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Gingras AS, Brassard A, Péloquin K, Lafontaine MF, Brault-Labbé A, Gosselin P. Anxiety and depressive symptoms in first-time parents: A dyadic longitudinal study based on attachment theory. J Affect Disord 2024; 355:122-130. [PMID: 38552919 DOI: 10.1016/j.jad.2024.01.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 12/12/2023] [Accepted: 01/04/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND The aim of this study was to examine the temporal and dyadic associations between anxiety and depressive symptoms during the transition to parenthood (TTP), while exploring the antecedence of attachment insecurities in these associations. METHOD Couples of first-time parents (N = 211) completed the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, the Experiences in Close Relationships scale, and a sociodemographic questionnaire during the second trimester of pregnancy and at four and twelve months postpartum. RESULTS Both prenatal anxiety and depressive symptoms predicted postnatal depressive and anxiety symptoms. Prenatal attachment-related anxiety predicted higher postnatal anxiety and depressive symptoms whereas prenatal attachment-related avoidance predicted higher postnatal depressive symptoms only. Parents whose partners had a higher level of prenatal attachment-related anxiety experienced higher postnatal anxious and depressive symptoms via their own's prenatal depressive symptoms. Parents whose partners had a higher level of prenatal attachment-related avoidance experienced higher postnatal depressive symptoms via their own's prenatal anxious symptoms. No gender differences were found for these associations. LIMITATIONS The sample was predominantly composed of educated heterosexual French-Canadian Caucasian couples and all measures were self-reported. CONCLUSIONS Our original findings suggest that professionals should routinely screen for anxiety and depressive symptoms in both partners from pregnancy up to one year postpartum. Also, our findings suggest addressing attachment insecurities with both partners to prevent the development of future symptoms during pregnancy or after childbirth. Finally, our study supports the relevance of considering these symptoms at subclinical levels during the TTP.
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Affiliation(s)
| | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, Québec, Canada.
| | | | | | | | - Patrick Gosselin
- Department of Psychology, Université de Sherbrooke, Québec, Canada
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Clifford BN, Eggum ND, Rogers A, Porter CL, Gale M, Sheppard JA, Lucca K, Rainey V, Bradley RH, Holmgren H, Jones BL. Mothers' and fathers' depressive symptoms across four years postpartum: An examination of between- and bidirectional within-person relations. J Affect Disord 2024; 351:560-568. [PMID: 38290580 DOI: 10.1016/j.jad.2024.01.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/08/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Both mothers and fathers are at risk for experiencing postpartum depressive symptoms shortly after the birth of a child. Previous studies suggest mothers' and fathers' depressive symptoms to be interrelated. This study examined bidirectional relations between mothers' and fathers' depressive symptoms across four years postpartum. METHODS Longitudinal data for this study were collected across five waves from 485 mothers and 359 fathers of infants when infants were on average 6 months-old until children were 54 months-old (1-year lags). Mothers and fathers reported on their depressive symptoms using the Center for the Epidemiological Studies Short Depression Scale (CES-D 10). A random intercept cross-lagged panel model (RICLPM) was specified to examine the bidirectional relations between mothers' and fathers' depressive symptoms over time. RESULTS At the between-person level, mothers' and fathers' depressive symptoms were positively associated. At the within-person level, unique carry-over effects were found for mothers and fathers in that when reporting higher depressive symptoms than their trait levels, they were more likely to report higher depressive symptoms one year later. Moreover, intermittent cross-lagged effects were observed from mothers' depressive symptoms to fathers' depressive symptoms during toddlerhood. LIMITATIONS The sample was not racially or structurally diverse thereby limiting the generalizations of the findings. CONCLUSIONS After the birth of a child, mothers and fathers are at risk for experiencing chronic depressive symptoms which can have implications for individual, couple and child health. Mothers' depressive symptoms are related to fathers' depressive symptoms over time.
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Affiliation(s)
- Brandon Neil Clifford
- Department of Psychology, Arizona State University, 950 S. McAllister Ave., Tempe, AZ 85287, United States of America.
| | - Natalie D Eggum
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, 85287-3701, United States of America
| | - Adam Rogers
- School of Family Life, Brigham Young University, 2091 JFSB, Provo, UT 84602, United States of America
| | - Chris L Porter
- School of Family Life, Brigham Young University, 2091 JFSB, Provo, UT 84602, United States of America
| | - Megan Gale
- School of Family Life, Brigham Young University, 2091 JFSB, Provo, UT 84602, United States of America
| | - J Andan Sheppard
- School of Family Life, Brigham Young University, 2091 JFSB, Provo, UT 84602, United States of America
| | - Kelsey Lucca
- Department of Psychology, Arizona State University, 950 S. McAllister Ave., Tempe, AZ 85287, United States of America
| | - Vanessa Rainey
- Department of Psychology, University of West Florida, Pensacola, FL 32514, United States of America
| | - Robert H Bradley
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, 85287-3701, United States of America
| | - Hailey Holmgren
- School of Family Life, Brigham Young University, 2091 JFSB, Provo, UT 84602, United States of America
| | - Blake L Jones
- Department of Psychology, Brigham Young University, Provo, UT 84604, United States of America
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Aviv EC, Preston EG, Waizman YH, Dews AA, Flores G, Saxbe DE. Fathers' subjective childbirth stress predicts depressive symptoms at six months postpartum. J Affect Disord 2023; 339:593-600. [PMID: 37459973 PMCID: PMC10923195 DOI: 10.1016/j.jad.2023.07.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/13/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Childbirth is a seminal experience in parents' lives. However, little research has investigated the link between fathers' birth experiences and their postpartum mental health. We hypothesized that a more subjectively stressful birth will predict greater self-reported depressive symptoms in fathers at six months postpartum. We also investigated the association between mode of delivery and paternal subjective stress. METHODS Seventy-seven heterosexual fathers expecting their first child and cohabiting with their pregnant partners participated in the study. Depressive symptoms were assessed in pregnancy and again at six months postpartum. Subjective birth stress was measured within the first few days of the birth, and birth charts were collected to examine mode of delivery. RESULTS Fathers' ratings of subjective birth stress significantly predicted postpartum depressive symptoms at six months postpartum. Subjective birth stress ratings varied significantly for fathers whose partners delivered via emergency cesarean section compared to those whose partners gave birth via both medicated and the unmedicated vaginal delivery. LIMITATIONS The study was limited by its small community (non-clinical) sample, which was restricted to heterosexual, cohabitating couples. Additionally, births were mostly uncomplicated and only 14 mothers underwent emergency cesarean section. CONCLUSION These findings highlight that the days immediately following childbirth are a window of opportunity for early intervention in new fathers at risk for postpartum depression.
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Affiliation(s)
- Elizabeth C Aviv
- University of Southern California Los Angeles, CA, United States.
| | - Emma G Preston
- University of Southern California Los Angeles, CA, United States
| | - Yael H Waizman
- University of Southern California Los Angeles, CA, United States
| | - Aridenne A Dews
- University of Southern California Los Angeles, CA, United States
| | - Genesis Flores
- University of Southern California Los Angeles, CA, United States
| | - Darby E Saxbe
- University of Southern California Los Angeles, CA, United States
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Smith I, O'Dea G, Demmer DH, Youssef G, Craigie G, Francis LM, Coles L, D'Souza L, Cain K, Knight T, Olsson CA, Macdonald JA. Associations between unintended fatherhood and paternal mental health problems: A systematic review and meta-analysis. J Affect Disord 2023; 339:22-32. [PMID: 37393953 DOI: 10.1016/j.jad.2023.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Unintended pregnancies are linked to adverse parental mental health, yet little attention has been given to this relationship in fathers specifically. We aimed to meta-analyse associations between unintended pregnancies and mental health problems in fathers with children aged ≤36 months. METHODS We conducted keyword searches of Medline, CINAHL, Academic Search Complete, PsycInfo and Embase to February 2, 2022, and hand searched included reference lists. RESULTS Of 2826 records identified, 23 studies (N = 8085 fathers), reporting 29 effects, were eligible for meta-analysis. Included studies assessed depression, anxiety, stress, parenting stress, post-traumatic stress disorder (PTSD), alcohol misuse and psychological distress. Pooled estimates, from random effects meta-analyses, for all mental health outcomes (k = 29; OR = 2.28) and depression only (k = 19; OR = 2.36), showed that the odds of reporting mental health difficulties were >2-fold higher in men reporting unintended births compared with those reporting intended births. However, there was no evidence of association with anxiety (k = 2) or stress (k = 2). Overall, mental health problems were greater in low-income countries. No differences were found across parity, timepoint of mental health assessment, or instruments used to measure mental health symptoms. LIMITATIONS Analyses were limited by the use of retrospective assessment of pregnancy intention, and heterogeneity of measures used. Further, assessment of fathers' mental health was restricted to the first year postpartum. This review was limited to English language studies. CONCLUSIONS Unintended pregnancies present an identifiable risk for postpartum mental health problems in fathers.
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Affiliation(s)
- Imogene Smith
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia; The Cairnmillar Institute, East Hawthorn, Australia.
| | - Gypsy O'Dea
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - David Hilton Demmer
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - George Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Georgia Craigie
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Lauren M Francis
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Laetitia Coles
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Levita D'Souza
- Faculty of Education, Monash University, Clayton, Australia
| | - Kat Cain
- Library Client Services, Deakin University, Geelong, Australia
| | - Tess Knight
- The Cairnmillar Institute, East Hawthorn, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
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Uriko K, Christoforou A, Motrico E, Moreno-Peral P, Kömürcü Akik B, Žutić M, Lambregtse-van den Berg MP. Paternal peripartum depression: emerging issues and questions on prevention, diagnosis and treatment. A consensus report from the cost action Riseup-PPD. J Reprod Infant Psychol 2023:1-19. [PMID: 37818835 DOI: 10.1080/02646838.2023.2266470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Paternal peripartum depression (P-PPD) is a serious and understudied public health problem associated with impaired family functioning and child development. The lack of recognition of P-PPD may result in limited access to both information and professional help. OBJECTIVE The aim of the study was to review studies on paternal peripartum depression and to identify issues and questions where future research and theory formation are needed. METHODS A literature search for systematic reviews, meta-analyses and primary studies was conducted using PubMed, Web of Science, Embase, Scopus, Medline, PsychInfo and Informit databases. Key results within the retrieved articles were summarised and integrated to address the review objectives. RESULTS Based on the literature, the knowledge related to prevalence, screening, risk factorsunique to fathers, management strategies and outcomes of P-PPD is lacking. Currently, there is no consensual understanding of the definition of P-PPD and recommendations for dealing with P-PPD. Limited data were available regarding the barriers preventing fathers from accessing support systems. CONCLUSION Emerging issues that need to be addressed in future research include: P-PPD definition and pathogenetic pathways; prevention strategies and assessment tools; self-help seeking and engagement with interventions; the cost-effectiveness of P-PPD management; needs of health professionals; effect on child development, and public awareness. Future studies and clinical practice should account the complexities that may arise from the father's perceptions of health care services. Results from this review highlights the critical issues on how to plan, provide and resource health services, to meet the health needs of fathers.
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Affiliation(s)
- Kristiina Uriko
- School of Natural Sciences and Health, Department of Psychology and Behavioural Sciences, Tallinn University, Tallinn, Estonia
| | - Andri Christoforou
- Department of Social and Behavioural Sciences, European University Cyprus, Nicosia, Cyprus
| | - Emma Motrico
- Department of Psychology, University Loyola Andalucia, Seville, Spain
| | - Patricia Moreno-Peral
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA). Biomedical Research Institute of Malaga (IBIMA plataforma Bionand), Malaga, Spain
| | | | - Maja Žutić
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
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DEMİRCİ Ö, INAN E. Postpartum Paternal Depression: Its Impact on Family and Child Development. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1153712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
The postpartum period is when parents undergo great changes and gain new responsibilities. Factors such as the changes that come with having a baby, not meeting the expectations about parenthood, having a child with a difficult temperament or health problems, or relational problems can be quite challenging in this period. These problems can deeply affect the psychological well-being of the parents. Although studies on depressive symptoms of mothers during pregnancy and postpartum are at an important level, studies aiming to examine the psychological state of fathers for the same period are still limited. However, perceptions that postpartum depression develops due to hormonal changes during pregnancy have been reshaped by the findings that this situation may also develop due to psychosocial factors. Relatedly, the number of studies on postpartum depression experienced by fathers has increased over time. Results of those studies show that fathers' psychological state also influences their parenting and the development of children. Fathers may experience paternal depression due to a lack of social support, economic conditions, relationship dynamics, and changing living conditions in the postpartum period. This situation may cause fathers to avoid parenting duties, spend less time with their children, be unable to cooperate with the mother, and have anger problems or deterioration in the relationship with the mother. The effects of depression on individuals' parenting styles negatively affect child-parent attachment and may cause children to develop emotional and behavioral problems. Therefore, it is very important to examine fathers' psychological state for children's development and the healthy progress of family dynamics. This review aims to address the effect of paternal depression on parenting and child development.
