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

S. Fassino1,3, A. Pierò1, S. Boggio1, V. Piccioni2 and L. Garzaro1
1 Department of Neurosciences, Psychiatric Institute and Clinic, University
School of Medicine, via Cherasco 15, CAP 10126, Turin and 2 Department of 
Obstetrics and Gynaecology, 'S. Anna' Hospital of Turin, Italy

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.