Factors associated with anxiety and depression in infertile couples: A Study in Thailand

Abstract

Background: Infertility affects about 15% of couples worldwide, and is associated with stress, family and social relationships. Anxiety and depression are common in couples with infertility. Objectives: The study investigated the prevalence of anxiety and depression and the relationships with marital satisfaction, personality, and sufficiency economy concept in infertile couples. These factors have never been explored. Methods: This study comprised a cross-sectional survey of 150 couples seeking treatment at two fertility centers in Chiang Mai, Thailand. Sociodemographic information, Outcome Inventory-21 (OI-21), ENRICH Marital Satisfaction Scale, and Sufficiency Economy Scale (SES) were completed by both partners. Five personality traits, (aggression (AG), sensation seeking (SS), extraversion (EX), Activity (AC) and neuroticism (NE) measured by Zuckerman-Kuhlman-Aluja Personality Questionnaire, were completed. A description test was performed to analyze sociodemographic characteristics. The 2 and t-test were used to analyze the differences in anxiety and depression between groups, and a correlation between variables using Pearson's coefficient was applied. Multiple regression was used to analyze the predictive effects of different variables on anxiety and depression. The dyads analysis was used to analyze the Actor – Partner Independence Model. Results: The mean age of all participants was 35.68 5.4 years old (20-62); males, 36.55  6.0 (20-62); women, 34.81 4.6 (21-51). Unemployment was associated with depression (F (4, 293) = 2.795, p ＜.05). Overall, 27.3% of infertile couples reported anxiety on OI-anxiety, 6.7% reported depression on OI-depression, and 6.3% had both anxiety and depression. The correlational coefficients between OI-anxiety and AG, NE, EX, and sufficiency economy concept were r’s = .353 (p <.01), .625 (p <.01), .139 (p <.05), and -.123 (p <.05), respectively. In comparison, the correlational coefficients between OI-depression and AG, NE, EX, and sufficiency economy were r’s = .317 (p <.01), .601 (p <.01), .133 (p <.05), -.157 (p <.01), respectively. The expectation of having children was negatively correlated with depression (r = -.121, p <.05), while the ENRICH was negatively correlated with OI-depression (r = -.209, p <.01). APIM showed that the overall actor effect between AG and NE and OI-anxiety were significant (p <.05), as were the overall actor effects between NE and ENRICH and OI-depression (p <.05). The actor effect between OI-anxiety and OI-depression was significant (p <.001), as was the overall partner effect between the expectation of having children and OI-depression (p = .039). Conclusions: The prevalence of anxiety among infertile couples is comparable to other studies, whereas the prevalence of depression is lower. Depression was associated with the expectation of having children and marital satisfaction. Aggression, extraversion and neuroticism were the predictors for anxiety and depression. Sufficiency economy concept was negatively associated with anxiety and depression. Most variables have only actor effects, only the expectation of having children exhibited a significant partner effect for depression.