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Wainwright S, Caskey R, Rodriguez A, Holicky A, Wagner-Schuman M, Glassgow AE. Screening fathers for postpartum depression in a maternal-child health clinic: a program evaluation in a midwest urban academic medical center. BMC Pregnancy Childbirth 2023; 23:675. [PMID: 37726664 PMCID: PMC10508033 DOI: 10.1186/s12884-023-05966-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Postpartum depression (PPD) impacts fathers as well as mothers, and is estimated to affect between 8 and 13% of fathers. Paternal PPD is a risk factor for worsened quality of life, poor physical and mental health, and developmental and relational harms in the father-mother-child triad. There are no current recommendations for PPD screening among fathers. Paternal PPD screening was piloted in an intergenerational postpartum primary care clinic. METHODS The pilot was carried out in an intergenerational postpartum primary care clinic located at a Midwest urban academic safety net health system from October 2021 to July 2022. Fathers actively involved in relationships with mothers or infants receiving primary care in the clinic were approached with mothers' permission. A novel survey instrument was used to collect demographic/social data, as well as mental health history and current stress levels; an Edinburgh Postnatal Depression Scale (EPDS) was also administered. Screenings were completed by social workers; data were collected in REDCap and descriptive statistics were calculated in SAS. RESULTS 29 fathers were contacted and 24 completed screening (83%). Mean age was 31 years (range 19-48). Most (87%) identified as belonging to a racial or ethnic minority group. Fathers self-reported low rates of stress and preexisting mental health conditions, but 30% screened positive for PPD on EPDS (score of ≥ 8, or suicidal ideation). Gaps in health care were found, as one-quarter (26%) of fathers were uninsured and half (54%) did not have a primary care provider. After screening, two requested mental health services, and three established new primary care with a physician. CONCLUSIONS Participation was high in a PPD screening pilot for fathers in a primary care setting. This small sample of fathers demonstrated significant peripartum mental health challenges unlikely to have been identified otherwise. For some participants, engaging in PPD screening was an effective tool to prompt their subsequent engagement with general health care. This pilot is a step toward incorporating the health of fathers into models for supporting the health of families. Expanding screening for paternal PPD into routine primary care is necessary to reach more affected fathers.
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Affiliation(s)
- Sam Wainwright
- Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, 820 S. Wood Street, CSN 440, M/C 718, Chicago, IL, 60612, USA.
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
| | - Rachel Caskey
- Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, 820 S. Wood Street, CSN 440, M/C 718, Chicago, IL, 60612, USA
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Aida Rodriguez
- Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, 820 S. Wood Street, CSN 440, M/C 718, Chicago, IL, 60612, USA
| | - Abigail Holicky
- Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, 820 S. Wood Street, CSN 440, M/C 718, Chicago, IL, 60612, USA
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Wagner-Schuman
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago, IL, USA
| | - Anne Elizabeth Glassgow
- Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, 820 S. Wood Street, CSN 440, M/C 718, Chicago, IL, 60612, USA
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
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Döblin S, Seefeld L, Weise V, Kopp M, Knappe S, Asselmann E, Martini J, Garthus-Niegel S. The impact of mode of delivery on parent-infant-bonding and the mediating role of birth experience: a comparison of mothers and fathers within the longitudinal cohort study DREAM. BMC Pregnancy Childbirth 2023; 23:285. [PMID: 37098555 PMCID: PMC10127505 DOI: 10.1186/s12884-023-05611-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 04/14/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The association between mode of delivery (MOD) and parent-infant-bonding has only been studied in mothers and findings have been inconclusive. The aim of this study was to prospectively investigate how MOD relates to postpartum parent-infant-bonding in both mothers and fathers and whether these associations are mediated by birth experience. METHODS This study is part of the prospective cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Our sample comprised N = 1,780 participants who completed quantitative questionnaires during pregnancy as well as 8 weeks and 14 months postpartum. MOD was dummy coded, contrasting spontaneous vaginal delivery against vaginal delivery induced by drugs, operative vaginal delivery, planned, and unplanned cesarean section. Parent-infant bonding and birth experience were assessed using validated scales. A moderated mediation analysis based on ordinary least square (OLS) regression and bootstrapped estimates was conducted, considering relevant confounding variables. RESULTS Compared to spontaneous vaginal delivery, all categories of MOD predicted more negative birth experiences in both parents. A more positive birth experience predicted stronger parent-infant-bonding at 8 weeks, but not at 14 months postpartum. Mothers who delivered via cesarean section (planned or unplanned) reported stronger parent-infant-bonding at 8 weeks and 14 months postpartum. In fathers, only unplanned cesarean section was associated with stronger parent-infant-bonding at 8 weeks postpartum. At 8 weeks postpartum, birth experience mediated the association between a vaginal delivery induced by drugs and a planned cesarean section and mother-infant-bonding and between a vaginal delivery induced by drugs, an operative vaginal delivery, and planned cesarean section and father-infant-bonding. At 14 months postpartum, birth experience mediated the association between a vaginal delivery induced by drugs, operative vaginal delivery, and planned cesarean section and parent-infant-bonding in both parents. CONCLUSIONS The results emphasize the importance of the birth experience for parent-infant-bonding in both mothers and fathers. Further research should address the mechanisms by which parents with an unplanned cesarean section establish stronger parent-infant-bonding compared to parents whose baby was delivered via spontaneous vaginal delivery, despite their overall more negative birth experiences.
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Affiliation(s)
- Svenja Döblin
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Lara Seefeld
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine TU Dresden, Dresden, Germany
| | - Victoria Weise
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susanne Knappe
- Evangelische Hochschule Dresden (Ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Eva Asselmann
- Faculty of Health, HMU Health and Medical University, Potsdam, Germany
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
- Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany.
- Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway.
- Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
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Parental anxiety and offspring development: A systematic review. J Affect Disord 2023; 327:64-78. [PMID: 36740142 DOI: 10.1016/j.jad.2023.01.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Parental anxiety has been associated with increased risk of emotional and behavioural problems for offspring, yet the differing impact of each parent is unclear. As emotional disorders continue to present a significant challenge to the health system and with the role of mothers and fathers changing over the past two decades, we sought to systematically review the available literature for an association between parental anxiety and offspring suboptimal outcomes. METHODS A systematic review was conducted using the following databases: Ovid MEDLINE, Embase; PsycINFO and Google Scholar. Reference lists of the included papers were also searched. Data was analysed and grouped based on offspring age. RESULTS Eighteen studies were included in this review. Results suggest that both parents' mental health can impact negatively on the functioning of offspring, during infancy, childhood, and adolescence. This association is weak in infancy, with equivocal results, however the association in childhood appears robust for both mothers and fathers. In adolescence, the findings suggest that maternal anxiety may be more influential than paternal anxiety. LIMITATIONS As the methodology of the included studies was heterogenous, and the timing of assessment varied across the papers, drawing concrete conclusions from the existing research is somewhat impaired. CONCLUSIONS Both mothers' and fathers' anxiety have the propensity to negatively impact on their child's development. Implementing preventative interventions, which include both parents, as well as systemic interventions, which include the whole family, are essential in stemming the intergenerational transmission of mental health problems within families.
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Zacher M, Wollanka N, Sauer C, Haßtenteufel K, Wallwiener S, Wallwiener M, Maatouk I. Prenatal paternal depression, anxiety, and somatic symptom burden in different risk samples: an explorative study. Arch Gynecol Obstet 2023; 307:1255-1263. [PMID: 35608702 PMCID: PMC10023642 DOI: 10.1007/s00404-022-06612-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/04/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE Growing evidence implies that transition to parenthood triggers symptoms of mental burden not only in women but likewise in men, especially in high-risk pregnancies. This is the first study that examined and compared the prevalence rates of depression, anxiety, and somatic symptom burden of expectant fathers who face different risk situations during pregnancy. METHODS Prevalence rates of paternal depression (Edinburgh postnatal depression scale), anxiety (generalized anxiety disorder seven), and somatic symptom burden (somatic symptom scale eight) were examined in two risk samples and one control group in the third trimester of their partners' pregnancy: risk sample I (n = 41) consist of expectant fathers whose partners were prenatally hospitalized due to medical complications; risk sample II (n = 52) are fathers whose partners were prenatally mentally distressed; and control group (n = 70) are those non-risk pregnancies. RESULTS On a purely descriptive level, the data display a trend of higher symptom burden of depression, anxiety, and somatic symptoms in the two risk samples, indicating that expectant fathers, whose pregnant partners were hospitalized or suffered prenatal depression, were more prenatally distressed. Exploratory testing of group differences revealed an almost three times higher prevalence rate of anxiety in fathers whose partner was hospitalized (12.2%) compared to those non-risks (4.3%). CONCLUSION Results underline the need for screening implementations for paternal prenatal psychological distress, as well as specific prevention and treatment programs, especially for fathers in risk situations, such as their pregnant partners' prenatal hospitalization. The study was registered with the German clinical trials register (DRKS00020131) on 2019/12/09.
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Affiliation(s)
- Magdalena Zacher
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Nele Wollanka
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Christina Sauer
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Kathrin Haßtenteufel
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Stephanie Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Markus Wallwiener
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
| | - Imad Maatouk
- Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian University Würzburg, Würzburg, Germany.
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J Henshaw E, Cooper M, Wood T, N Doan S, Krishna S, Lockhart M. Psychosocial predictors of early postpartum depressive and anxious symptoms in primiparous women and their partners. BMC Pregnancy Childbirth 2023; 23:209. [PMID: 36973695 PMCID: PMC10041514 DOI: 10.1186/s12884-023-05506-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND While the majority of research on postpartum depressive and anxious symptoms has focused on mothers, a growing body of research suggests a need to understand the role of the partner's health and relationship quality as predictors of postpartum maternal depression, while also better understanding correlates of partner or paternal depression in the postpartum period. The purpose of the current study is to evaluate mother and partner stress, anxiety, mood, infant care support, and relationship quality as predictors of perinatal depressive and anxious symptoms in first time mothers and partners during the postpartum hospital stay. METHODS First time parent couples (n = 116) completed a survey during the two-day postpartum stay in a Midwest hospital. Depressive (EPDS) and anxiety symptoms (DASS-21-Anxiety) were assessed in both mothers and partners. Hierarchical linear regression was used to evaluate relationship satisfaction, partner infant care support, stress, and co-parent mood as predictors of mood in mothers and partners separately. RESULTS Stress was a predictor of anxiety and depression symptoms in both mothers and partners. Additionally, co-parent anxiety significantly predicted anxiety in both mothers and partners. Maternal relationship satisfaction was a predictor of the partner's depressive symptoms, and maternal perceptions of partner infant support predicted maternal depressive symptoms. CONCLUSIONS Together, these results suggest that stress, relationship satisfaction, and co-parent mood are related to depressive and anxious symptoms in mothers and partner, underscoring the need to continue exploring mother and partner mental health in a dyadic framework.
