Effect of Expressive Writing on Depression and Anxiety Among Infertile Women: A Randomized Controlled Trial

Abstract

Background: Infertility is one of the most significant crises in a woman's life, often involving prolonged and costly treatments that can lead to psychological problems such as depression and anxiety, which may require therapy. Objectives: The present study was conducted to determine the effect of expressive writing on depression and anxiety among infertile women who visited infertility clinics in Isfahan. Methods: This randomized controlled trial was conducted on 102 infertile women who visited infertility clinics in Isfahan and met the inclusion criteria. The intervention group engaged in expressive writing for 20 minutes per day over 3 days. The control group wrote about their daily routine (neutral writing). The depression and anxiety levels of the participants were evaluated before, immediately after, and 2 weeks following the intervention using the Depression/Anxiety/Stress Scale-21 (DASS-21) Questionnaire. Data were analyzed using ANOVA and t-test with SPSS software version 21. Results: The mean scores for depression and anxiety showed no significant difference between the two groups before the intervention. However, at both stages after the intervention, the mean scores were significantly lower in the intervention group (P < 0.001 in all cases). Furthermore, in both groups, the difference in mean scores for depression and anxiety over time, from before the intervention to immediately after and two weeks post-intervention, was statistically significant (P < 0.001). Additionally, the pattern of changes in mean scores for depression and anxiety from before the intervention to two weeks post-intervention showed a significant difference between the intervention and control groups (P < 0.001). Conclusions: Both expressive and neutral writing can reduce the levels of depression and anxiety in infertile women, but the effect of expressive writing is more significant. Midwives and gynecologists could consider expressive writing as a simple, low-cost, available, and effective method for reducing depression and anxiety levels in infertile women.