Psychiatric symptoms in Turkish infertile women

Abstract

The aims of this study were to determine the psychiatric symptoms which may develop because of infertility in Turkish women and to find out the precipitating factors. Fifty women with primary infertility and 50 healthy controls were evaluated using the Beck Depression Inventory, Spielberger Stait-Trait Anxiety Inventory, Rosenberg self-esteem scale and Symptom Checklist scale. They were also asked to describe the reactions received from their husband, husbands' families and social group because of infertility.

Psychiatric symptoms were not significantly different between the two groups. However, within the infertile group, depression and anxiety were more frequent in the women who received negative reactions from their husband, their husbands' families and social group. Depression, anxiety and self-esteem were improved in the infertile women as age and the duration of infertility increased.

In conclusion, our findings indicate that the reactions the infertile women are faced with play an important role in the development of certain psychiatric symptoms.

Human reproductive strategy differs from that of most other mammals, including Apes such as the closely related chimpanzee (Pan troglodytes) and the bonobo (Pan paniscus). For example, humans, although basically polygamic, exhibit a strong tendency to (serial) monogamy and - very rare for a mammal - provide biparental care. Moreover, humans are (almost) permanently willing to mate but, in contrast to other species, do so only in private.

Unlike chimpanzees and bonobos, the human female exhibits no external signs of ovulation; rather a number of bodily features, e.g. permanently swollen milk glands and the quality of skin and hair, indicate fitness to breed.

Human males also exhibit qualities that are rare among mammals: fertile males can be in the company of fertile females without sex being an imperative -although the awareness of sexuality is generally omnipresent. Moreover, unlike most other Apes, human males can cooperate in large groups, in spite of their polygynic inclination and their tendency to compete with each other for access to females. This capacity probably evolved in response to the necessity to acquire food, in particular meat, which was difficult to obtain by a single man. But life in large, complex, multi-male, multi-female groups places great demands on the members' social skills and, to be able to meet these demands, a large, sophisticated brain (neocortex) is needed.

Food (and in its wake, cooking) probably forced man to live in ever-larger groups and to evolve the capacity to cooperate. This, in its turn, drove man's present-days psychosocial (emotional and intellectual) make-up. But for this to evolve, an adaptation of reproductive strategy was a conditio sine qua non.

Key Words:

• anxiety
• depression
• female infertility
• psychiatric symptoms
• human reproductive strategy
• food
• evolution