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Affiliation(s)
- Erin J Henshaw
- Department of Psychology, Denison University, 100 W. College St, Granville, OH, 43023, USA.
| | - Marie Cooper
- Riverside Methodist Hospital, OhioHealth, 3535 Olentangy River Rd., Columbus, OH, 43214, USA
| | - Teresa Wood
- Nursing Operations, OhioHealth, Columbus, USA
| | - Stacey N Doan
- Claremont McKenna College, 888 N. Columbia Ave, Claremont, CA, 91711, USA
| | - Sanchita Krishna
- OhioHealth Research Institute, 3535 Olentangy River Rd, Columbus, OH, 43214, USA
| | - Marie Lockhart
- OhioHealth Research Institute, 3535 Olentangy River Rd, Columbus, OH, 43214, USA
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12
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Baldoni F, Agostini F, Terrone G, Casu G, Giannotti M. A Psychometric Study of the Perinatal Assessment of Maternal Affectivity (PAMA) for the Screening of Perinatal Affective Disorders in Mothers. Healthcare (Basel) 2023; 11:healthcare11060907. [PMID: 36981563 PMCID: PMC10048133 DOI: 10.3390/healthcare11060907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/13/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Recently, empirical evidence from perinatal studies has led researchers to pay more attention to fathers. The need to evaluate male suffering led at first to using the same screening tools developed for mothers. However, these instruments present validity concerns with fathers, and today the need to assume a gender-based perspective is clear. The Perinatal Assessment of Paternal Affectivity (PAPA) is a self-reported questionnaire for the screening of a variety of psychological and behavioral dimensions related to affectivity as experienced by fathers during the perinatal period. In the present study, the psychometric properties of the maternal version of the scale (Perinatal Assessment of Maternal Affectivity; PAMA) were examined. The study, based on 225 mothers and their partners (n = 215), used a cross-sectional design with a single assessment at the third trimester of pregnancy. Results indicated a one-factor structure for a seven-item version of the PAMA, which showed adequate internal consistency reliability and was associated in the expected direction with other clinically relevant variables (depression, psychological distress, perceived stress and dyadic adjustment). The findings suggest the usefulness of developing gender sensitive screening tools for the detection of perinatal affective disorders.
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Affiliation(s)
- Franco Baldoni
- Department of Psychology, University of Bologna, 40127 Bologna, Italy
| | | | - Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giulia Casu
- Department of Psychology, University of Bologna, 40127 Bologna, Italy
| | - Michele Giannotti
- Department of Psychology and Cognitive Sciences, University of Trento, 38068 Trento, Italy
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13
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Challacombe FL, Pietikäinen JT, Kiviruusu O, Saarenpää-Heikkilä O, Paunio T, Paavonen EJ. Paternal perinatal stress is associated with children's emotional problems at 2 years. J Child Psychol Psychiatry 2023; 64:277-288. [PMID: 36215991 PMCID: PMC10092317 DOI: 10.1111/jcpp.13695] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Paternal mental health in pregnancy and postpartum has been increasingly highlighted as important both in its own right, but also as crucial for the development of children. Rates of help-seeking among fathers is low, possibly due to conceptualising their own difficulties as stress rather than problems with mood. The relationship between paternal stress and child outcomes has not been investigated. METHODS This study used data from the Finnish CHILD-SLEEP birth cohort. Data were available for 901 fathers and 939 mothers who completed questionnaires on demographics, stress, anxiety and depression at 32 weeks gestation, 3 months, 8 months and 24 months postpartum. Parental report of child emotional and behavioural problems was collected at 24 months. RESULTS Around 7% of fathers experienced high stress (over 90% percentile) at each timepoint measured in the perinatal period, rising to 10% at 2 years postpartum. Paternal stress measured antenatally, at 3 and 24 months was associated with child total problems at 24 months, while paternal depression and anxiety were not related to child outcomes when in the same model. After adjusting for concurrent maternal depression, anxiety and stress, an association remained between paternal stress at each timepoint and child total problem scores at 24 months. The strongest association was with paternal stress at 3 months (OR 3.17; 95% CI 1.63-6.16). There were stronger relationships between paternal stress and boys' rather than girls' total problem scores, although the interactions were not statistically significant. CONCLUSIONS Paternal stress is an important manifestation of perinatal distress and is related to child mental health, particularly when present in the early postpartum months. Paternal stress should therefore be assessed in the perinatal period, which presents opportunities for early intervention and prevention of difficulties for both father and child.
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Affiliation(s)
| | - Johanna T Pietikäinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Olli Kiviruusu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Outi Saarenpää-Heikkilä
- Pediatric Clinics, Tampere University Hospital, Tampere, Finland.,Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Tiina Paunio
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - E Juulia Paavonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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14
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Mental health as a family experience: Relationship of paternal characteristics with maternal perinatal depressive symptoms in a matched sample. Arch Womens Ment Health 2023; 26:135-139. [PMID: 35982295 DOI: 10.1007/s00737-022-01254-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/03/2022] [Indexed: 11/02/2022]
Abstract
The present study investigates the relationship between perinatal maternal depressive symptoms and paternal factors using linked maternal-paternal survey data. From October 2018 to July 2019, among a representative sample and 2-6 months following the birth of an infant, mothers and fathers completed surveys and reported depressive symptoms. Results from the linked dyadic data (n = 243) show the prevalence of maternal depressive symptoms, both overall (16%) and by marital status and paternal health care involvement. Viewing mental health as a family experience may further understanding of postpartum maternal mental illness.
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15
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The social predictors of paternal antenatal mental health and their associations with maternal mental health in the Queensland Family Cohort prospective study. Arch Womens Ment Health 2023; 26:107-116. [PMID: 35984501 PMCID: PMC9908725 DOI: 10.1007/s00737-022-01257-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 08/04/2022] [Indexed: 11/02/2022]
Abstract
Antenatal depression (AND) affects 1 in 10 fathers, potentially negatively impacting maternal mental health and well-being during and after the transition to parenthood. However, few studies have assessed the social predictors of paternal AND or their possible associations with maternal mental health. We analysed data from 180 couples participating in the Queensland Family Cohort longitudinal study. Both parents completed surveys measuring mental health, relationship quality, social support, and sleep quality at 24 weeks of pregnancy. Mothers also completed the same surveys 6 weeks' postpartum. Antenatal depression, stress, and anxiety were highest among fathers reporting lower social support and higher sleep impairment. Maternal AND, stress, and anxiety were higher among mothers reporting higher physical pain and poor sleep quality. Postnatally, mothers reporting lower social support also reported higher depression, anxiety, stress, and psycho-social well-being. While there were no significant associations between AND among fathers and maternal antenatal or postnatal depression, an exploratory analysis revealed that mothers whose partners reported lower antenatal social support also reported lower postnatal social support and higher postnatal depression. Our findings highlight the importance of including data among fathers to achieve a whole family approach to well-being during the transition to parenthood.
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16
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An Evidence-Based Project to Improve Paternal Postpartum Depression. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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17
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Relações entre a saúde mental e a conjugalidade de gestantes primíparas. PSICO 2022. [DOI: 10.15448/1980-8623.2022.1.38230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Este estudo avaliou as relações entre variáveis sociodemográficas, saúde mental da mulher e conjugalidade durante a gestação. Participaram desta pesquisa correlacional 50 mulheres primíparas, que coabitavam com o genitor do bebê e que estavam no segundo ou terceiro trimestre de gestação do primeiro filho. Os sintomas de transtornos mentais comuns foram avaliados pelo Self-Reporting Questionnaire (SRQ-20) e os sintomas depressivos pelo Inventário Beck de Depressão (BDI-I). A conjugalidade foi avaliada com a Escala de Ajustamento Diádico. Os resultados de testes de correlação e de comparação de grupos mostraram que a presença de sintomas de transtornos mentais comuns e de depressão esteve associada a menor nível de ajustamento diádico. Discute-se a importância de identificar problemas na saúde mental da mulher e no ajustamento diádico durante a gestação, para favorecer o bem-estar da tríade mãe-pai-bebê na transição para a parentalidade.
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18
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Jen WH, Hung TH, Chen CY, Tsai YF. Validity and Reliability of the Chinese Version of the Edinburgh Postnatal Depression Scale for Fathers of Newborns. Am J Mens Health 2022; 16:15579883221138191. [PMID: 36411977 PMCID: PMC9703513 DOI: 10.1177/15579883221138191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Studies often use the Edinburgh Postnatal Depression Scale (EPDS) or the Beck Depression Inventory-II (BDI-II) as a screening tool for depression in new mothers or fathers following the birth of an infant, but no studies have evaluated EPDS as a predictor of postnatal depression for new fathers in a Chinese population. This study aimed to test the validity and reliability of a Chinese version of the EPDS for fathers of newborns in Taiwan. The study included 368 parents with newborns ≤2 months of age and without any health problems. Construct and criterion-related validities were assessed and Cronbach's alpha was used for measuring internal consistency reliability. The receiver operating characteristic (ROC) curve analyzed the optimal cutoff score for the EPDS. Scores for the Chinese EPDS were significantly higher for fathers who were >34 years of age, employed in a professional occupation, and participated in feeding their infant (p < .05). Mean scores among the fathers for the EPDS and BDI-II were significantly correlated (r = .64, p < .001). The Cronbach's alpha was .83 for the EPDS; ROC curve analysis revealed the optimal cutoff of the EPDS was ≥8 points and the area under the ROC curve was 0.91. The EPDS had good validity and reliability and should therefore be considered suitable for the evaluation of postnatal depression in fathers of newborn infants in Taiwan.
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Affiliation(s)
- Wei-Hsuan Jen
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Tai-Ho Hung
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan,Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Yen Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan,Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Yun-Fang Tsai
- Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan,School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan,Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan,Yun-Fang Tsai, RN, PhD, FAAN, School of Nursing, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road Tao-Yuan, 333, Taiwan.
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19
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Baldoni F, Giannotti M, Casu G, Agostini F, Mandolesi R, Peverieri S, Ambrogetti N, Spelzini F, Caretti V, Terrone G. The Perinatal Assessment of Paternal Affectivity (PAPA): Italian validation of a new tool for the screening of perinatal depression and affective disorders in fathers. J Affect Disord 2022; 317:123-130. [PMID: 36028014 DOI: 10.1016/j.jad.2022.08.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 08/05/2022] [Accepted: 08/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Questionnaires for the screening of paternal perinatal psychological distress are based on clinical manifestations expressed by women, showing limitations in capturing the wide array of signs and symptoms exhibited by men. The current study aimed to validate the Perinatal Assessment of Paternal Affectivity, a new self-report tool for the screening of paternal depressive and affective disorder. METHOD This study used a cross-sectional design with a 3-month test-retest, involving respectively 385 (T1) and a sub-sample of 111(T2) fathers. Confirmatory factor analysis (CFA) was performed to test structural validity and concurrent validity was assessed by Spearman correlations. We assessed reliability using McDonald's ω and ordinal alpha. Group differences in PAPA scores based on sociodemographic were also tested. RESULTS The CFA reported a one factor structure as the optimal solution. The PAPA also showed adequate reliability and internal consistency as well as acceptable test-retest indices. Concurrent validity was confirmed by significant correlations between PAPA total score and standardized test scores. Non-Italian fathers and fathers who experienced recent stressful life events reported higher PAPA scores. LIMITATIONS Our sample was not homogeneous in terms of nationality and most of the participants, were from Northern Italy. Some risk factors associated with paternal parental psychological distress (e.g., unplanned pregnancy) have not been considered. CONCLUSION This study provides initial evidence of validity and reliability of the PAPA as a brief and sensitive screening tool to detect signs and symptoms of paternal affective disorder during both prenatal and postnatal period.
