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Male infertility and depression: a neglected problem in the Middle East.

INTRODUCTION
Little attention has been paid to the psychological status of infertile men from developing countries who have been traditionally stigmatized as feeble and ineffective.


AIM
The aim of this study is to evaluate the prevalence of depression and its socio-demographic correlates in a sample of Iranian infertile men.


METHODS
One hundred and fourteen infertile men filled out the 21-item Beck Depression Inventory. Men who scored ≥ 17 were considered depressed and those with the score ≤ 16 were assumed to be nondepressed.


MAIN OUTCOME MEASURES
(i) Comparison between depressed and non-depressed men regarding age, education level, economic status, ethnicity, age at time of marriage, duration, and type of infertility and regular cigarette smoking. (ii) Independent risk factors for depression.


RESULTS
The mean age of participants was 34.1 ± 7.1 years. The diagnosis of depression was made in 42.9% of infertile men. Current age, age at marriage, economic status, and type of infertility were not statistically different between two groups (P > 0.05). Statistically significant association was detected between depression symptoms and education (P < 0.001), cigarette smoking (P < 0.008), and duration of infertility (P < 0.03). In an adjusted multiple regression model, education (odds ratio [OR] 0.2; confidence interval [CI] 0.06-0.5, P < 0.003), ethnicity (OR 4.5; CI 1.5-13.3, P < 0.006), and cigarette smoking (OR 5.1; CI 1.4-18.5, P < 0.01) retained their significance, while duration of infertility lost its power.


CONCLUSION
Depression among Iranian infertile men is remarkably higher in comparison with Western countries. Azaris, cigarette smokers, and individuals with low educational level are at higher risk of developing depression among infertile men.