Anxiety, depression and anger suppression in infertile couples: a controlled study

BACKGROUND: Although several authors have suggested an important pathogenic role for psychosocial factors in ‘functional’ infertility, the extent to which depression, anxiety and expressed emotional patterns correlate to infertility is not yet clear. METHODS: This study included 156 infertile couples (recruited at intake) and 80 fertile couples, whose personal characteristics were recorded. They were examined using scales for the evaluation of the degree of psychopathology [Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D)], and anger expression [State–Trait Anger Expression Inventory (STAXI)]. The 156 infertile couples were then subdivided into groups based on the cause of infertility (‘organic’, ‘functional’ or ‘undetermined’). The psychometric evaluation was double-blind with respect to the causes of infertility. RESULTS: Differences emerged in the degree of psychopathology between ‘organic’ and ‘functional’ infertile subjects and fertile controls. In women, logistic regression identified three variables able to predict the diagnosis subtype; these variables are HAM-A, HAM-D, and tendency toward anger suppression. In men, anger did not emerge as a predictor for diagnosis, whereas HAM-A and HAM-D did. CONCLUSIONS: The ‘functional’ infertile subjects of this sample showed particular psychopathological and psychological features, independent from the stress reaction following the identification of the cause of infertility.