & Obstetrics, 3. DOI: https://doi.org/10.1002/ijgo.12310
Cuijpers, P., Quero, S., Noma, H., Ciharova, M., Miguel, C., Karyotaki, E., . . . Furukawa, T. (2021). Psychotherapies for depression: a network meta-analysis covering ef?cacy, acceptability and long-term outcomes of all main treatment types. World Psychiatry, 20(2), 283-293. DOI: https://doi.org/10.1002/wps.20860
David, D. (2017). Tratat de Psihoterapii Cognitive ?i Comportamentale [Cognitive-Behavioral Psychotherapies]. Ia?i: Polirom.
Ellis, A. (1962). Reason and Emotion in Psychotherapy. New York: Lyle Stuart.
Endler, N., & Parker, J. (1990a). Coping Inventory for Stressful Situations (CISS): Manual. Toronto: Multi-Health Systems.
Fahrenberg, J., Hampel, R., & Selg, H. (2010). Freiburger Persönlichkeitsinventar (FPI-R). Göttingen: Hogrefe.
Galst, J. (2017). The Elusive Connection Between Stress and Infertility: A Research Review With Clinical Implications. Journal of Psychotherapy Integration. DOI: https://doi.org/10.1037/int0000081
Golshani F , Mirghafourvand M , Hasanpour S, Seiiedi Biarag L (2020). The Effect of Cognitive Behavioral Therapy on Anxiety and Depression in Iranian Infertile Women: A Systematic and Meta-Analytical Review. Iran J Psychiatry Behav Sci. doi: 10.5812/ijpbs.96715. DOI: https://doi.org/10.5812/ijpbs.96715
Gurel, E., & Tat, M. (2017). SWOT Analysis: A Theoretical Review. The Journal of International Social Research , 10(51), 994-1006. DOI: https://doi.org/10.17719/jisr.2017.1832
Ispas, D., Iliescu, D., Ilie, A., & Johnson, R. (2014). Exploring the Cross-Cultural Generalizability of the Five-Factor Model of Personality: The Romanian NEO PI-R. Journal of Cross-Cultural Psychology, 45(7), 1074-1088. DOI: https://doi.org/10.1177/0022022114534769
Jackson-Koku, G. (2016). Beck Depression Inventory. Occupational Medicine, 174-175. DOI: https://doi.org/10.1093/occmed/kqv087
Kaniasty, K., & Norris, F. (2008). Longitudinal linkages between perceived social support and posttraumatic stress symptoms: sequential roles of social causation and social selection. Journal of Traumatic Stress, 21, 274-278. DOI: https://doi.org/10.1002/jts.20334
López-López, J., Davies, S., Caldwell, D., Churchill, R., Peters, T., Tallon, D., . . . Welton, N. (2019). The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis. Psychological Medicine, 49, 1937-1947. DOI: https://doi.org/10.1017/S003329171900120X
Maroufizadeh, S., Ghaheri, A., Almasi-Hashiani, A., Mohammadi, M., Navid, B., Ezabadi, Z., & Samani, R. (2018). The prevalence of anxiety and depression among people with infertility referring to Royan Institute in Tehran, Iran: A cross-sectional questionnaire study. Middle East Fertility Society Journal, 23(2), 103-106. DOI: https://doi.org/10.1016/j.mefs.2017.09.003
Maroufizadeh, S., Navid, B., Omani-Samani, R., & Amini, P. (2019). The effects of depression, anxiety and stress symptoms on the clinical pregnancy rate in women undergoing IVF treatment. BMC Research Notes. doi:https://doi.org/10.1186/s13104-019-4294-0 DOI: https://doi.org/10.1186/s13104-019-4294-0
Nakagawa A, Mitsuda D, Sado M, et al. (2017). Effectiveness of supplementary cognitive-behavioral therapy for Pharmacotherapy-Resistant depression. J Clin Psychiatry, 78. DOI: https://doi.org/10.4088/JCP.15m10511
Oladeji, S., & OlaOlorun, A. (2018). Depression among infertile women in Ogbomosoland. South African Family Practice, 60(2), 41-45. doi:https://doi.org/10.1080/20786190.2017.1370840 DOI: https://doi.org/10.4102/safp.v60i2.4865
Peterson, C., Maier, S., & Seligman, M. (1993). Learned Helplessness: A Theory for the Age of Personal Control. New York: Oxford University Press.
Ren, P., Qin, X., Zhang, Y., & Zhang, R. (2018). Is Social Support a Cause or Consequence of Depression? A Longitudinal Study of Adolescents. Frontiers in Psychology. DOI: https://doi.org/10.3389/fpsyg.2018.01634
Sava, F., & Popa, R. (2011). Personality types based on the big five model. A cluster analysis over the romanian population. Cognition, Brain, Behavior. An Interdisciplinary Journal, 15(3), 359-384.
Thimm, J., & Antonsen, L. (2014). Effectiveness of cognitive behavioral group therapy for depression in routine practice. BMC Psychiatry, 14. DOI: https://doi.org/10.1186/s12888-014-0292-x
Trifu, S., Onil?, D., & Busuioc, L. (2012). Fragilitatea psihic? în bolile psihosomatice [Mental fragility in psychosomatic diseases]. In E. Avram, Psihologia S?n?t??ii [Health Psychology]. Bucure?ti: Editura Universitar?.
Twomey, C., O'Reilly, G., & Meyer, B. (2017). Effectiveness of an individually-tailored computerised CBT programme (Deprexis) for depression: A meta-analysis. Psychiatry Research, 371-377. DOI: https://doi.org/10.1016/j.psychres.2017.06.081
Vasile C. (2020). CBT and medication in depression (Review). Exp Ther Med, 20(4). DOI: https://doi.org/10.3892/etm.2020.9014
Vioreanu, A. (2021). The Psychological Impact of Infertility. Directions for the Development of Interventions. Mental Health: Global Challenges Journal, 4(1). doi:https://doi.org/10.32437/mhgcj.v4i1.113 DOI: https://doi.org/10.32437/mhgcj.v4i1.113
Wang, G., Jung Lei, X. (2022). Cognitive behavioural therapy for women with infertility: A systematic review and meta-analysis. Clinical Psychology & Psychotherapy. doi: https://doi.org/10.1002/cpp.2792 DOI: https://doi.org/10.1002/cpp.2792
World Health Organization, W. (2001). International Classification of Functioning, Disability and Health. Geneva: WHO.
World Health Organization, W. (2002). International Statistical Classification of Diseases and Related Health Problems. Sydney: WHO.
Zegers-Hochschild, F., Adamson, D., Dyer, S., Racowsky, C., de Mouzon, J., Sokol, R., van der Poel, S. (2017). The International Glossary on Infertility and Fertility Care, 2017. Human Reproduction, 32(9), 1786–1801. doi:10.1093/humrep/dex234 DOI: https://doi.org/10.1093/humrep/dex234
Zhen, R., Quan, L., & Zhou, X. (2018). How does social support relieve depression among survivors after massive flood? The contribution of feelings of safety, self-disclosure, and posttraumatic cognition. Journal of Affective Disorders, 229, 186-192. DOI: https://doi.org/10.1016/j.jad.2017.12.087
Zurlo, M., Cattaneo Della Volta, M., & Vallone, F. (2017). Factor structure and psychometric properties of the Fertility Problem Inventory–Short Form. Health Psychology Open, 1-11. doi:10.1177/2055102917738657 DOI: https://doi.org/10.1177/2055102917738657
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