Abstract
Ninety five men who accompanied their wives to the fertility clinic of a Nigerian teaching hospital (index group) were compared with 95 matched controls using the Hospital Anxiety and Depression Scale (HADS). Their rates of significant anxiety symptoms (24.2%) and depressive symptoms (20.0%) were higher than the corresponding rates of 13.7% and 9.5% for the controls. The higher rate of significant depressive symptoms in the infertility group was significant (p<0.05). Their mean scores on the two subscales of HADS (anxiety and depressive subscales) were also significantly higher (p<0.001). Results of multiple regression analysis indicated that lower anxiety symptoms were predicted by age group among subjects in the index group, indicating that belonging to higher age groups was associated with lower anxiety symptoms. In addition, lower anxiety symptoms were predicted by ‘being very religious’. However, higher anxiety symptoms were predicted by previous exposure to couple counselling. On the predictors of depressive symptoms, lower symptoms were predicted by age group and religiosity while higher symptoms were predicted by respondents’ previous exposure to couple counselling and higher number of wives. Other factors investigated such as level of education, duration of infertility, attitude towards child adoption, pressure from extended family members on account of infertility, expectation of the respondents on the possible outcome of treatment and the result of semen analysis were not observed as predictors of anxiety and/or depressive symptoms. The observations on emotional distress among these men, together with previous observations that counselling/support received from gynecological consultations is usually inadequate indicates that the quality of psychological support that is available to them needs to be improved and modified. Involvement of mental health professionals (psychiatrists and clinical psychologists) in the provision of psychological couple counselling for infertility-related emotional distress could improve the quality of support provided. The establishment of special counselling units in hospitals providing treatment for infertility is advocated.
Keywords: Spouses of women with infertility, psychological profile, anxiety, depression, predictors.
Résumé
Quatrevingt quinze hommes qui ont accompagné leurs femmes a la clinique de fertilité a l’hopital universitaire Nigerian groupe index etaient compares avec 95 controls sain associes utilisant l’anxiété de l’hospital et de dépression [HADS. Leurs taux de symptomes d’anxiété etaient de 24.2% et de symptomes depressifs de 20.0%, plus élevé que le taux correspondant sain de 13.7% et 9.5% pour les control sains. Le plus grand taux des symptomes dépressifs chez le groupe d’infertilité était significativement important (p ‹ 0.05). La note moyenne chez les deux sous groupes de HADS était aussi significativement élevé [p ‹ 0.001. Les résultats de l’analyse de regression multiple ont indiqués que peu des symptomes d’anxiete etaient predit selon le groupe d’age parmis les sujets du groupe indexé. Ceux appartenant au groupe d’age elevé etaient associé aux faibles symptomes d’anxieté. Les symptomes d’ anxieté plus elevé dans les couples matrimoniaux que chez les tres religieux étaient détecter des visites précedentes. Les prédicateurs des faibles symptomes de dépression tels que l’age , la croyance et symptomes severés inclu femme de foyer, niveau d’éducation, durée de l’infertilité, attitude envers les enfants adoptés, la pression familiales vis a vis l’infertilité. L’esperance de patients de l’efficacité du traitement et les résultats de l’analyse de l’éjaculat n’etaient pas des prédicateurs des symptomes d’anxieté et de dépression. La détresse émotionnelle chez ces hommes associés aux observations précedentes d’aller en soins gynécologiques montre que la qualité du support psychologique est inadéquate et nécessite une amélioration. L’implication des psychiatres et des psychologues clinique dans l’apport des conseils aux couples souffrant d’une dépression emotionnelle résultant de l’infertilité est encouragée afin d’améliorer la qualité du support. L’établissement des unites spéciales de conseils dans les hopitaux apportant des traitements pour l’infertilité est recommendé.
Correspondence: Dr. F.O. Fatoye, Department of Mental Health, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria
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