English abstract
Objectives: Miscarriage is a common pregnancy complication causing substantial
psychiatric complications. This study was designed to investigate whether the
administration of brief supportive psychotherapy (BSP) is effective on the management of
women with miscarriage when conducted in the first 24 hours of hospitalization in order
to prevent symptoms of anxiety, depression, and grief at four-months post-miscarriage.
Methods: We conducted a randomized clinical trial on 79 women with miscarriage
hospitalized in Ayatollah Rohani teaching hospital. The women were randomly
assigned into two groups (39 in the experimental group and 40 in the control
group). All interventions were implemented for two study groups during the first 24
hours of hospitalization in a private room in the hospital. The experimental group
received a two-hour BSP. The objective outcomes were assessed using Hospital
Anxiety and Depression Scale and Perinatal Grief Scale (PGS), which has three
subscales (active grief, difficulty coping, and despair) and were measured before
the intervention and at four-months post-miscarriage. Results: The results of pre tests in the follow-up of the trial suggested that the participants who received BSP
reported significant reductions in the mean scores of active grief (-34.2±9.7 vs.
28.1±-6.9), difficulty coping (27.1±6.4 vs. 23.3±4.3), despair (28.0±8.4 vs. 22.8±5.2),
and total PGS (89.6±23.1 vs. 74.4±15.3), in contrast to participants in the control group
who did not report such results. Further, the results of generalized estimating equations
models revealed that brief supportive psychotherapy caused a significant decrease in
the level of factors including active grief, difficulty coping, despair, total perinatal grief,
anxiety symptoms, and depressive symptoms in subjects in the experimental group
compared to those in the control group after miscarriage. Also, the frequency of anxiety
symptoms (13.5% vs. 60.5%), depressive symptoms (32.4% vs. 71.1%), and grief symptoms
(10.8% vs. 65.8%) was found to be significantly lower in the group receiving psychotherapy
than in the control group at four-months follow-up. Conclusions: Administration of
BSP session during the first 24 hours of hospitalization for women with miscarriage can
be considered a reliable method to prevent anxiety symptoms, depression symptoms, and
perinatal grief at four-months follow-up.