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Affiliation(s)
- F Baldoni
- Department of Psychology, University of Bologna, Italy
| | - M Giannotti
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy.
| | - G Casu
- Department of Psychology, University of Bologna, Italy
| | - F Agostini
- Department of Psychology, University of Bologna, Italy
| | - R Mandolesi
- Department of Psychology, University of Bologna, Italy
| | - S Peverieri
- Department of Psychology, University of Bologna, Italy
| | - N Ambrogetti
- Department of Psychology, University of Bologna, Italy
| | - F Spelzini
- Operative Unit of Obstetrics and Gynecology, Rimini Hospital, AUSL Romagna, Rimini, Italy
| | | | - G Terrone
- University of Rome Tor Vergata, Rome, Italy
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20
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Motrico E, Moreno‐Peral P, Uriko K, Hancheva C, Brekalo M, Ajaz E, Apter G, Bramante A, Conejo‐Cerón S, Christoforou A, Dikmen‐Yildiz P, Evagorou O, Fonseca A, Lupattelli A, Radoš SN, al Maach N, Rodriguez‐Muñoz MF, Žutić M, Lambregtse ‐ van den Berg MP. Clinical practice guidelines with recommendations for peripartum depression: A European systematic review. Acta Psychiatr Scand 2022; 146:325-339. [PMID: 35838293 PMCID: PMC9805017 DOI: 10.1111/acps.13478] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/16/2022] [Accepted: 07/12/2022] [Indexed: 01/29/2023]
Abstract
OBJECTIVE This study aims to systematically review all Clinical Practice Guidelines (CPGs) with recommendations for peripartum depression in European countries. METHODS A systematic review according to the PRISMA statement was conducted. CPGs focussing on peripartum depression or with at least one specific recommendation for peripartum depression from European countries were selected. Searching was conducted in electronic databases (MEDLINE and PsycINFO), and by contacting professional societies and international experts until November 24th, 2021. Characteristics of the included CPGs and their recommendations were extracted. A methodological quality assessment was conducted using the AGREE-II tool. RESULTS A total of 239 records were identified after duplicate removal. Of these, 54 were examined for full-text inspection. The final selection yielded 14 CPGs from 11 European countries in 10 languages. Of them, 11 provided recommendations on pharmacological treatments, 10 on psychological treatment (e.g., cognitive-behavioural therapy), 10 on screening, 8 on diagnosis, 6 on other treatments (e.g., physical exercise), 5 on prevention, and 5 other recommendations (e.g., provide information). Regarding the overall methodological quality, only five (35.7%) guidelines were rated as of adequate quality, reaching a score ≥ 70% in the overall assessment of the AGREE-II instrument. Of the six AGREE-II domains, applicability scored the lowest and clarity of presentation scored the highest. CONCLUSION The absence of CPGs in most European countries, the discrepancy in recommendations and the low methodological quality of the guidelines may lead to disparities and inequalities in peripartum depression management in Europe. The COST Action Riseup-PPD highlights key considerations for future guideline developers.
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Affiliation(s)
- Emma Motrico
- Department of PsychologyUniversidad Loyola AndaluciaSevilleSpain
| | | | - Kristiina Uriko
- Department of Psychology and Behavioural SciencesTallinn UniversityEstonia
| | | | | | - Erilda Ajaz
- Department of Education Sciences and PsychologyBeder College UniversityTiranaAlbania
| | - Gisele Apter
- Perinatal and Child Psychiatry, Le Havre HospitalNormandie University RouenFrance
| | | | | | - Andri Christoforou
- Department of Social and Behavioral SciencesEuropean University CyprusNicosiaCyprus
| | | | - Olympia Evagorou
- Department of Psychiatry, Medical SchoolDemocritus University of ThraceAlexandroupolisGreece
| | - Ana Fonseca
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC)University of CoimbraCoimbraPortugal
| | | | | | - Nadia al Maach
- Department of Psychiatry and Child and Adolescent PsychiatryErasmus University Medical Center RotterdamRotterdamThe Netherlands
| | | | - Maja Žutić
- Catholic University of CroatiaZagrebCroatia
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21
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Dhillon HS, Sasidharan S, Dhillon GK, Babitha M. Paternal depression: "The silent pandemic". Ind Psychiatry J 2022; 31:350-353. [PMID: 36419706 PMCID: PMC9678161 DOI: 10.4103/ipj.ipj_236_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 06/08/2021] [Accepted: 11/12/2021] [Indexed: 11/04/2022] Open
Abstract
Maternal mental health during and after pregnancy is a well researched entity. However, father's mental health during the same period and even while raising the children has not been given due consideration. Recent studies have tried to explore the prevalence, risk factors, symptoms and implications of paternal depression on the children, marriage and the whole family. In this short communication, we aim to bring to the fore the recommendations for prevention and management of paternal depression.
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Affiliation(s)
- Harpreet Singh Dhillon
- Department of Psychiatry, Command Hospital, Western Command, Chandimandir, Haryana, India
| | - Shibu Sasidharan
- Department of Anaesthesiology and Critical Care, Command Hospital, Western Command, Chandimandir, Haryana, India
| | - Gurpreet Kaur Dhillon
- Department of Paediatrics, Command Hospital, Western Command, Chandimandir, Haryana, India
| | - M Babitha
- Department of Radio-Diagnosis, Ojas Hospital, Panchkula, Haryana, India
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22
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Smythe KL, Petersen I, Schartau P. Prevalence of Perinatal Depression and Anxiety in Both Parents: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2218969. [PMID: 35749112 PMCID: PMC9233234 DOI: 10.1001/jamanetworkopen.2022.18969] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
IMPORTANCE New and expectant parents experience perinatal mood disorders, with consequences to parenting ability, bonding with the neonate, interpersonal relationships, and health and well-being of parents. Research shows that maternal and paternal perinatal mood disorders are associated, but no recent systematic review has addressed the prevalence of perinatal mood disorders in both mothers and fathers (parental dyad). OBJECTIVE To examine the prevalence of perinatal mood disorders in parental dyads and identify factors associated with perinatal mood disorders in parental dyads. DATA SOURCES Ovid (MEDLINE, Embase, and PsycINFO) and Web of Science were searched from January 1, 1990, to June 8, 2021, for observational studies reporting on the prevalence of perinatal depression or anxiety in a parental dyad. STUDY SELECTION Studies reporting the prevalence of anxiety or depression in both members of a parental dyad were included, with diagnosis according to established criteria (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition], International Classification of Diseases, 11th Revision) or use of validated screening tools. DATA EXTRACTION AND SYNTHESIS Prevalence data were extracted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were analyzed in subgroups: antenatal depression, early postnatal depression (0-12 weeks), late postnatal depression (3-12 months), and perinatal anxiety. Pooled prevalence was calculated using a random-effects meta-analysis model. Quality assessment was performed using Joanna Briggs Institute Appraisal Checklist for Studies Reporting Prevalence Data. Data were analyzed in June 2021. MAIN OUTCOMES AND MEASURES Prevalence of perinatal anxiety and perinatal depression in parental dyads. RESULTS Twenty-three studies were included, with data from 29 286 couples. The pooled prevalence of antenatal depression in both parents was 1.72% (95% CI, 0.96%-2.48%; P < .001). The prevalence of early postnatal depression (up to 12 weeks post partum) was 2.37% (95% CI, 1.66%-3.08%; P < .001) and the prevalence of late postnatal depression (3-12 months post partum) was 3.18% (95% CI, 2.3-4.05; P < .001). Only 3 studies reported on perinatal anxiety in both parents, precluding a quantitative analysis. CONCLUSIONS AND RELEVANCE In up to 3.18% of couples, both parents may concurrently experience perinatal depression. Perinatal health care must consider the mental health needs of parents, both as individuals and as a parental dyad. Further research is needed to examine outcomes in families where both parents experience perinatal mood disorders.
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Affiliation(s)
- Kara L Smythe
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Irene Petersen
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Patricia Schartau
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
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Höflich A, Kautzky A, Slamanig R, Kampshoff J, Unger A. Depressive symptoms as a transdiagnostic mediator of mother-to-infant bonding: Results from a psychiatric mother-baby unit. J Psychiatr Res 2022; 149:37-43. [PMID: 35219874 DOI: 10.1016/j.jpsychires.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/31/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
Maternal symptoms of depression can interfere with the establishment of healthy mother-infant-bonding, which negatively affects developmental trajectories of the child and maternal wellbeing. However, current evidence about the effects of treatment in severely affected women is still lacking and the transdiagnostic prognostic value of depressive symptoms is not fully clear. Therefore, a naturalistic clinical sample of 140 mother-infant-dyads in inpatient treatment at a mother-baby-unit was analyzed with instruments being administered at admission and before dismissal. Linear mixed effects models were calculated in order to assess the longitudinal influence of scores on the Edingburgh Postpartum Depression Scale (EPDS) on post-partum-bonding measured with the postpartum bonding questionnaire (PBQ). Furthermore, interaction-effects with psychiatric diagnosis of the mothers (depression vs. psychosis) and their partners were assessed. Successful treatment of depressive symptoms was paralleled by a significant decrease of impaired bonding, with only 6.4% of the women having PBQ total scores above cut-off at discharge. Overall, higher scores on the EPDS were associated with a significantly poorer outcome on the PBQ (p = < 0.001), irrespective of diagnosis (p = 0.93). Importantly, there was an interaction effect of EPDS and a psychiatric diagnosis of the partner on the PBQ (p = 0.017). Thus, our results further emphasize the significance of postpartum symptoms of depression for mother-child bonding, which can be effectively improved by comprehensive treatment even in severely affected women. Optimizing treatment and diagnostics as early as possible and enabling access for all women must become a priority.
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Affiliation(s)
- A Höflich
- Medical University of Vienna, Department of Psychiatry and Psychotherapy, Division of Social Psychiatry, Austria.
| | - A Kautzky
- Medical University of Vienna, Department of Psychiatry and Psychotherapy, Division of Social Psychiatry, Austria
| | - R Slamanig
- Anton Proksch Institute, Vienna, Austria
| | - J Kampshoff
- Medical University of Vienna, Department of Psychiatry and Psychotherapy, Division of Social Psychiatry, Austria
| | - A Unger
- Medical University of Vienna, Department of Psychiatry and Psychotherapy, Division of Social Psychiatry, Austria
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24
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Jewell JS, Farewell CV, Walls J, Brooks-Russell A, Dempsey A, Leiferman JA. Parents' Mental Health Experiences during the Perinatal Transition: A Qualitative Study. Issues Ment Health Nurs 2022; 43:323-329. [PMID: 34529532 DOI: 10.1080/01612840.2021.1975329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Capturing the voices of both parents regarding perinatal mental health is imperative. This qualitative study employed a purposive sampling technique to interview 23 individuals, including mothers, partners, and perinatal practitioners/educators. Qualitative data analysis utilized an inductive, data-driven approach. Four themes emerged. First, mothers' perception of risk of postpartum depression (PPD) changed over time and with subsequent children. Theme two focused on identity loss. Third, the stay-at-home parent often feels unrecognized by their partner. Fourth, a PPD prevention class for parents should include certain key elements. These themes can aid practitioners in prioritizing the needs of parents during the perinatal period.
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Affiliation(s)
- Jennifer S Jewell
- Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA
| | - Charlotte V Farewell
- Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA
| | - Jessica Walls
- Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA
| | | | - Allison Dempsey
- Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jenn A Leiferman
- Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA
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Genova F, Neri E, Trombini E, Stella M, Agostini F. Severity of preterm birth and perinatal depressive symptoms in mothers and fathers: Trajectories over the first postpartum year. J Affect Disord 2022; 298:182-189. [PMID: 34728282 DOI: 10.1016/j.jad.2021.10.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 10/12/2021] [Accepted: 10/23/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Preterm birth has been recognized as a risk factor for perinatal depression (PND), with consequences for parenting and child development; however, the impact of severity of prematurity on parental PND course has not been studied extensively. Exploring the PND trajectory across postpartum period, investigating whether it changed according to birth weight and parental role, can help developing effective interventions. METHODS At 3 (T1), 9 (T2) and 12 (T3) months postpartum, the Edinburgh Postnatal Depression Scale (EPDS) was administered to 177 parental couples, differentiated in 38 parents of extremely low birth weight (ELBW), 56 of very low birth weight (VLBW) and 83 of full-term (FT) infants. Trajectories were modeled by Growth Curve Models. RESULTS As a function of time, results revealed a general decrease in PND across the year. Considering birth weight, ELBW parents showed higher PND levels at T1 and a higher reduction of symptoms over time than VLBW and FT ones. Given also parental role, ELBW mothers showed higher PND levels at T1 and a higher decrease of symptoms over time than VLBW and FT mothers and fathers. LIMITATIONS Limitations included modest sample size, self-report measures, and unmeasured potential confounders. CONCLUSION Findings suggest that premature birth in relation to its severity may lead to different affective reactions in mothers and fathers; particularly mothers, in case of more serious preterm condition, are at higher risk for PND in the first trimester, however showing improvement over time. Interventions should be promoted, and tailored, according to the risk connected to severity of prematurity.
