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The influences of childlessness on the psychological well-being and social network of the oldest old
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Geriatric. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
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2011 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 11, no 78Article in journal (Refereed) Published
Abstract [en]

Background: The ELSA 85 project is a population-based study with the purpose to learn more about the “elderly elderly”. The aim of this part of the ELSA 85 study is to explore the effects of childlessness on the psychological wellbeing, living situation and social support of 85-year old individuals.

Methods: A postal questionnaire was sent to all (650) 85-year old men and women living in Linköping Municipality in 2007. Psychological well-being and social network was measured using a number of questions.

Results: 496 individuals participated in the study. No differences in psychological wellbeing were found between the 85-year olds who were childless and those who were parents. The childless 85-year olds were less likely to have relatives close by and to receive help than those who were parents. Individuals of both groups were equally likely to end up in institutional care, to have friends close by and to be in contact with neighbours.

Conclusions: Even though elderly childless individuals have social networks of less support potential than those who are parents there are no differences in certain psychological wellbeing indicators between the two groups. Apparently, childless elderly individuals find ways to cope with whatever negative effects of childlessness they may have experienced.

Place, publisher, year, edition, pages
2011. Vol. 11, no 78
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-73616DOI: 10.1186/1471-2318-11-78ISI: 000208731700078OAI: oai:DiVA.org:liu-73616DiVA: diva2:475160
Available from: 2012-01-10 Created: 2012-01-10 Last updated: 2017-12-08Bibliographically approved
In thesis
1. The influence of infertility and in vitro fertilization treatment on postpartum and long-term mental health in women
Open this publication in new window or tab >>The influence of infertility and in vitro fertilization treatment on postpartum and long-term mental health in women
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: It is estimated that about 10-15% of couples suffer from infertility, i.e. the inability to achieve a clinical pregnancy after at least one year of regular, unprotected intercourse and that between 2-5% of births are a result of in vitro fertilization (IVF) treatment. Infertility and its treatment can have adverse effects on psychological well-being. While previous studies on postpartum depression (PPD) in IVF women suffer some methodological issues, there are no published studies on the risk of postpartum psychosis (PPP) after IVF pregnancies. Long-term, most women adjust well emotionally after IVF treatment but some, especially the childless, still suffer negative consequences. Meanwhile, few studies have extended beyond the first decade after treatment. Some studies have found that the childless elderly have social networks of less support potential but most show that psychological well-being is not affected by parental status. None of the studies have focused on the oldest old (≥85 years) and many have excluded those who live in institutional care, thus the frailest.

Objective: The overall aim of this thesis was to study postpartum mental health in women who have undergone IVF treatment, using psychiatric diagnoses as outcomes, while controlling for major PPD and PPP risk factors as well as to determine the influences of childlessness, infertility and IVF treatment on long-term mental health in women. Materials and methods: Studies I-II are register-based, case control studies of 3532 (I) and 10,412 (II) primiparous women included in the Swedish IVF register. A control group of 8,553 (I) and 18,624 (II) primiparous women with spontaneous conceptions was selected from the Medical Birth Register. The main outcomes were PPD and PPP diagnoses the 1st year postpartum collected from the National Patient Register. Studies III-IV are cross-sectional. Study III included 470 women who had undergone IVF treatment 20-23 years previously. The Symptom Checklist-90 was used to investigate self-reported mental health. The results were compared with those from a population-based study and by parental status group. Study IV included 496 85-year olds. Psychological well-being, living situation, demographics and social network was investigated through a questionnaire and an interview.

Results: Study I-II: There were no differences between the IVF and control group in the risk of receiving a PPD or PPP diagnosis. Having previously been diagnosed with any psychiatric, an affective or personality disorder increased  the risk of PPD while any previous psychiatric, psychotic, bipolar, depressive, anxiety or personality disorder diagnosis increased the risk of PPP. None of the women had committed suicide. Study III: The IVF women reported symptoms of higher intensity and were at increased risk of symptoms of depression, obsessive-compulsion and somatisation compared with the reference group. Childless women, compared with parents, reported a higher level of mental health problems as well as symptoms of depression and phobic anxiety. Study IV: No differences in psychological wellbeing, living situation or having friends close by were found across parental status groups. The childless 85-year olds were less likely to have relatives close by and to receive help.

Discussion: This thesis indicates that the risk of receiving a PPD or PPP diagnosis from in- or outpatient psychiatric care or of committing suicide during the first year postpartum is not increased in women who have undergone IVF treatment. Any negative effects of infertility and its treatment might have been mitigated by the “healthy patient effect”; those who choose to enter treatment are generally psychologically robust. A history of mental illness is a major risk factor for PPD and PPP. The risk of some adverse symptoms of mental illness might be increased in women who have undergone IVF treatment twenty years previously, especially in those who have remained childless. The childless elderly appear to have social networks of less support potential but are not more likely to live in institutional care and do not experience more adverse effects on psychological well-being than the elderly who are parents.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. 110 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1554
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology Geriatrics Family Medicine
Identifiers
urn:nbn:se:liu:diva-132764 (URN)10.3384/diss.diva-132764 (DOI)9789176856376 (ISBN)
Public defence
2016-12-16, Berzeliussalen, Campus US, Linköping, 09:00 (Swedish)
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Supervisors
Available from: 2016-11-23 Created: 2016-11-23 Last updated: 2016-11-23Bibliographically approved

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Vikström, JosefinBladh, MarieHammar, MatsMarcusson, JanWressle, EwaSydsjö, Gunilla

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Obstetrics and gynecologyFaculty of Health SciencesDepartment of Gynaecology and Obstetrics in LinköpingGeriatricDepartment of Geriatric Medicine in Linköping
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