Comparison of self-esteem and depression among fertile and infertile women

Abstract

Aims This study aimed to explore the effect of infertility on self–esteem and depression, and to identify the sociodemographic and infertility characteristics associated with self-esteem and depression among infertile women in Ekiti State, Nigeria. Method Self-esteem and depression were assessed in 100 infertile women and 100 women seeking family planning (controls) using the Rosenberg Self-Esteem Scale (RSES) and Patient Health Questionnaire (PHQ-9), respectively. PHQ-9 score ≥10 was defined as major depressive disorder (MDD). Continuous variables were presented as mean ± standard deviation and categorical variables as frequency (percentage). Cases and controls were compared using Student's t test. χ2 or Fisher's exact (when cell size <5) tests were performed to compare proportions. Simple and multiple linear regression analyses were used to examine the association between the sociodemographic, infertility characteristics and RSES or PHQ-9 scores among infertile women Result Infertile women had significantly lower RSES score (19.4 ± 4.5 vs. 20.7 ± 4.4, p = 0.038) and higher PHQ-9 score (5.1 ± 4.1 vs 3.8 ± 3.5, p = 0.023) compared to controls. Seventeen infertile women (17%) and 8 women in the control group (8%) had MDD (PHQ-9 score ≥10) and were referred for further evaluation. Among infertile women, marital status, being remarried, duration of infertility, and RSES score were associated with PHQ-9 score on simple linear regression. Similar association was not seen in the controls. On multiple linear regression analysis, RSES score had a negative association with PHQ-9 score (β = -0.32, p < 0.001) among infertile women. Older age [OR (95% CI):1.13 (1.01–1.25); p = 0.030], ≤6 years formal education [OR (95% CI): 4.76 (1.13–20.00); p = 0.033], being remarried [OR (95% CI): 10.87 (1.86–63.64); p = 0.008], longer duration of infertility [OR (95% CI): 1.11 (1.01–1.22); p = 0.040] and RSES score [OR (95% CI): 0.79 (0.67–0.92); p = 0.003] were significantly associated with MDD. On multiple logistic regression analysis, only the association between RSES score and MDD remained statistically significant (p = 0.004) Conclusion Infertile women have lower self-esteem and higher depression scores in comparison to women seeking family planning. Mental health screening and management should be an integral part of care administered to infertile women