Brief report Early-onset major depressive disorder in men is associated with childlessness ☆ William R. Yates a,b, ⁎, William H. Meller c , Brian C. Lund a , Steve Thurber d , Patricia L. Grambsch e a Laureate Institute for Brain Research, Tulsa, OK, United States b University of Oklahoma College of Medicine, Department of Psychiatry, Tulsa, Oklahoma, United States c University of Minnesota College of Medicine, Department of Psychiatry, Minneapolis, MN, United States d Department of Psychology, Woodlands Center, Willmar, Minnesota, United States e University of Minnesota School of Public Health, Division of Biostatistics Minneapolis, MN, United States article info abstract Article history: Received 20 July 2009 Received in revised form 26 October 2009 Accepted 27 October 2009 Methods: The self-reported number of children was compared for men and women from the National Epidemiologic Survey of Alcoholism and Related Conditions Survey (NESARC). Subjects with a diagnosis of major depressive disorder or bipolar disorder were compared to those without an axis I disorder. The effect of age, gender, marriage and diagnostic status on number of children was completed using multivariate analyses. Results: Men with a history of major depressive disorder but not bipolar disorder reported higher rates of childlessness and lower mean number of children. This reduced number of children was related to an early age of onset of MDD. Thirty percent of men with an age of onset of MDD before 22 were childless compared to only 18.9% of men without an axis I disorder (Odds ratio = 1.82, 95% CI = 1.45–2.27). No effect of mood disorder on number of children was found in women with major depression or bipolar disorder. Discussion: This study suggests that an early age of onset of major depressive disorder contributes to childlessness in men. © 2009 Elsevier B.V. All rights reserved. Keywords: Depression Childlessness Bipolar disorder 1. Introduction Mood disorders impact multiple domains including emotional regulation (Drevets et al., 2008), cognition (Wingo et al., 2009), attachment (Allen et al., 2007), marital function (Rehman et al., 2008) and sexual function (Shifren et al., 2008). Many of the domains impacted by mood disorders may interact with the selection of a partner and childbearing. These domains include biological and psycho- social variables with the potential to ultimately influence the number of children. The role of a mood disorder on the number of children in families in community samples has received limited attention. Studies of the effect of mood disorder on fertility and number of children have produced mixed results (Williams et al., 2007). Many studies have focused on clinical popula- tions and have small sample sizes. Reduced fertility rates for women with major depression or bipolar disorder have been found in some clinical samples (Calzeroni et al., 1990; Jönsson, 1991). However, a controlled study of over 30,000 women hospitalized for mood disorder found no difference in the number of children (Odergard, 1980). A small study of bipolar disorder found indication of decreased fertility in both men and women (Baron et al., 1982). Childbearing patterns in the United States demonstrate strong associations with maternal and paternal age and with marriage (Kreider and Elliot, 2009). Mood disorders with an early age of onset are often severe and can reduce the likelihood of marriage (Zisook et al., 2007; Zisook et al., 2004). Therefore, any study of childbearing frequency in mood disorders needs to control for effects of age and marital status. Journal of Affective Disorders 124 (2010) 187–190 ☆ Work completed at the Laureate Institute for Brain Research, Tulsa, Oklahoma. ⁎ Corresponding author. 8601 S Darlington, Ave, Tulsa, OK 74137, United States. E-mail address: william-yates@ouhsc.edu (W.R. Yates). 0165-0327/$ – see front matter © 2009 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2009.10.024 Contents lists available at ScienceDirect Journal of Affective Disorders journal homepage: www.elsevier.com/locate/jad