Paternal postnatal depression in Japan: an investigation of correlated factors including relationship with a partner

Abstract

BackgroundA negative effect of paternal depression on child development has been revealed in several previous studies. The aims of this study were to examine the prevalence and relevant factors associated with paternal postnatal depression at four months postpartum, including age, part-time work or unemployment, experience of visiting a medical institution due to a mental health problem, economic anxiety, unexpected pregnancy, pregnancy with infertility treatment, first child, partner’s depression, and lower marital relationship satisfaction.MethodsWe distributed 2032 self-report questionnaires to couples (one mother and one father) with a 4-month old infant between January and April 2013. Data from 807 couples (39.7 %) were analyzed. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS). In order to clarify the factors related with paternal depression, a logistic regression analysis was conducted.ResultsOne hundred and ten fathers (13.6 %) and 83 mothers (10.3 %) were depressed. According to the logistic regression analysis, paternal depression was positively associated with partner’s depression (adjusted odds ratio (AOR) 1.91, 95 % confidence interval (CI) 1.05–3.47), and negatively with marital relationship satisfaction (AOR 0.83, 95 % CI 0.77–0.89). History of infertility treatment (AOR 2.37, 95 % CI 1.32–4.24), experience of visiting a medical institution due to a mental health problem (AOR 4.56, 95 % CI 2.06–10.08), and economic anxiety (AOR 2.15, 95 % CI 1.34–3.45) were also correlated with paternal depression.ConclusionsThis study showed that the prevalence of paternal depression at four months after childbirth was 13.6 % in Japan. The presence of partner’s depression and low marital relationship satisfaction were significantly correlated with paternal postpartum depression, suggesting that health professionals need to pay attention to the mental status of both fathers and mothers, and to their relationship.

Prevalence and Factors Associated With Postpartum Depression in Fathers: A Regional, Longitudinal Study in Japan

“…An effective psychosocial stress screening tool for expectant fathers is needed, and clinical settings should create some opportunity during the antenatal period to assess risk for postnatal depression, which can facilitate the provision of further support and care for those affected. While the father's relationship with his partner has been significantly associated with paternal depression in the postnatal period in previous studies (Gawlik et al, 2014;Matthey et al, 2000;Nishimura et al, 2015), we found no association between paternal postpartum depressive symptoms and the quality of the relationship with the partner. However, we used only data reported by fathers about the couple's relationship during pregnancy, so further studies are needed to assess both the mother's and the father's views on the quality of their relationship and the impact of marital relationship quality on fathers' postpartum depression.…”

“…In previous studies in other countries with larger, nationally representative samples, the prevalence of paternal postpartum depression was around 10% (Giallo et al, ; Paulson & Bazemore, ; Paulson et al, ). Nishimura & Ohashi (, ) conducted cross‐sectional studies in Japan and found that 14.3% (19/133) and 13.6% (110/807) of fathers had depression at four weeks and four months postpartum, respectively. The period prevalence of 17% in the present study, across all three months in the postpartum period, was similar to the results of Nishimura & Ohashi (), but the point prevalence of 6.3% at one month postpartum was approximately half that reported by Nishimura.…”

“…The scale includes 10 items designed to screen symptoms of emotional distress during pregnancy and the postnatal period (Cox, Holden, & Sagovsky, ), with scores ranging from 0 to 3 and a maximum total score of 30. Okano et al () verified the reliability and validity of the Japanese version of the EPDS for women (75% sensitivity, 93% specificity, and Cronbach alpha = 0.78); Nishimura & Ohashi (, ) conducted analysis for men (82% sensitivity, 94% specificity, and Cronbach alpha = 0.81). The baseline instrument and all follow‐up questionnaires included the EPDS items.…”

“…Based on previous studies in Japan, we allocated fathers who scored 8 and above on the EPDS at any time point to a paternal depressive symptoms group and those who scored 7 or less to a no paternal depressive symptoms group (Nishimura & Ohashi, , ). Fathers with missing values on the EPDS were grouped in the no‐depression group for that time point, enabling the sample size to remain robust but increasing the likelihood that we underestimated the prevalence of paternal depression.…”

“…In addition, parenting-related factors, including parenting distress, parenting efficacy (Demontigny et al, 2013;Giallo et al, 2013), parental attachment (Buist et al, 2003;Fang & Hung, 2012), and birthing concerns during pregnancy (Gawlik et al, 2014), have been linked to fathers' depression. The quality of the marital relationship (Gawlik et al, 2014;Matthey, Barnett, Ungerer, & Waters, 2000;Nishimura, Fujita, Katsuta, Ishihara, & Ohashi, 2015), maternal depression (Areias et al, 1996;Goodman, 2004;Ngai & Ngu, 2015) and low social support (Gao et al, 2009;Kamalifard et al, 2014;Mao et al, 2011) also are significantly associated with paternal depression in the postpartum period.…”