A Two-Phase Survey of Psychiatric Morbidity among Females with Infertility in a Tertiary Hospital in North-Western Nigeria

Abstract

ABSTRACT Background: The inability of couples to conceive or infertility has been identified as a major source of psychiatric morbidity. In several studies in sub-Saharan Africa, the psychological burden, often higher among females, is mostly assessed through screening measures and hardly by diagnostic instruments. This study evaluated the prevalence and clinical pattern of psychiatric morbidity among adult female patients attending Aminu Kano Teaching Hospital (AKTH) infertility clinic using the two-phase survey method. Methods: In the first phase, 281 respondents were assessed using sociodemographic, clinical, and the 12-item General Health Questionnaire (GHQ-12). The second phase was by using the World Health Organization Schedule for Clinical Assessment in Neuropsychiatry (SCAN) to interview all probable cases on the GHI-12 with a score of 3 or more, and 10% of non-cases. Psychiatric diagnosis was made in accordance with the diagnostic criteria of the 10th edition of the International Classification of Diseases (ICD-10). Results: The point prevalence of psychiatric morbidity in this study was 29.2% with a weighted prevalence rate of 64.8% projected onto the infertile population seeking medical help within the 3-month study period. Depression (21%) was the most occurring diagnosis. Generalized Anxiety Disorder and Somatisation were diagnosed in 6% and 2% respectively. There was a significant relationship between psychiatric morbidity and age, educational status, religion, and the duration of marriage (p<0.05). Conclusion: About one-third of infertile women in this study had psychiatric morbidity with depression being the most prevalent diagnosis. Psychiatric morbidity was significantly associated with increasing age, high educational attainment, religion and longer duration of marriage. The study demonstrated the need to include Consultation-Liaison Mental Health Practitioners in the management of women with infertility in order to meet their unmet mental health needs.