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Affiliation(s)
- Federica Genova
- Department of Psychology "Renzo Canestrari", University of Bologna, Carlo Berti Pichat Road, 5, 40127 Bologna, Italy.
| | - Erica Neri
- Department of Psychology "Renzo Canestrari", University of Bologna, Carlo Berti Pichat Road, 5, 40127 Bologna, Italy
| | - Elena Trombini
- Department of Psychology "Renzo Canestrari", University of Bologna, Carlo Berti Pichat Road, 5, 40127 Bologna, Italy
| | - Marcello Stella
- Paediatric and Neonatal Intensive Care Unit, Maurizio Bufalini Hospital, Cesena, Italy
| | - Francesca Agostini
- Department of Psychology "Renzo Canestrari", University of Bologna, Carlo Berti Pichat Road, 5, 40127 Bologna, Italy
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Lau Y, Yen KY, Wong SH, Cheng JY, Cheng LJ. Effect of digital cognitive behavioral therapy on psychological symptoms among perinatal women in high income-countries: A systematic review and meta-regression. J Psychiatr Res 2022; 146:234-248. [PMID: 34774299 DOI: 10.1016/j.jpsychires.2021.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/11/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Abstract
Several reviews focused on the use of digital cognitive behavioral therapy (CBT) across different populations. This review synthesized randomized controlled trials (RCTs) that evaluated the effectiveness of digital CBT on psychological symptoms (depression, anxiety, and stress symptoms). An extensive search was conducted in 10 databases from inception until August 29, 2021. A meta-analysis using a random-effects model was performed using Hedges' g. The potential sources of heterogeneity were explored through subgroup analyses and meta-regression analysis. A total of 18 RCTs in 2514 perinatal women were identified from over 23 countries. The sample size ranged from 25 to 910. Meta-analyses showed that digital CBT significantly reduced depression (g = -0.56, 95% CI: -0.85, -0.27, I2 = 84.81%, p < 0.001), anxiety (g = -0.30, 95% CI: -0.44, -0.17, I2 = 0%, p < 0.001), and stress (g = -0.75, 95% CI: -0.95, -0.56, I2 = 0%, p < 0.001) symptoms at post-intervention and stress symptoms at follow-up (g = -0.52, 95% CI: -0.93, -0.11, I2 = 0%, p = 0.01) compared with those in the control group. Subgroup analyses highlighted that the intervention was effective when CBT was combined with other therapeutic components which delivered via a mobile application. Preferable features of intervention should be more than eight sessions and conducted for than 6 weeks among postnatal women. Multivariable meta-regression showed that age was a significant covariate on depression symptoms. The sample size in the selected RCTs was small, and the overall quality of the evidence was very low. Digital CBT is a potential intervention for alleviating psychological outcomes in perinatal women. This review suggests the essential features to optimize the intervention effect. Further well-designed RCTs with large sample sizes are necessary.
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Affiliation(s)
- Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Kai Yoong Yen
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Sai Ho Wong
- Alexandra Hospital, National University Health System, Singapore.
| | - Jing Ying Cheng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ling Jie Cheng
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Filippetti ML, Clarke ADF, Rigato S. The mental health crisis of expectant women in the UK: effects of the COVID-19 pandemic on prenatal mental health, antenatal attachment and social support. BMC Pregnancy Childbirth 2022; 22:68. [PMID: 35081906 PMCID: PMC8790719 DOI: 10.1186/s12884-022-04387-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/04/2022] [Indexed: 12/14/2022] Open
Abstract
Background Pregnancy has been shown to be times in a woman’s life particularly prone to mental health issues, however a substantial percentage of mothers report subclinical perinatal mental health symptoms that go undetected. Experiences of prenatal trauma, such as the COVID-19 pandemic, may exacerbate vulnerability to negative health outcomes for pregnant women and their infants. We aimed to examine the role of: 1) anxiety, depression, and stress related to COVID-19 in predicting the quality of antenatal attachment; 2) perceived social support and COVID-19 appraisal in predicting maternal anxiety and depression. Methods A sample of 150 UK expectant women were surveyed during the COVID-19 pandemic. Questions included demographics, pregnancy details, and COVID-19 appraisal. Validated measures were used to collect self-reported maternal antenatal attachment (MAAS), symptoms of anxiety (STAI), depression (BDI-II), and stress related to the psychological impact of COVID-19 (IES-r). Results We found that the pandemic has affected UK expectant mothers’ mental health by increasing prevalence of depression (47%), anxiety (60%) and stress related to the psychological impact of COVID-19 (40%). Women for whom COVID-19 had a higher psychological impact were more likely to suffer from depressive (95% HDPI = [0.04, 0.39]) and anxiety symptoms (95% HPDI = [0.40, 0.69]). High depressive symptoms were associated with reduced attachment to the unborn baby (95% HPDI [-0.46, -0.1]). Whilst women who appraised the impact of COVID-19 to be more negative showed higher levels of anxiety (HPDI = [0.15, 0.46]), higher social support acted as a protective factor and was associated with lower anxiety (95% HPDI = [-0.52, -0.21]). Conclusions The current findings demonstrate that direct experience of prenatal trauma, such as the one experienced during the COVID-19 pandemic, significantly amplifies mothers’ vulnerability to mental health symptoms and impairs the formation of a positive relationship with their unborn baby. Health services should prioritise interventions strategies aimed at fostering support for pregnant women. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04387-7.
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Affiliation(s)
- Maria Laura Filippetti
- Centre for Brain Science, Department of Psychology, University of Essex, Colchester, UK.
| | - Alasdair D F Clarke
- Centre for Brain Science, Department of Psychology, University of Essex, Colchester, UK
| | - Silvia Rigato
- Centre for Brain Science, Department of Psychology, University of Essex, Colchester, UK
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Rodrigues AL, Ericksen J, Watson B, Gemmill AW, Milgrom J. Interventions for Perinatal Depression and Anxiety in Fathers: A Mini-Review. Front Psychol 2022; 12:744921. [PMID: 35126228 PMCID: PMC8810528 DOI: 10.3389/fpsyg.2021.744921] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 12/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background and Objectives Up to 10% of fathers experience perinatal depression, often accompanied by anxiety, with a detrimental impact on the emotional and behavioural development of infants. Yet, few evidence-based interventions specifically for paternal perinatal depression or anxiety exist, and few depressed or anxious fathers engage with support. This mini-review aims to build on the evidence base set by other recent systematic reviews by synthesising more recently available studies on interventions for paternal perinatal depression and anxiety. Secondarily, we also aimed to identify useful information on key implementation strategies, if any, that increase the engagement of men. Methods We drew upon three major previous systematic reviews and performed an updated search of PubMed/Medline; Psycinfo; Cochrane Database; Embase and Cinahl. The search was limited to trials, feasibility studies or pilot studies of interventions published between 2015 and 2020 that reported on fathers' perinatal mental health. We included psychological, educational, psychosocial, paternal, couple-focused, or group therapies, delivered face-to-face, via telephone and/or online that reported on either paternal depression, anxiety or both. Results Eleven studies satisfied search criteria (5 of which were not included in previous reviews). The majority were randomised controlled trials. Most interventions incorporated counselling, therapy or psychoeducation and took an indirect approach to perinatal mental health through antenatal or postnatal education and were couple-focused. No studies reported a presence of diagnosed depression or anxiety at baseline, although five studies reported a positive effect on sub-threshold symptoms. Discussion There was some evidence that these approaches may be useful in the initial engagement of fathers with perinatal supports and improve depression and anxiety scores. No studies targeted the explicit treatment of clinically depressed or anxious men, and this remains the most substantial gap in the peer-reviewed evidence base. Our results highlight the need to deliver perinatal interventions specifically designed for men and evaluate them in populations with clinical levels of depressive and anxious symptomatology.
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Affiliation(s)
- Andre L. Rodrigues
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Jennifer Ericksen
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Brittany Watson
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Alan W. Gemmill
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Heidelberg Repatriation Hospital, Heidelberg Heights, VIC, Australia
- University of Melbourne School of Psychological Sciences, Parkville, VIC, Australia
- *Correspondence: Jeannette Milgrom
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Stefana A, Biban P, Padovani EM, Lavelli M. Fathers' experiences of supporting their partners during their preterm infant's stay in the neonatal intensive care unit: a multi-method study. J Perinatol 2022; 42:714-722. [PMID: 34471215 PMCID: PMC8409081 DOI: 10.1038/s41372-021-01195-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 08/07/2021] [Accepted: 08/20/2021] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To explore how the fathers experience their role as a support for their partner and the relationship with them during their preterm infant's stay in the NICU. STUDY DESIGN Multi-method longitudinal study involving ethnographic observation, semi-structured interviews, self-report questionnaires, and clinical information. Twenty fathers of preterm infants hospitalized in a level-III-NICU were included. Data were analyzed using thematic continent analysis. RESULTS Three main themes were identified: support for mother (subthemes: putting mother's and infant's needs first; hiding worries and negative emotions; counteracting the sense of guilt; fear that the mother would reject the child), mother's care for the infant (subthemes: observing mother engaged in caregiving; mother has "something extra"), and couple relationship (subthemes: collaboration; bond). CONCLUSION Fathers supporting their partners during the stay in the NICU experience emotional distress and the need for being supported that often are hidden. This demands a great deal of emotional and physical energy.
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Affiliation(s)
| | - Paolo Biban
- grid.411475.20000 0004 1756 948XNeonatal and Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital of Verona, Verona, Italy
| | - Ezio Maria Padovani
- grid.411475.20000 0004 1756 948XNeonatal and Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital of Verona, Verona, Italy
| | - Manuela Lavelli
- grid.5611.30000 0004 1763 1124Department of Human Sciences, University of Verona, Verona, Italy
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Yoo H, Ahn S, Park S, Kim J, Oh J, Koh M. Factors influencing prenatal and postpartum depression in Korea: a prospective cohort study. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2021; 27:326-336. [PMID: 36311450 PMCID: PMC9328632 DOI: 10.4069/kjwhn.2021.11.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose This study explored the prevalence of prenatal and postpartum depression in Korea and its influencing factors from 20 weeks of pregnancy to 12 weeks postpartum. Methods Using a prospective cohort study design, data on women’s depression and its influencing factors were collected at 20, 28, and 36 weeks of pregnancy and at 2, 6, and 12 weeks postpartum. The participants were 219 women and 181 spouses during pregnancy; and 183 mothers and 130 spouses after childbirth. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale and influencing factors were measured by the Postpartum Depression Predictors Inventory-Revised, parity, and spousal depression. Results The prevalence of maternal depression was 10.5% to 21.5% before birth, and it was 22.4% to 32.8% postpartum. The prevalence slightly decreased during the prenatal period but peaked at 2 weeks postpartum. Antenatal depression was influenced by low socioeconomic status, lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, a previous history of depression, lower social support, lower marital satisfaction, and higher life stress. The factors influencing postpartum depression were lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, lower social support, lower marital satisfaction, and higher life stress, as well as infant temperament and maternal blues. Parity and spousal depression had no impacts. Conclusion The prevalence and influencing factors of maternal depression changed over time. Nurses need to screen women accordingly during the perinatal period and should provide education or counseling to prevent depression and promote adjustment to parenthood.
