title: Are severe depressive symptoms associated with infertility-related distress in individuals and their partners?
abstract: OBJECTIVE
  Are severe depressive symptoms in women and men associated with individual and dyadic infertility-related stress in couples undergoing infertility treatment?
  
  
  CONCLUSIONS
  Severe depressive symptoms were significantly associated with increased infertility-related distress at both the individual and partner level. WHAT IS KNOWN ALREADY?: An infertility diagnosis, the stress of medical treatments and a prior history of depression are risk factors for future depression in those undergoing fertility treatments. Studies examining the impact of severe depressive symptoms on infertility-related distress in couples are lacking.
  
  
  METHODS
  This cross-sectional study included 1406 couples who were consecutively referred patients undergoing fertility treatments in Denmark in the year 2000. A total of 1049 men and 1131 women were included in the study.
  
  
  METHODS
  Participants were consecutively referred patients undergoing a cycle of medically assisted reproduction treatment at five Danish public and private clinics specializing in treating fertility patients. Severe depressive symptoms were measured by the Mental Health Inventory 5 from the Short Form Health Survey 36. Infertility distress was measured by the COMPI Fertility Problem Stress Scales. Multilevel modelling using the actor-partner interdependence model was used to study the couple as the unit of analysis.
  
  
  RESULTS
  Severe depressive symptoms were reported in 11.6% of women and 4.3% of men, and were significantly associated with increased infertility-related distress at the individual and partner level. There was no significant interaction for gender indicating that men and women did not differ in how severe depressive symptoms were associated with infertility distress.
  
  
  CONCLUSIONS
  Because of the cross-sectional study design, the study findings only show an association between severe depressive symptoms to individual and partner distress at a single point in time; however, nothing is known about causality.
  
  
  CONCLUSIONS
  This study adds to the growing body of literature using the couple as the unit of analysis to study the relationship between depression and infertility distress. Recommendations for medical and mental health professionals that underscore the potential risk factors for depressed men and women who are pursuing infertility treatments are provided. Additional studies using a longitudinal study design to track the impact of depression on distress over the course of the infertility treatment cycle would be valuable for increasing our understanding of the complex relationship that exists between these psychosocial factors.
  
  
  BACKGROUND
  Authors Brennan Peterson and Matthew Pirritano have no financial disclosures for this study. Camilla Sandal Sejbaek and Lone Schmidt have received research grants from the Danish Health Insurance Foundation (J. nr. 2008B105) and Merck Sharp & Dohme. The funders had no influence on the data collection, analyses or conclusions of the study.
authors.affiliation: Faculty of Psychology, Crean School of Health and Life Sciences, Chapman University, Orange, CA, USA.
authors.forename: Brennan D
authors.initials: BD
authors.lastname: Peterson
authors.forename: Camilla S
authors.initials: CS
authors.lastname: Sejbaek
authors.forename: Matthew
authors.initials: M
authors.lastname: Pirritano
authors.forename: Lone
authors.initials: L
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003718:Denmark; D003863:Depression / Q000150:complications*; D003866:Depressive Disorder / Q000150:complications*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007246:Infertility / Q000523:psychology* / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D027724:Reproductive Techniques, Assisted / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology
keywords: couples; cross-sectional study; depressive symptoms; infertility distress