Mother-reported EPDS-Partner (EPDS-P) Enables Indirect Screening of Paternal Perinatal Depression Independent of Maternal Factors: A Community-Based Cohort Study 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 validated the diagnostic 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 routine visits by health nurses. Paternal depression was defined as a Center for Epidemiologic Studies Depression Scale score ≥16. Receiver operating characteristic curves were used to evaluate diagnostic accuracy, and binomial logistic regression was used to assess the influence 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 diagnostic accuracy (area under the curve: 0.783, prenatal; 0.746, postpartum). The optimal prenatal and postpartum cut-off values (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 was the only significant predictor of paternal depression. The EPDS-P is a valid and practical tool for indirectly screening for paternal perinatal depression, independent of maternal influences. 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.