Prevalence and factors associated with Generalized Anxiety Disorder among adult women seeking infertility services: a multi-centre study

Abstract

Background: Infertility is a global issue and the majority of its causes are reported from third-world nations. Unfortunately, it puts a heavy psychological burden on the affected individuals and therefore has far-reaching mental effects on these individuals. Generalized anxiety disorder (GAD) is the most commonly diagnosed anxiety disorder in infertile people. However, there is limited information on the prevalence of GAD among infertile women in sub Saharan Africa and Uganda in particular. The objective of this study was to establish the prevalence of GAD and its associated factors among adult women seeking infertility services at Kawempe National Referral Hospital (KNRH) and Neogenesis Fertility Centre in Uganda. Methods: This was a multi-Centre Cross-sectional study conducted at Kawempe National referral Hospital and Neogenesis Fertility Centre over five months from April 2023 to August 2023. Using a consecutive non-probability sampling method, a total of 306 women seeking infertility services were enrolled. We utilized an interviewer-administered questionnaire to determine the factors associated with GAD while the Mini-International Neuropsychiatric Interview (M.I.N.I) tool was used to assess GAD. Data was entered into Epidata, exported and analyzed using STATA 14. We generated descriptive statistics as well as bivariate and multivariate outputs using logistic regression. Results: The overall prevalence of GAD was 43.5%. stigmatizing behaviours (AOR = 3.78; 95% CI:1.8–8.0, P = 0.001), Lack of partner’s support(AOR = 3.14; 95% CI:1.3–7.4, P = 0.008), Low monthly income of the partner(AOR = 2.36; 95% CI:1.1–5.2, P =0.032),history of abortion(AOR = 1.84; 95% CI:1.1–3.4, P = 0.049) and negative opinions of family and friends(AOR = 6.88; 95% CI:3.7–12.8, P <0.001) were the factors associated with GAD among women seeking infertility services. Conclusion and Recommendation: The prevalence of GAD among women seeking infertility services at KNRH and Neogenesis Fertility Centre was 43.5%.The significant factors associated with GAD in this group of patients were, history of abortion, lack of partner’s support, stigmatizing behaviours, low partner’s monthly income and negative opinions of family and friends. All women seeking infertility services should be screened for GAD to identify those who may need treatment and link them to appropriate care. In addition integration of psychological support into infertility treatment is recommended to ensure adequate psychological assessment and management.