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Affiliation(s)
- Hyeji Yoo
- College of Nursing, Chungnam National University, Daejeon, Korea
| | - Sukhee Ahn
- College of Nursing, Chungnam National University, Daejeon, Korea
- Corresponding author Sukhee Ahn College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon 35015, Korea Tel: +82-42-580-8324 E-mail:
| | - Seyeon Park
- College of Nursing, Chungnam National University, Daejeon, Korea
| | - Jisoon Kim
- Department of Nursing, College of Health and Welfare, Woosong University, Daejeon, Korea
| | - Jiwon Oh
- College of Nursing, Chungnam National University, Daejeon, Korea
| | - Minseon Koh
- Department of Nursing, Yeoju Institute of Technology, Yeoju, Korea
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Oh J, Ahn S. Predictors of Antenatal Depression in Pregnant Couples. Clin Nurs Res 2021; 31:881-890. [PMID: 34961355 DOI: 10.1177/10547738211065238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pregnant women and their partners are at an increased risk of antenatal depression. Therefore, this cross-sectional study of data from 116 couples investigated predictors of maternal and paternal antenatal depression using sociodemographic data, women's risk factors for depression during the antenatal period, women's perceived stress, and antenatal depression in the other partner. Pregnant women had higher depression scores (7.4 ± 4.7) and a higher frequency of being at high risk for depression (25.9%) than their spouses (4.6 ± 3.5, 9.5%). Multiple linear regression analysis revealed that the statistically significant predictors of antenatal depression in pregnant women were perceived stress (β = .45, p < .001) and antenatal depression risk factors (β = .30, p = .002) and in spouses, women's antenatal depression risk factors (β = .29, p = .013). The present findings suggest that nurses should intervene to mitigate the risk of maternal antenatal depression and perceived stress to prevent depression in pregnant couples.
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Affiliation(s)
- Jiwon Oh
- Chungnam National University, Daejeon, Republic of Korea
| | - Sukhee Ahn
- Chungnam National University, Daejeon, Republic of Korea
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Mediating mechanisms for maternal mental health from pre- to during the COVID-19 pandemic: Mediators of maternal mental illness during COVID-19. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100287. [PMID: 34881379 PMCID: PMC8640076 DOI: 10.1016/j.jadr.2021.100287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/01/2021] [Accepted: 11/24/2021] [Indexed: 02/04/2023] Open
Abstract
Background Mothers have experienced a near doubling of depression and anxiety symptoms pre- to during the COVID-19 pandemic. The identification of mechanisms that account for this increase can help inform specific targets for mental health recovery efforts. The current study examined whether women with higher levels of depression and anxiety symptoms pre-pandemic, reported higher levels of depression and anxiety symptoms during the pandemic, and whether these increases were mediated by perceived stress, strained relationships, coping attitudes, participation in activities, alcohol use, and financial impact. Methods Mothers (n = 1,333) from an ongoing longitudinal cohort (All Our Families; AOF) from Calgary, Alberta, Canada, completed online questionnaires prior to (2017–2019) and during the COVID-19 pandemic (May-July 2020). Mothers reported on depressive and anxiety symptoms pre- and during the pandemic, as well as perceived stress, engagement in physical and leisure activities, coping, alcohol use, and financial impact of the pandemic. Results In unadjusted analyses, maternal depression and anxiety symptoms pre-pandemic were strongly associated with COVID-19 depressive (r = 0.57, p<.01) and anxiety symptoms (r = 0.49, p<.01). Significant indirect effects between maternal depressive symptoms pre- and during COVID-19 were found for coping behavior (abcs=0.014, 95%CI=0.005, 0.022, p=.001), perceived stress (abcs=0.22, 95%CI=0.179, 0.258, p<.001), and strained relationships (abcs=0.013, 95%CI= 0.005, 0.022, p=.003). For maternal anxiety symptoms pre- and during COVID-19, significant indirect effects were observed for perceived stress (abcs=0.012, 95%CI=0.077, 0.154, p=.003) and strained relationships (abcs=0.010, 95%CI=0.001, 0.018, p=.03). Conclusions Perceived stress, coping attitudes, and interpersonal relationships are three potential intervention targets for mitigating COVID-19 related mental distress in mothers.
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Michałek-Kwiecień J, Kaźmierczak M, Karasiewicz K. Closeness with a partner and parental bond with a child during the transition to parenthood. Midwifery 2021; 105:103209. [PMID: 34890879 DOI: 10.1016/j.midw.2021.103209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 09/17/2021] [Accepted: 11/19/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this longitudinal study was to examine the dyadic interdependence of the relationships between partners' perception of closeness with one another and their pre- and postnatal bonds with a child. RESEARCH DESIGN AND PARTICIPANTS A total of 213 first-time expectant couples participated in the study both during pregnancy (1st stage) and after the child's birth (2nd stage). MEASUREMENTS The participants completed the following measures: the one-item pictorial Inclusion of Other into the Self (IOS) scale and the brief maternal and paternal versions of the Antenatal Attachment Scales (MAAS/PAAS, respectively) and Postnatal Attachment Scales (MPAS/PPAS, respectively). FINDINGS The Actor-Partner Interdependence Models (APIM) for distinguishable dyads were performed and revealed the positive effect of parents' perceptions of closeness with their partners regarding both their own and their partners' bond with their child during pregnancy. However, after the child's birth, for both mothers and fathers, only their own perception of closeness with their partners was associated with their bond with their child. Moreover, only the actor effects of bonding with a child during pregnancy as well as the change in perception of closeness with a partner on the partner's bond with their child after birth were found (no partner effect). KEY CONCLUSIONS Couple attributes during the transition to parenthood should be emphasized to promote the development of parental pre- and postnatal bonds.
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Yoo H, Ahn S, Oh J, Park S, Kim J, Koh M. Depression and stress in Korean parents: A cohort study. Appl Nurs Res 2021; 62:151519. [PMID: 34814991 DOI: 10.1016/j.apnr.2021.151519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 09/30/2021] [Accepted: 10/26/2021] [Indexed: 11/15/2022]
Abstract
AIM This study identified the level of depression and stress in couples experiencing pregnancy and childbirth. BACKGROUND Married couples who experience pregnancy and delivery, deal with psychological changes during the parenthood transition. If they do not adapt well, they experience negative emotions that negatively affect them and their child. Therefore, the incidence and changing patterns of depression among couples need to be explored. METHODS Using a prospective cohort study design, the researchers collected the couples' depression and stress levels 6 times. This study included 219 prenatal pregnant women, 181 spouses during pregnancy in the prenatal period, 178 postpartum mothers, and 125 spouses after childbirth. The levels of depression and stress were investigated using the Edinburgh Postnatal Depression Scale and Perceived Stress Scale. RESULTS The incidence rate of prenatal depression was 10.5- 21.5% in pregnant women and 10.5-12.7% in their spouses. After childbirth, the incidence rate of depression was 21.3- 32.0% in postpartum women and 6.4-10.4% in their spouses. The levels of depression and stress varied from the prenatal to the postpartum period, showing different patterns between women and their spouses. Significantly, the emotional patterns in the couples were different as far as parity was concerned. CONCLUSIONS The levels of depression and stress in couples continuously changed during the prenatal and postpartum periods and the patterns differed as well. Even couples who experience a healthy pregnancy and childbirth experience negative emotional changes. Therefore, timely nursing management will alleviate stress and depression not first-time by first-time parents.
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Affiliation(s)
- Hyeji Yoo
- Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon 35015, Republic of Korea
| | - Sukhee Ahn
- Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon 35015, Republic of Korea.
| | - Jiwon Oh
- Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon 35015, Republic of Korea
| | - Seyeon Park
- Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon 35015, Republic of Korea
| | - Jisoon Kim
- Department of Nursing, Woosong University, 171, Dongdaejeon-ro, Dong-gu, Daejeon 34606, Republic of Korea
| | - Minseon Koh
- Department of Nursing, Yeoju Institute of Technology, 338, Sejong-ro, Yeoju-si, Gyeonggi-do 12652, Korea
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McDonald SE, Tomlinson CA, Applebaum JW, Moyer SW, Brown SM, Carter S, Kinser PA. Human-Animal Interaction and Perinatal Mental Health: A Narrative Review of Selected Literature and Call for Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10114. [PMID: 34639416 PMCID: PMC8508333 DOI: 10.3390/ijerph181910114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022]
Abstract
There is a paucity of research exploring how relationships with household pets may impact maternal mental health. We are unaware of any study to date that has examined associations between individuals' relationships with their pets and psychological adjustment in the perinatal period. Using a biobehavioral lens, this paper provides a narrative overview of the literature on perinatal mental health and human-animal interaction (HAI). We focus on the role of social relationships, stress, and stress reduction in relation to perinatal mental health; the role of HAI in perceptions of social support, stressors, and stress reduction; and gaps in empirical knowledge concerning the role of HAI in perinatal mental health. Finally, we integrate contemporary biobehavioral models of perinatal mental health and HAI (i.e., Comprehensive Model of Mental Health during the Perinatal Period and the HAI-HPA Transactional Model) to propose a new conceptual framework that depicts ways in which HAI during the perinatal period may influence maternal and child health and wellbeing. To our knowledge, this is the first paper to consider the role of HAI in biobehavioral responses and mental health during the perinatal period. We conclude with recommendations for future research and improved perinatal care.
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Affiliation(s)
- Shelby E. McDonald
- Children, Families, and Animals Research (CFAR) Group, LLC, Richmond, VA 23223, USA
| | - Camie A. Tomlinson
- School of Social Work, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Jennifer W. Applebaum
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL 32611, USA;
| | - Sara W. Moyer
- School of Nursing, Virginia Commonwealth University, Richmond, VA 23298, USA; (S.W.M.); (P.A.K.)
| | - Samantha M. Brown
- School of Social Work, Colorado State University, Fort Collins, CO 80523, USA;
| | - Sue Carter
- The Kinsey Institute, Indiana University, Bloomington, IN 47405, USA;
| | - Patricia A. Kinser
- School of Nursing, Virginia Commonwealth University, Richmond, VA 23298, USA; (S.W.M.); (P.A.K.)
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Macdonald JA, Francis LM, Skouteris H, Youssef GJ, Graeme LG, Williams J, Fletcher RJ, Knight T, Milgrom J, Di Manno L, Olsson CA, Greenwood CJ. Cohort profile: the Men and Parenting Pathways (MAPP) Study: a longitudinal Australian cohort study of men's mental health and well-being at the normative age for first-time fatherhood. BMJ Open 2021; 11:e047909. [PMID: 34315795 PMCID: PMC8317085 DOI: 10.1136/bmjopen-2020-047909] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The Men and Parenting Pathways (MAPP) Study is a prospective investigation of men's mental health and well-being across the normative age for transitioning to fatherhood. This includes trajectories and outcomes for men who do and do not become fathers across five annual waves of the study. PARTICIPANTS Australian resident, English-speaking men aged 28-32 years at baseline were eligible. Recruitment was over a 2-year period (2015-2017) via social and traditional media and through engagement with study partners. Eight hundred and eighteen eligible men consented to participate. Of these, 664 men completed the first online survey of whom 608 consented to ongoing participation. Of the ongoing sample, 83% have participated in at least two of the first three annual online surveys. FINDINGS TO DATE Three waves of data collection are complete. The first longitudinal analysis of MAPP data, published in 2020, identified five profiles that characterise men's patterns of depressive symptom severity and presentations of anger. Profiles indicating pronounced anger and depressive symptoms were associated with fathers' lack of perceived social support, and problems with coparenting and bonding with infants. In a second study, MAPP data were combined with three other Australian cohorts in a meta-analysis of associations between fathers' self-reported sleep problems up to 3 years postpartum and symptoms of depression, anxiety and stress. Adjusted meta-analytic associations between paternal sleep and mental health risk ranged from 0.25 to 0.37. FUTURE PLANS MAPP is an ongoing cohort study. Waves 4 and 5 data will be ready for analyses at the end of 2021. Future investigations will include crossed-lagged and trajectory analyses that assess inter-relatedness and changing social networks, mental health, work and family life. A nested study of COVID-19 pandemic-related mental health and coping will add two further waves of data collection in a subsample of MAPP participants.
