AIMS

This study aims to investigate the bidirectional association between symptoms of depression and quality of marital relationship in a population-based cohort of women.

METHODS

The bidirectional association was examined longitudinally in over 3694 women participating in the Mater-University study of Pregnancy, Brisbane, Australia, over a 14-year period. Women were interviewed 3-5 days postdelivery and again when the child was 6 months, 5 years, and 14 years of age. A transition model was developed to examine changes in exposures and risk factors over the 14 years of follow-up.

RESULTS

Nearly 40% of the women with depressive symptoms continued to report symptoms, and a similar proportion of women who reported being in a poor quality marital relationship remained in a poor quality relationship over long periods of time. Approximately 1 in 10 women who had not reported symptoms of depression or a poor relationship in the previous phase did so at the subsequent phase. The bidirectional relationships between depressive symptoms and quality of marital relationship are both consistent and strong. Negative changes in either symptoms of depression or quality of marital relationship predicted a poor outcome. The estimated population attributable risk was similar for both depressive symptoms and quality of the marital relationship.

CONCLUSIONS

The findings from this study suggest that symptoms of depression and quality of relationship are strongly associated with each other and that this association is bidirectional. Clinical intervention in poor quality marital relationships represents a logical approach to addressing symptoms of depression in women. Similarly, there needs to be a focus on family outcomes for those women with impaired mental health.