Individual and dyadic network analysis of anxiety and depression among infertile couples: A cross-sectional study

This study aims to explore anxiety and depression symptom networks in infertile couples, focusing on sex differences and the transmission of psychological distress between partners.

This cross-sectional study recruited patients from the First Affiliated Hospital of Soochow University between October 2021 and April 2024. Participants completed the Generalized Anxiety Disorder 7-Item Scale and the Patient Health Questionnaire-9. Network analysis constructed separate symptom networks for men and women. A dyadic network approach identified bridge symptoms linking psychological distress between partners. Network characteristics, including Expected Influence and Bridge Expected Influence, were systematically compared.

Of the 1179 infertile couples recruited, 1047 completed questionnaires (response rate: 88.8 %). Women reported significantly higher levels of most anxiety and depressive symptoms compared to men. Network analysis showed "fatigue" (EI = 1.16) central for women and "sad mood" (EI = 1.05) central for men. Dyadic analysis identified "guilt"(BEI = 0.08) in women and "suicidal ideation"(BEI = 0.12) in men as bridge symptoms.

Sex-specific symptom networks identified "fatigue" in women and "sad mood" in men as central symptoms. Dyadic analysis highlighted "guilt" and "suicidal ideation" as key transmission pathways. These findings underscore the importance of incorporating both individual and dyadic perspectives in intervention planning to effectively address psychological distress in infertile couples.