The relationship between marital satisfaction and depression in infertile couples: an actor-partner interdependence model approach

Background: 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). Methods: 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. Results: The APIM analysis revealed that both men and women's marital satisfaction excreted an actor effect on their own depression (beta = -0.412, P < 0.001; beta = -0.263, P = 0.002, respectively). Furthermore, men's marital satisfaction exerted a significant partner effect on their wives' depression symptoms (beta = -0.170, p = 0.047). However, the wives' marital satisfaction was not related to their husbands' depressive symptoms (beta = -0.028, P=0.735). Conclusions: 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.