Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Health Qual Life Outcomes. 2018 Apr 24;16(1):73. doi: 10.1186/s12955-018-0904-0.
Infertility can cause psychological distress and has a negative impact on quality of life (QoL). There have been no studies investigating the effect of depression on QoL in infertile couples at the dyadic level. This study aimed to investigate the effects of actors' and partners' depression on QoL in male-female dyads experiencing infertility using an innovative dyadic analysis approach, the Actor-Partner Interdependence Model (APIM).
We conducted this cross-sectional study on 180 infertile couples in Tehran, Iran, during August-September 2017. Quality of life and depression were assessed using Fertility Quality of Life and Patient Health Questionnaire-9, respectively. Dyadic data were analyzed by the APIM approach. In this method, actor effect is the impact of a person's depression on his/her own QoL. Partner effect is the impact of a person's depression on his/her partner's QoL.
Results from APIM revealed that both males and females' depression exuded an actor effect on their own QoL (β = - 0.589, p < 0.001; β = - 0.588, p < 0.001, respectively). Furthermore, males' depression exuded a significant partner effect on their wives' QoL (β = - 0.128, p = 0.030). Although the partner effect of females' depression on males' QoL was not statistically significant (β = - 0.108, P = 0.070), males whose wives had higher depression were more to indicate their own QoL was poorer. Based on equality constraint test, both actor and partner effects of depression on QoL were similar between males and females.
The findings suggest that QoL in infertile patients was influenced by not only their own depression but also their spouses' depression; therefore, interventions to improve QoL should include both males and females.
不孕不育会导致心理困扰，对生活质量（QoL）产生负面影响。目前还没有研究从对偶层面探讨抑郁对不孕夫妇 QoL 的影响。本研究旨在采用创新的对偶分析方法—— Actor-Partner Interdependence Model（APIM），探讨男性-女性对偶体中，夫妻双方抑郁对不孕夫妇 QoL 的影响。
本横断面研究于 2017 年 8 月至 9 月在伊朗德黑兰招募了 180 对不孕夫妇。使用生育质量问卷和患者健康问卷 9 分别评估生活质量和抑郁。采用 Actor-Partner Interdependence Model（APIM）分析对偶数据。在该方法中，个体的抑郁对自身 QoL 的影响是个体效应，个体的抑郁对伴侣 QoL 的影响是伴侣效应。
APIM 结果显示，男性和女性的抑郁对自身 QoL 均有个体效应（β=-0.589，p<0.001；β=-0.588，p<0.001）。此外，男性的抑郁对其妻子的 QoL 有显著的伴侣效应（β=-0.128，p=0.030）。虽然女性的抑郁对男性 QoL 的伴侣效应无统计学意义（β=-0.108，P=0.070），但妻子抑郁程度越高的男性，越会报告自身 QoL 较差。基于等方差检验，抑郁对 QoL 的个体和伴侣效应在男性和女性之间相似。
这些发现表明，不孕患者的 QoL 不仅受自身抑郁的影响，还受配偶抑郁的影响；因此，提高 QoL 的干预措施应同时包括男性和女性。
