Internet-delivered self-help for depression with therapist guidance has shown efficacy in several trials. Results from meta-analyses suggest that guidance is important and that self-help programs without support are less effective. However, there are no direct experimental comparisons between guided and unguided internet-based treatments for depression. The present study compared the benefits of a 10-week web-based unguided self-help treatment with the same intervention complemented with weekly therapist support via e-mail. A waiting-list control group was also included. Seventy-six individuals meeting the diagnostic criteria of major depression or dysthymia were randomly assigned to one of the three conditions. The Beck Depression Inventory (BDI-II) was used as the primary outcome measure. Secondary outcomes included general psychopathology, interpersonal problems, and quality of life. Sixty-nine participants (91%) completed the assessment at posttreatment and 59 (78%) at 6-month follow-up. Results showed significant symptom reductions in both treatment groups compared to the waiting-list control group. At posttreatment, between-group effect sizes on the BDI-II were d = .66 for unguided self-help versus waiting-list and d = 1.14 for guided self-help versus waiting-list controls. In the comparison of the two active treatments, small-to-moderate, but not statistically significant effects in favor of the guided condition were found on all measured dimensions. In both groups, treatment gains were maintained at 6-month follow-up. The findings provide evidence that internet-delivered treatments for depression can be effective whether support is added or not. However, all participants were interviewed in a structured diagnostic telephone interview before inclusion, which prohibits conclusions regarding unguided treatments that are without any human contact.

Despite the absence of clinical effects on mental health measures, psychological interventions were found to improve some patients' chances of becoming pregnant. Psychological interventions represent an attractive treatment option, in particular, for infertile patients who are not receiving medical treatment.

Purpose: Gender-specific differences exist between male and female infertility patientsʼ mental health, the meaning of infertility in their lives, and the coping strategies used. This systematic

Infertility is a stressful experience, yet little is known about the specific issues confronting infertile women. In the present study, researchers sought to identify themes important to infertile women and examine possible associations with mental health levels. Using qualitative content analysis, researchers analyzed the email messages of 57 infertile women participating in a German-language Internet-based treatment for infertility. The themes most important to infertile women were emotions surrounding their wish for a child, coping with this unfulfilled wish, and medical aspects. Clinically anxious women reported substantially and significantly more negative and positive emotions than non-anxious women did (Mann-Whitney U(1)=178; p=0.034). Participants who were both clinically anxious and depressed reported more negative emotions and substantially fewer positive emotions when compared to participants who were solely anxious. The themes identified, considered important by infertile women, could be helpful to health professionals working in fertility treatment.

Purpose: Infertility is a widespread disease that often has a negative effect on the mental health of infertile patients. A common reaction of infertile patients is depression, but there is still inconclusiveness regarding the level of depression in infertile patients. The aim of this study was to examine the level of depression in infertile patients, and to assess existing preventive health services. Material and Methods: Thirty-nine infertile women and 24 infertile men of a Swiss fertility centre completed self-report questionnaires on depression, physical health, and the degree of suffering from unfulfilled child wish. Results: A high proportion of the infertile patients reported depressive symptoms. More than 40 % scored above the threshold of mild depression and 26 % showed clinically relevant depressive symptoms. The depression score of one partner related to the depression score and the suffering caused by infertility of the other partner. The cause of infertility was not linked to the levels of depression of infertile patients. Conclusions: A great proportion of Swiss infertile patients experience depressive symptoms reaching sometimes clinically relevant levels of depression. Offering psychological or pharmacological support for patients during the medical treatment of infertility seems advisable in order to prevent and treat the patientsʼ depressive symptoms.