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Affiliation(s)
- Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Lauren M Francis
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Warwick Business School, University of Warwick, Coventry, West Midlands, UK
| | - George J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Liam G Graeme
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Joanne Williams
- Department of Health Sciences and Biostatistics, Swinburne University of Technology-Hawthorn Campus, Hawthorn, Victoria, Australia
- School of Health and Social Development, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Richard J Fletcher
- Family Action Centre, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Tess Knight
- Cairnmillar Institute, Camberwell, Victoria, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Heidelberg, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Laura Di Manno
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Christopher J Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
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Gugliandolo MC, Cuzzocrea F, Costa S, Soenens B, Liga F. Social support and motivation for parenthood as resources against prenatal parental distress. SOCIAL DEVELOPMENT 2021. [DOI: 10.1111/sode.12521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Francesca Cuzzocrea
- Department of Health Science University ‘Magna Graecia’ of Catanzaro Catanzaro Italy
| | - Sebastiano Costa
- Department of Psychology University of Campania ‘Luigi Vanvitelli’ Caserta Italy
| | - Bart Soenens
- Department of Developmental, Personality and Social Psychology Ghent University Ghent Italy
| | - Francesca Liga
- Department of Clinical and Experimental Medicine University of Messina Messina Italy
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Macdonald JA, Greenwood CJ, Letcher P, Spry EA, Mansour K, McIntosh JE, Thomson KC, Deane C, Biden EJ, Edwards B, Hutchinson D, Cleary J, Toumbourou JW, Sanson AV, Olsson CA. Parent and Peer Attachments in Adolescence and Paternal Postpartum Mental Health: Findings From the ATP Generation 3 Study. Front Psychol 2021; 12:672174. [PMID: 34122266 PMCID: PMC8195233 DOI: 10.3389/fpsyg.2021.672174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/30/2021] [Indexed: 01/19/2023] Open
Abstract
Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood. Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 male participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum (N = 409 infant offspring) for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments. Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other. Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems.
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Affiliation(s)
- Jacqui A Macdonald
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Christopher J Greenwood
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Primrose Letcher
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Elizabeth A Spry
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Kayla Mansour
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia
| | - Jennifer E McIntosh
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia.,The Bouverie Centre, School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Kimberly C Thomson
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, BC, Canada
| | - Camille Deane
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia
| | - Ebony J Biden
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Ben Edwards
- Centre for Social Research and Methods, Australian National University, Canberra, ACT, Australia
| | - Delyse Hutchinson
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Joyce Cleary
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - John W Toumbourou
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Ann V Sanson
- Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Craig A Olsson
- Faculty of Health, School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
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Rayburn SR, Coatsworth JD. Becoming Fathers: Initial Exploration of a Support Program for New Fathers. J Perinat Educ 2021; 30:78-88. [PMID: 33897232 DOI: 10.1891/j-pe-d-20-00015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Emerging fathers experience a variety of stressors, including identity and role transitions, changes in their relationships, and challenges in developing caregiving skills. Increasing expectations for father involvement in childcare are emphasizing the importance of the father role, but social supports for new fathers remain scarce. Nineteen expectant and new fathers participated in a pilot 5-week group intervention aimed at improving stress coping and involvement attitudes using a combination of mindfulness practices and skill-building for parenting and partner communication. We administered surveys pre- and postintervention to assess efficacy in the areas of stress, depressive symptoms, father involvement attitudes, and mindfulness. Within-participant differences were compared across participants as well as examining individual reliable change. Results indicated initial reductions in stress and depressive symptoms and increases in the mindfulness constructs of nonjudgment and nonreactivity. No significant changes were found in father involvement attitudes. Perinatal intervention specific to fathers holds promise as an underexplored avenue for supporting families across the transition to parenthood.
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Macdonald JA, Graeme LG, Wynter K, Cooke D, Hutchinson D, Kendall G, StGeorge J, Dowse E, Francis LM, McBride N, Fairweather AK, Manno LD, Olsson CA, Allsop S, Leach L, Youssef GJ. How are you sleeping? Starting the conversation with fathers about their mental health in the early parenting years. J Affect Disord 2021; 281:727-737. [PMID: 33234285 DOI: 10.1016/j.jad.2020.11.081] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/18/2020] [Accepted: 11/08/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Approximately 1 in 10 fathers of infants experience symptoms of common mental health disorders, prompting calls for paternal postpartum screening. However, numerous obstacles exist to screening implementation. The aim of this study was to provide preliminary evidence for an alternative approach that starts with asking fathers about their sleep. METHODS Using self-reported father data at 0 to 36 months postpartum (N=1204) from four Australian cohort studies, we assessed associations between responses to various single-item questions about sleep (good to poor), and scores on validated measures of mental health (depression, anxiety and stress). We conducted regressions, unadjusted and adjusted for father age, child age, household income, education, first or later child, and marital status, to test associations between sleep and each indicator of mental health. We then meta-analyzed effects and assessed interactions between sleep and each of the covariates. RESULTS Consistent associations between fathers' subjective poor sleep and depression, anxiety and stress were replicated across the four cohorts despite heterogeneity in the sleep questions. At the meta-analytic level, effects ranged from weak to moderate (0.25 to 0.37) and were robust to all adjustments. Interactions were only detected between family income and poor sleep, such that the association was stronger for high income fathers. LIMITATIONS This study does not address the sensitivity or specificity of single-item sleep questions for assessing paternal mental health risk. CONCLUSIONS A low-cost, non-stigmatizing single question to postpartum fathers about their sleep may present a gateway opportunity to enquiring about mental health.
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Affiliation(s)
- Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia.
| | - Liam G Graeme
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Karen Wynter
- Deakin University, School of Nursing and Midwifery, Faculty of Health, Geelong, Australia; Deakin University, Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Australia
| | - Dawson Cooke
- Curtin University, School of Nursing, Midwifery and Paramedicine, Perth, Australia
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia; University of New South Wales, National Drug and Alcohol Research Centre, Sydney, Australia
| | - Garth Kendall
- Curtin University, School of Nursing, Midwifery and Paramedicine, Perth, Australia
| | | | - Eileen Dowse
- University of Newcastle, School of Nursing and Midwifery, Newcastle, Australia
| | - Lauren M Francis
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Nyanda McBride
- Curtin University, National Drug Research Institute, Perth, Australia
| | - A Kate Fairweather
- Flinders University, Discipline of Behavioural Health, College of Medicine and Public Health, Adelaide, Australia
| | - Laura Di Manno
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia
| | - Steve Allsop
- Curtin University, National Drug Research Institute, Perth, Australia
| | - Liana Leach
- Australian National University, National Centre for Epidemiology and Population Health, Canberra, Australia
| | - George J Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
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Dowse E, Chan S, Ebert L, Wynne O, Thomas S, Jones D, Fealy S, Evans TJ, Oldmeadow C. Impact of Perinatal Depression and Anxiety on Birth Outcomes: A Retrospective Data Analysis. Matern Child Health J 2021; 24:718-726. [PMID: 32303935 DOI: 10.1007/s10995-020-02906-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES During the perinatal period, 10-20% of women experience anxiety and/or depression. Untreated perinatal depression has the potential for adverse effects on the family and infant resulting in long-term deleterious consequences. This study measured the association between self-reported depression using the Edinburgh Postnatal Depression Scale scores, self-reported anxiety and neonatal birth outcomes. METHODS A retrospective design was used with ObstetriX™ data retrieved from 16 metropolitan and rural hospitals in NSW, Australia during 2009-2014. Data were available for 53,646 singleton births. The Edinburgh Postnatal Depression Scale was used to identify self-reported depression while women self-reported pregnancy related anxiety. Regression modelling measured the effects of self-reported depression and self-reported pregnancy related anxiety on neonatal birth outcomes. Linear regression and logistic regression were used to model the effect on birth weight, gestational age, admission to NICU or the SCN, outcome (stillborn vs livebirth), and Apgar scores. Cox proportional hazards regression was used to estimate the effect on neonatal length of stay. RESULTS Babies born to women self-reporting anxiety were more likely to have birth complications, be admitted to the nursery, had lower Apgar scores and longer hospital stays. Babies born to women self-identifying as experiencing a level of depression were more likely to have a lower birth weight, shorter gestational age, and, lower Apgar score. These babies were more likely to be admitted to the nursery with an increased length of stay. CONCLUSIONS Perinatal anxiety and depression contribute to poor birth outcomes. Early detection of maternal perinatal anxiety and depression is an important step towards treatment interventions. More research is needed to identify models of care that are effective in identifying and managing perinatal depression and anxiety to improve birth outcomes for women and their babies.
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Affiliation(s)
- Eileen Dowse
- School of Nursing and Midwifery, University of Newcastle, Callaghan Campus, University Drive, Callaghan, NSW, 2308, Australia. .,University of Newcastle Priority Research Centre for Reproductive Science: Mothers and Babies, Callaghan, Australia.
| | - Sally Chan
- University of Newcastle Priority Research Centre for Brain & Mental Health, Callaghan, Australia.,University of Newcastle Priority Research Centre for Health Behaviour, Callaghan, Australia.,University of Newcastle, UON Singapore Operation, Singapore, Singapore
| | - Lyn Ebert
- School of Nursing and Midwifery, University of Newcastle, Callaghan Campus, University Drive, Callaghan, NSW, 2308, Australia.,University of Newcastle Priority Research Centre for Reproductive Science: Mothers and Babies, Callaghan, Australia
| | - Olivia Wynne
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Susan Thomas
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Donovan Jones
- School of Nursing and Midwifery, University of Newcastle, Callaghan Campus, University Drive, Callaghan, NSW, 2308, Australia.,University of Newcastle Priority Research Centre for Brain & Mental Health, Callaghan, Australia.,School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Port Macquarie Campus, 7 Major Innes Road, Port Macquarie, NSW, 2444, Australia
| | - Shanna Fealy
- School of Nursing and Midwifery, University of Newcastle, Callaghan Campus, University Drive, Callaghan, NSW, 2308, Australia.,School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,University of Newcastle Priority Research Centre for Health Behaviour, Callaghan, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Port Macquarie Campus, 7 Major Innes Road, Port Macquarie, NSW, 2444, Australia
| | - Tiffany-Jane Evans
- School of Nursing and Midwifery, University of Newcastle, Callaghan Campus, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Christopher Oldmeadow
- School of Nursing and Midwifery, University of Newcastle, Callaghan Campus, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
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Lee M, Kim YS, Lee MK. The Mediating Effect of Marital Intimacy on the Relationship between Spouse-Related Stress and Prenatal Depression in Pregnant Couples: An Actor-Partner Interdependent Model Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E487. [PMID: 33435308 PMCID: PMC7827389 DOI: 10.3390/ijerph18020487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/27/2020] [Accepted: 12/31/2020] [Indexed: 11/16/2022]
Abstract
Prenatal depression is an important factor in predicting postpartum depression. Most studies have assessed factors affecting prenatal depression by focusing on pregnant wives. However, the emotional and psychological aspects of both expectant parents need to be considered. Therefore, the purpose of this study was to examine the effect of spouse-related stress in expectant couples on prenatal depression and investigate the mediating effects of marital intimacy on this relationship. A total of 120 expectant couples from two cities in Korea at more than 15 weeks of completed pregnancy participated in the study. Using a structured questionnaire, we assessed the general characteristics of the participants, spouse-related stress, prenatal depression, and marital intimacy. The results revealed that four actor effects and one partner effect were significant. Marital intimacy and prenatal depression among expectant parents were affected by spouse-related stress. Moreover, spouse-related stress in the husbands completely mediated marital intimacy in pregnant wives, demonstrating partner effects on prenatal depression in pregnant wives. Therefore, it was observed that paternal factors affect prenatal depression in pregnant wives. This warrants the inclusion of husbands in marital interventions and strategies to improve marital intimacy in pregnant wives.
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Affiliation(s)
| | | | - Mi-Kyoung Lee
- College of Nursing, Eulji University, 77, Gyeryong-ro, 771 beon-gil, Jung-gu, Daejeon 34824, Korea; (M.L.); (Y.-S.K.)
