title: An investigative study into psychological and fertility sequelae of gestational trophoblastic disease: the impact on patients' perceived fertility, anxiety and depression.
abstract: OBJECTIVE
  Gestational Trophoblastic Disease (GTD) comprises a group of disorders that derive from the placenta. Even if full recovery is generally expected, women diagnosed with GTD have to confront: the loss of a pregnancy, a potentially life-threatening diagnosis and delays in future pregnancies. The aim of the study is to evaluate the psychological impact of GTD, focusing on perceived fertility, depression and anxiety.
  
  
  METHODS
  37 patients treated for GTD at San Raffaele Hospital, Milan, took part in the study. The STAI-Y (State-Trait Anxiety Inventory), the BDI-SF (Beck Depression Scale-Short Form) and the FPI (Fertility Problem Inventory) were used. Patients were grouped on the basis of presence of children (with or without), age (< or ≥35) and type of diagnosis (Hydatidiform Mole, HM, or Gestational Trophoblastic Neoplasia, GTN). Differences in the values between variables were assessed by a t-type test statistic. Three-way ANOVAs were also carried out considering the same block factors.
  
  
  RESULTS
  The study highlights that women suffering from GTN had higher depression scores compared to women suffering from HM. A significant correlation was found between anxiety (state and trait) and depression. Younger women presented higher Global Stress scores on the FPI, especially tied to Need for Parenthood and Relationship Concern subscales. Need for Parenthood mean scores significantly varied between women with and without children too.
  
  
  CONCLUSIONS
  We can conclude that fertility perception seems to be negatively affected by GTD diagnosis, particularly in younger women and in those without children. Patients should be followed by a multidisciplinary team so as to be supported in the disease's psychological aspects too.
authors.affiliation: Vita-Salute San Raffaele University, Faculty of Psychology, Milan, Italy; Clinical and Health Psychology Unit, Department of Clinical Neurosciences, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: Valentina E
authors.initials: VE
authors.lastname: Di Mattei
authors.affiliation: Clinical and Health Psychology Unit, Department of Clinical Neurosciences, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Carnelli
authors.affiliation: Vita-Salute San Raffaele University, Faculty of Psychology, Milan, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Bernardi
authors.affiliation: Clinical and Health Psychology Unit, Department of Clinical Neurosciences, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Pagani Bagliacca
authors.affiliation: Clinical and Health Psychology Unit, Department of Clinical Neurosciences, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Zucchi
authors.affiliation: Vita-Salute San Raffaele University, Faculty of Psychology, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Lavezzari
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Giorgione
authors.affiliation: Vita-Salute San Raffaele University, Faculty of Psychology, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ambrosi
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Mangili
authors.affiliation: Vita-Salute San Raffaele University, Faculty of Psychology, Milan, Italy; Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Candiani
authors.affiliation: Vita-Salute San Raffaele University, Faculty of Psychology, Milan, Italy; Clinical and Health Psychology Unit, Department of Clinical Neurosciences, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Sarno
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000150:complications*; D003863:Depression / Q000150:complications*; D005260:Female; D005298:Fertility; D031901:Gestational Trophoblastic Disease / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D007246:Infertility / Q000150:complications / Q000523:psychology; D008875:Middle Aged; D010465:Perception; D011247:Pregnancy; D013315:Stress, Psychological; D055815:Young Adult