Investigating the Time Interval between Infertility and Mental Disorders Onset as well as Risk Factors among Patients with Infertility Using Survival Analysis and Data Mining

Background: The 2010 total fertility rate in Taiwan was 0.90 and the issue of the fewer children trend becomes extraordinarily severe. Patients with infertility may suffer from depression and anxiety disorders. However, there is a dearth of nationally-representative analyses on infertility-to-mental-disorders time interval as well as risk factors by using survival analysis and data mining. Therefore, this study sought to investigate the relative risks of mental disorders, with a highlight of the interval, among this vulnerable group.

Methods: In the retrospective cohort design, the present research conducted longitudinal analyses by utilizing the medical claims data from 1,000,000 randomly sampled beneficiaries recorded in the 2002-2012 Taiwan National Health Insurance (NHI) Research Database. A total of 16,413 subjects with the principal infertility diagnosis code was identified and analyzed in SAS 9.3 and PASW Modeler 13. Infertility-related mental disorders include depression and anxiety.

Results: The average interval between the diagnosis of infertility and the diagnosis of mental disorder was 21.16 months. Factors significantly associated with mental disorders among the subjects with infertility were identified. The results of data mining indicated that high income, hormone medicine use, and surgery were the risk factors of infertility, whereas low income, veterans and religious persons, and high comorbidity were the risk factors of mental disorders among patients with infertility.

Conclusions: The intervention for mental disorders prevention is suggested to conduct no later than the first year of infertility diagnosis. Policymakers might target the high-risk individuals, in the attempt to conduct timely medical interventions for preventing mental disorders.