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Baldoni F, Ancora G, Latour JM. Being the Father of a Preterm-Born Child: Contemporary Research and Recommendations for NICU Staff. Front Pediatr 2021; 9:724992. [PMID: 34552898 PMCID: PMC8450441 DOI: 10.3389/fped.2021.724992] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Most studies on parental reactions to a preterm birth and to hospitalization of the newborn in Neonatal Intensive Care Units (NICUs) have involved mothers. However, emotional responses and behaviors of fathers are equally important. Usually, the father is the first to meet the preterm newborn, to find out information about baby's condition and to communicate to the mother and other family members. In this context he is often left alone and can show psychological difficulties including affective disorders such as depression or anxiety. This paper describes the role of fathers in the NICU, the best practices to support fathers, and to explain the role of a psychologist in the NICU staff. Considerations and suggestions are provided on the difficulties encountered to support parents, with a focus on the role of fathers during the COVID-19 pandemic. Methods and Discussion: Considering contemporary research data and following an attachment perspective, we analyze the role of the father of a preterm-born child in the relation with the partner and in newborn caring. Research has shown that involving fathers in newborn care in NICU and at home is essential not only because it promotes the father/son attachment relationship and has positive effects on the psychological and somatic development of the newborn, but also for the health of the mother and whole family. Conclusion: Recommendations are provided to enhance the functions of fathers in the NICU, promote their involvement in the care of their infant, and interventions to prevent the manifestation of psychological suffering and/or perinatal affective disorders. The commitments of a psychologist in a NICU team are presented and require not only clinical skills, but also the ability to manage the emotional and relational difficulties of fathers, family and NICU staff. Considerations and suggestions are provided on the difficulties encountered by parents in the NICU during the COVID-19 pandemic.
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Affiliation(s)
- Franco Baldoni
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Gina Ancora
- Neonatal Intensive Care Unit, Infermi Hospital, Rimini, Italy
| | - Jos M Latour
- Faculty of Health, School of Nursing and Midwifery, University of Plymouth, Plymouth, United Kingdom.,Department of Nursing, Hunan Children's Hospital, Changsha, China
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44
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Sensitivity and reliability of screening measures for paternal postpartum depression: an integrative review. J Perinatol 2021; 41:2713-2721. [PMID: 34974537 PMCID: PMC8752439 DOI: 10.1038/s41372-021-01265-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 10/15/2021] [Accepted: 10/29/2021] [Indexed: 11/08/2022]
Abstract
The American Academy of Pediatrics (AAP) recommends screening mothers for Postpartum Depression (PPD) during the postpartum period. Research shows depression in parents is associated with impaired growth and development in their children. The National Perinatal Association (NPA) encourages screening fathers for depression at least twice during the first postpartum year, however a preferred screening tool has yet to be determined. To promote optimal outcomes for children, providers must assess the mental health of all new parents, regardless of gender. Therefore, the purpose of this integrative review is to examine previous scientific evidence regarding the sensitivity of screening measures for postpartum depression in fathers. Future research should be directed towards describing the psychometric properties of a tool to assess postpartum mood disorders in American fathers while analyzing appropriate screening intervals during the postpartum period.
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45
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Screening for Early Signs of Paternal Perinatal Affective Disorder in Expectant Fathers: A Cluster Analysis Approach. J Pers Med 2020; 11:jpm11010010. [PMID: 33374704 PMCID: PMC7822454 DOI: 10.3390/jpm11010010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/16/2020] [Accepted: 12/20/2020] [Indexed: 11/25/2022] Open
Abstract
Previous studies documented gender-related differences in the expression of Perinatal Affective Disorders. However, little attention has been paid to screening the male population during the perinatal period. This study was based on three aims: (1) to investigate the mental health of expectant fathers based on their levels of depression, anxiety, addiction, anger attacks/hostility, and somatization, identifying psychological profiles; (2) to analyze the association between these profiles and the individual variable of perceived stress; (3) and to examine the association between these profiles and the couple’s variable of marital adjustment. A total of 350 Italian expectant fathers in the last trimester of pregnancy were asked to fill in questionnaires concerning perceived stress, dyadic adjustment, psychiatric symptomatology, and depression. Three different clusters were found: “psychologically healthy men” (68%) with low levels of symptoms on all the scales; “men at risk of externalized behavioral problems” (17.1%), characterized by one or more addictive or risky behaviors and moderate levels of scales scores; and “men experiencing psychological distress” (14.9%), with the highest scores on all the scales. A significant association emerged among the perceived stress, marital adjustment, and cluster membership. These results highlight the importance of screening fathers in perinatal health services, which are still predominantly mother-centered, and underscore the necessity to create tailored and personalized interventions.
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46
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Thiel F, Pittelkow MM, Wittchen HU, Garthus-Niegel S. The Relationship Between Paternal and Maternal Depression During the Perinatal Period: A Systematic Review and Meta-Analysis. Front Psychiatry 2020; 11:563287. [PMID: 33192682 PMCID: PMC7658470 DOI: 10.3389/fpsyt.2020.563287] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/17/2020] [Indexed: 01/26/2023] Open
Abstract
Background: Meta-analyses suggest an increased prevalence of paternal depression during the perinatal period of around 10%. The relationship between paternal and maternal symptoms, however, has received little attention. Objective: To determine pooled estimates pertaining to the relationship between paternal and maternal depression during the perinatal period according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sources: Studies reporting on the relationship between depression in fathers and mothers between the first trimester and the first year following childbirth were identified using PubMed, PsycINFO, and EMBASE for the period between November 2009 and February 2020. Study selection: A total of 28 primary, empirical studies published in English or German, reporting effect estimates for the relationship of depression in mother-father/partner dyads, involving 11,593 couples, were included. Ten studies included multiple assessments, resulting in 64 extracted effects. Analysis: Information on correlations and odds ratios were extracted. Four random-effects analyses were conducted for the pooled association between paternal and maternal depression: (a) during the prenatal and (b) during the postnatal period, as well as for the prospective relationships between (c) paternal depression and maternal depression at a later timepoint, and (d) vice versa. Models were specified as restricted maximum-likelihood estimation. Heterogeneity was assessed using H 2 and I 2. Funnel plots, the Egger method, and the trim-and-fill test were used to assess publication bias. Sensitivity analyses with and without studies for which we approximated r were conducted. Data synthesis: With substantial heterogeneity, positive associations were found between paternal and maternal depression (a) during pregnancy (r = 0.238), (b) in the postnatal period (r = 0.279), as well as for the prospective relationship between (c) paternal and later maternal depression (r = 0.192), and (d) maternal and later paternal depression (r = 0.208). Conclusion: Paternal depression showed positive correlations with maternal depression across the perinatal period. Given notable methodological and cultural heterogeneity and limitations of individual studies, it was not possible to further identify determining or moderating factors. Increasing evidence for implications of parental depression for child development warrants further scientific attention.
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Affiliation(s)
- Freya Thiel
- Department of Medicine, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
- Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Technical University of Dresden, Dresden, Germany
| | - Merle-Marie Pittelkow
- Department of Psychometrics and Statistics, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Hans-Ulrich Wittchen
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Susan Garthus-Niegel
- Department of Medicine, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
- Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Technical University of Dresden, Dresden, Germany
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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Molgora S, Accordini M. Motherhood in the Time of Coronavirus: The Impact of the Pandemic Emergency on Expectant and Postpartum Women's Psychological Well-Being. Front Psychol 2020; 11:567155. [PMID: 33192847 PMCID: PMC7649390 DOI: 10.3389/fpsyg.2020.567155] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/06/2020] [Indexed: 01/10/2023] Open
Abstract
The birth of a child is a critical and potentially stressful experience for women, entailing several changes both at the individual and interpersonal level. This event can lead to different forms of distress, ranging in intensity and duration. Many studies highlighted medical, psychological, and social variables as risk factors potentially influencing the onset or aggravation of perinatal maternal conditions. The current pandemic emergency and the restrictive measures adopted by local governments to prevent the spread of the coronavirus infection may negatively affect mothers-to-be and new mothers potentially increasing the likelihood of anxiety, depressive or post-traumatic symptoms to develop. Moreover, the forced quarantine combined with the limited access to professional or family support may increase feelings of fatigue and isolation. The present study aims to investigate women's psychological well-being during pregnancy and in the first months after childbirth, integrating the evaluation of some traditionally studied variables with the specificities of the current situation. 575 Italian women have been administered an online self-report questionnaire assessing the presence of anxiety disorders, depressive and post-traumatic symptoms as well as the expectations toward childbirth (for mothers-to-be) or the subjective experience of childbirth (for postpartum women). Findings revealed a higher percentage of women than that reported in the literature scored above the clinical cut-off both during pregnancy and postpartum on a series of measures of psychological well-being, thus demonstrating that this period was perceived as particularly challenging and stressful and had significant impact on the women's well-being. Moreover, some socio-demographic, medical, and pandemic-related variables, especially the lack of presence and support from one's partner during labor and delivery as well as in the first days postpartum was found to predict women's mental health. These findings suggest the need for developing specific interventions targeted at women who cannot benefit from the support of their partners or family.
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Affiliation(s)
- Sara Molgora
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Monica Accordini
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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Holopainen A, Hakulinen T. New parents' experiences of postpartum depression: a systematic review of qualitative evidence. ACTA ACUST UNITED AC 2020; 17:1731-1769. [PMID: 31021977 DOI: 10.11124/jbisrir-2017-003909] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The objective of the review was to synthesize the evidence on new mothers' and fathers' experiences of postpartum depression (PPD). INTRODUCTION Postpartum depression is a form of clinical depression that affects women and, less frequently, men, typically during the first months after childbirth. It has been estimated that 10% to 20% of women and 10% of men suffer from PPD and it may have serious consequences for mothers, fathers and their children. Therefore, this review covers the experiences of both mothers and fathers. INCLUSION CRITERIA This qualitative review considered studies that included new mothers and fathers who had any number of children and who experienced PPD within a one-year postpartum period. The phenomenon of interest was the lived experience of new mothers and fathers with PPD. Qualitative studies including, but not limited to, phenomenology, grounded theory, ethnography, action research and feminist research were considered. METHODS The review systematically searched the following databases: MEDLINE, CINAHL, PsycINFO, Scopus and the Finnish database MEDIC. In addition, the search for unpublished articles included ProQuest Dissertations and Theses. The methodological quality of the included studies was assessed independently by two reviewers, and qualitative data were extracted from papers by two independent reviewers using a standardized data extraction tool. Qualitative research findings were pooled using the JBI methodology. RESULTS Thirteen papers that considered mothers' (n = 199) experiences of PPD were included in the review. A total of 98 findings were extracted and aggregated into 14 categories, and from them, four synthesized findings were developed: i) Depressed mothers feel unable to control their own lives due to low resilience; ii) The ambivalent feelings depressed mothers experience towards their babies, partners and in-laws cause distress and suffering; iii) Depressed mothers experience anger and despair if they perceive imbalances between their support needs and the support they get from healthcare providers and significant others; and iv) Depressed mothers experience hopelessness and helplessness resulting from their new-found motherhood and financial worries. Two papers that considered fathers' (n = 20) experiences of PPD were included in the review. A total of 19 findings were extracted and aggregated into six categories, and from them, two synthesized findings were developed: i) Depressed fathers experience disappointment arising from perceived imbalances between their support needs and the support they get from their partner and significant others; and ii) Depressed fathers are more imbalanced after childbirth than fathers who are not suffering from PPD, so they feel unable to control their own lives due to low resilience. CONCLUSIONS The qualitative studies concerning new parents' experiences of PPD have focused on the mother's perspective, and studies of the father's perspective, especially of the father's own experiences of PPD, are scarce. Both mothers and fathers do not receive enough support from their significant others. In addition, mothers want more support from health professionals. Because PPD has a great influence on the well-being of mothers and fathers, as well as children, it is important to understand what parents undergo after childbirth.
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Affiliation(s)
- Arja Holopainen
- Nursing Research Foundation, Helsinki, Finland.,Finnish Centre for Evidence-Based Health Care: a Joanna Briggs Institute Affiliated Group
| | - Tuovi Hakulinen
- Finnish Centre for Evidence-Based Health Care: a Joanna Briggs Institute Affiliated Group.,National Institute for Health and Welfare, Helsinki, Finland
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Seedat S. Paternal perinatal mental disorders are inextricably linked to maternal and child morbidity. World Psychiatry 2020; 19:337-338. [PMID: 32931111 PMCID: PMC7491621 DOI: 10.1002/wps.20782] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Baldoni F, Giannotti M. Perinatal Distress in Fathers: Toward a Gender-Based Screening of Paternal Perinatal Depressive and Affective Disorders. Front Psychol 2020; 11:1892. [PMID: 32973604 PMCID: PMC7461929 DOI: 10.3389/fpsyg.2020.01892] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/09/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Franco Baldoni
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Michele Giannotti
- Department of Psychology and Cognitive Sciences, University of Trento, Trento, Italy
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