Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
BMC Psychiatry. 2018 Sep 25;18(1):310. doi: 10.1186/s12888-018-1893-6.
Much evidence consistent with the Marital Discord Model of Depression (MDMD) suggests that marital discord is associated with depression, but no studies examine the relationship between marital satisfaction and depression at the dyadic level in infertile couples. This study examined the effect of actors' and partners' marital satisfaction on depressive symptoms in husband-wife dyads with infertility using an innovative dyadic analysis approach, the Actor-Partner Interdependence Model (APIM).
In this cross-sectional study, the sample comprised of 141 infertile couples in the evaluation phase of treatment. We collected data in a referral infertility center in Tehran, Iran between February and May 2017. Marital satisfaction and depression were measured using ENRICH marital satisfaction scale and Hospital Anxiety and Depression Scale, respectively, before starting the treatment. Dyadic analysis applying the APIM was used. In this study, actor effect is the impact of a person's marital satisfaction on his/her own depression. Partner effect is the impact of a person's marital satisfaction on his/her partner's depression.
The APIM analysis revealed that both men and women's marital satisfaction excreted an actor effect on their own depression (β = - 0.412, P < 0.001; β = - 0.263, P = 0.002, respectively). Furthermore, men's marital satisfaction exerted a significant partner effect on their wives' depression symptoms (β = - 0.170, p = 0.047). However, the wives' marital satisfaction was not related to their husbands' depressive symptoms (β = - 0.028, P = 0.735).
The findings support that the MDMD is a valid theoretical model for the conceptualization of marital satisfaction and depressive symptoms among infertile couples and suggest that interventions to reduce depressive symptoms should include both men and women.
大量与抑郁的婚姻冲突模型（MDMD）一致的证据表明，婚姻冲突与抑郁有关，但没有研究在不孕夫妇的对偶水平上检查婚姻满意度与抑郁之间的关系。本研究使用创新的对偶分析方法——演员-伙伴相互依存模型（APIM），研究了演员和伴侣的婚姻满意度对不孕夫妇夫妻对偶中抑郁症状的影响。
在这项横断面研究中，样本包括 141 对正在接受治疗评估阶段的不孕夫妇。我们于 2017 年 2 月至 5 月在伊朗德黑兰的一家不孕不育转介中心收集数据。在开始治疗之前，使用 ENRICH 婚姻满意度量表和医院焦虑抑郁量表分别测量婚姻满意度和抑郁程度。应用 APIM 进行对偶分析。在本研究中，演员效应是指一个人的婚姻满意度对其自身抑郁的影响。伙伴效应是指一个人的婚姻满意度对其伴侣抑郁的影响。
APIM 分析显示，男性和女性的婚姻满意度对自身抑郁均产生了演员效应（β=-0.412，P<0.001；β=-0.263，P=0.002）。此外，男性的婚姻满意度对其妻子的抑郁症状产生了显著的伙伴效应（β=-0.170，P=0.047）。然而，妻子的婚姻满意度与丈夫的抑郁症状无关（β=-0.028，P=0.735）。
研究结果支持 MDMD 是不孕夫妇婚姻满意度和抑郁症状概念化的有效理论模型，并表明，减少抑郁症状的干预措施应同时包括男性和女性。
