Item content Handling ﬁnances Recreational activities Religion Friends Conventions (correct or proper behaviour) Philosophy of life Socializing with family and friends Aims and life goals Time together Important decisions Household tasks Leisure time interests and activities Decisions regarding career/personal development Total DCS score Table I. Dyadic Consensus Subscale (DCS) presenting differences between mothers and fathers using the Wilcoxon signed rank test. The instruction in the questionnaire read: ‘Most people have disagreements in their relationship. Please make an assessment of the extent to which you and your partner agree or disagree’. Relationship discord at childbirth and parental postpartum depressive symptoms 433 Positive ranks (Father’s score > Mother’s score) n (%) Negative ranks Ties (Father’s score < (Father’s score = Mother’s score) Mother’s score) n (%) n (%) Mean Mean positive ranks negative ranks P values 57 (19.4) 52 (17.8) 43 (15.4) 44 (15.0) 58 (20.9) 62 (21.5) 58 (19.9) 53 (18.4) 48 (16.6) 47 (16.0) 83 (28.6) 57 (19.5) 51 (17.5) 44 (15.0) 77 (26.4) 46 (16.5) 90 (30.6) 58 (20.9) 75 (26.0) 67 (23.0) 86 (29.9) 78 (26.9) 70 (23.9) 54 (18.6) 81 (27.7) 86 (29.6) 193 (65.6) 163 (55.8) 190 (68.1) 160 (54.4) 161 (58.1) 152 (52.6) 166 (57.0) 149 (51.7) 164 (56.6) 176 (60.1) 153 (52.8) 154 (52.7) 154 (52.9) 40 (15.7) 50.85 63.48 46.73 65.91 61.91 70.18 61.41 69.51 65.56 60.77 70.83 68.98 65.67 99.98 51.19 66.03 43.38 68.25 55.09 68.03 64.37 70.30 62.23 57.81 66.19 69.86 70.98 114.22 < 0.001*** 0.228 0.024* 0.975 0.549 0.372 0.312 0.006** 0.024* 0.071 0.007** 0.045* 0.001** 0.121 101 (39.8) 113 (44.5) Note: Signiﬁcant p-values are bold-faced. * p < 0.05; ** p < 0.01; *** p < 0.001.* DCS has been found to have a high validity and reliability, with a Cronbach’s alpha of 0.84 (31). Edinburgh Postnatal Depression Scale (EPDS) EPDS is developed with the purpose of creating a self-reported questionnaire to screen for postpartum depressive symptoms in women (27). The scale has been translated into several languages, including Swed- ish (32–34), and validated internationally on mothers (34,35) and fathers (36). The scale has been found to be a useful screening instrument for identifying postpartum depressive symptoms in primary health care (35,37,38). In a systematic review of the EPDS, the sensitivity was found to range from 59% to 100% and speciﬁcity from 44% to 97%; positive likelihood ratios ranged from 1.81 to 88 (39). EPDS uses a ten-item four-point scale with scores ranging between 0 and 3 on each item and a total score of between 0 and 30; the higher the score, the more depressive symptoms. To evaluate an individual’s level of postpartum depressive symptoms, the person has to answer all the questions in the EPDS ques- tionnaire. Cox et al. (22,27) recommend a cut-off of >9 to identify the risk of postpartum depression and a cut-off of >11 to identify depressive illness of varying severity (27). Even a relatively mild depression can have long-lasting consequences for the mother–infant relationship (10,34). In the present study, the cut-off of >9 was used for both the mothers and the fathers. Statistical analyses DCS and EPDS are measured on an ordinal scale and are thus primarily analysed using non-parametric methods. Consequently, the values for DCS and EPDS are presented as medians and quartiles, median (q1; q3). Values for categorical variables are given as frequencies and percentages, n (%). The mother and the father in a couple are considered dependent, and all analyses involving comparisons between mothers and fathers are thus analysed using statistical methods for paired data. McNemar’s test was used for comparing the occur- rence of postpartum depressive symptoms between mothers and fathers. The correlations between DCS scores, EPDS scores, and between DCS and EPDS scores were calculated with Spearman’s rank correla- tion method. Pearson’s chi-square test and Fisher’s exact test were used for comparing categorical variables. The Wilcoxon signed rank test was used for mea- suring differences between mothers’ and fathers’ per- ceived levels of marital discord. The Mann–Whitney U test was used for analysing differences regarding