Indirect screening for paternal perinatal depression independent of maternal factors using mother-reported EPDS-partner in a community-based cohort in Japan

Paternal perinatal depression negatively affects maternal mental health and child development. However, early detection remains limited, particularly in countries such as Japan, where paternal involvement in perinatal care is low. The Edinburgh Postnatal Depression Scale-Partner (EPDS-P), a maternal-rated tool for screening paternal depression, offers a feasible solution. This study longitudinally evaluated the screening performance of the EPDS-P from the prenatal to postpartum periods and examined its independence from maternal psychological and demographic characteristics. This prospective, community-based cohort study in Towada, Japan, included couples assessed during home visits by public health nurses and midwives. Elevated paternal depressive symptoms were defined as a Center for Epidemiologic Studies Depression Scale score ≥ 16. Receiver operating characteristic curves were used to evaluate discriminatory accuracy, and multivariable analyses were used to assess the association of maternal and paternal age, parity, gestational weeks or postpartum days, and maternal Edinburgh Postnatal Depression Scale and Mother-to-Infant Bonding Scale scores. Data from 385 prenatal and 411 postpartum couples were analyzed. The EPDS-P demonstrated fair discriminatory accuracy (area under the curve: 0.783, prenatal; 0.746, postpartum). The prenatal and postpartum selected decision thresholds (3 and 4, respectively) achieved sensitivities of 70.7% and 61.5% and specificities of 75.9% and 86.8%, respectively. The EPDS-P score assessed paternal perinatal depression while remaining largely independent of maternal factors. Its integration into routine perinatal care may help identify at-risk fathers in settings with limited paternal engagement and contribute to more inclusive, family-centered mental health support. Clinical trial number: This study protocol was registered with the University Hospital Medical Information Network-Clinical Trials Registry: UMIN-CTR (https://www.umin.ac.jp/ctr/) on September 28, 2021 (Trial registration number: UMIN000045584). UMIN-CTR has been recognized by the International Committee of Medical Journal Editors (ICMJE) as an “acceptable registry.”