title: Paternal postnatal depression in Japan: an investigation of correlated factors including relationship with a partner.
abstract: BACKGROUND
  A 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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  One 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.
  
  
  CONCLUSIONS
  This 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.
authors.affiliation: Department of Nursing, School of Nursing, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, 650-8530, Japan. nisimura@huhs.ac.jp.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nishimura
authors.affiliation: Department of Nursing, School of Nursing, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, 650-8530, Japan. fujita@huhs.ac.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Department of Nursing, Japan Red Cross Hiroshima College of Nursing, 1-2 Ajinadaihigashi, Hatsukaichi, 738-0052, Hiroshima, Japan. mk11150@jrchcn.ac.jp.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Katsuta
authors.affiliation: Department of Nursing, School of Nursing, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, 650-8530, Japan. a-ishihara@huhs.ac.jp.
authors.forename: Aya
authors.initials: A
authors.lastname: Ishihara
authors.affiliation: Department of Children and Women's Health, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, 565-0871, Osaka, Japan. ohashi@sahs.med.osaka-u.ac.jp.
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Ohashi
mesh_terms: D000328:Adult; D001007:Anxiety; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D019052:Depression, Postpartum / Q000453:epidemiology; D005191:Family Characteristics; D005220:Fathers / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008393:Marriage / Q000523:psychology*; D009035:Mothers / Q000523:psychology; D010549:Personal Satisfaction; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D011795:Surveys and Questionnaires