Transition to parenthood and mental health at 30 years: a prospective comparison of mothers and fathers in a large Brazilian birth cohort

Prevalence of mental disorders among Australian females: Comparison according to motherhood status using Australian birth cohort data

PURPOSE

Studies examining mental disorders among women have primarily focused on either depression, anxiety, or substance use disorders and not included the broader spectrum of mental disorders. Mixed evidence exists on the prevalence rates of mental disorders among mothers. This study compares the prevalence of different mental disorders and mental comorbidities between mothers and non-mothers and assesses correlates of mental disorders among mothers.

METHODS

A population-based birth cohort design was adopted, consisting of 40,416 females born in Queensland, Australia, in 1983/84. Linked administrative data from hospital admissions were used to identify mental disorders. Cumulative incidence curves of different mental disorders were created separately for mothers and non-mothers.

RESULTS

Mental disorder prevalence among females by age 29-31 years was 7.8% (11.0% for mothers and 5.2% for non-mothers). Mothers were overrepresented in almost all categories of mental disorders, with overrepresentation becoming more pronounced with age. Mothers with a mental disorder were more likely to be unmarried, Indigenous, young at birth of first child, have greater disadvantage, and have a single child, compared to mothers without a mental disorder. Nearly half of the mothers (46.9%) had received a mental disorder diagnosis before having their first child.

CONCLUSIONS

Mothers, particularly unmarried, Indigenous, having greater disadvantage, and younger at birth of first child, represent a unique group with high vulnerability to mental disorders, that begins in childhood and is amplified with age. Presence of significant mental disorder comorbidities among females highlights the critical importance of a comprehensive, integrated approach to prevent and address multiple comorbidities.

Mental health and service use of parents with and without borderline intellectual functioning

BACKGROUND

People with borderline intellectual functioning (BIF) encounter greater social adversities than the general population and have an increased prevalence of mental illness. However, little is known about the socio-demographic characteristics and mental health of parents with BIF.

METHODS

A secondary data analysis of the Adult Psychiatric Morbidity Survey 2014 was conducted. Logistic regression models were fitted to compare differences in socio-demographic, mental health and service-use characteristics between parents and non-parents with and without BIF, and to investigate if the relationship between parent status and mental health outcomes was modified by BIF status, sex, and employment.

RESULTS

Data from 6872 participants was analyzed; 69.1% were parents. BIF parents had higher odds of common mental disorder, severe mental illness, post-traumatic stress disorder, self-harm/suicide and were more likely to see their General Practitioner (GP) and to receive mental health treatment than non-BIF parents. BIF parents did not have a higher prevalence of mental health problems than BIF non-parents. Being a parent, after adjusting for BIF status and other confounders, was associated with increased odds of having a common mental disorder, visits to see a GP and treatment for mental health. Female parents had higher odds of treatment for mental health problems.

CONCLUSIONS

Being a parent is associated with elevated rates of common mental disorders. There is a higher burden of mental health problems and service use in people with BIF. A greater provision of specialist support services including ascertainment is indicated for this group.

Sleep and its association with depressive and anxiety symptoms during the last weeks of pregnancy: A population-based study

OBJECTIVE

To evaluate the association between sleep characteristics and depressive and anxiety symptoms during the immediate postpartum period.

METHODS

People who had hospital births during 2019 in the municipality of Rio Grande (southern Brazil) were assessed with a standardized questionnaire concerning sociodemographic (eg, age and self-reported skin color) and health-related variables (eg, parity and stillbirth) (n = 2314) 24-48 hours after birth. We used the Munich Chronotype Questionnaire to assess sleep latency, inertia, duration, and chronotype; the Edinburgh Postpartum Depression Scale for depressive symptoms; and the General Anxiety Disorder 7-Item Scale to evaluate anxiety symptoms. We used logistic regression models to calculate odds ratios.

RESULTS

The prevalence of depressive symptoms was 13.7%, and of anxiety symptoms was 10.7%. Depressive symptoms were more likely in those with vespertine chronotype (odds ratios = 1.63; 95% CI: 1.14-2.35) and those with a sleep latency of more than 30 minutes (OR = 2.36; 95% CI: 1.68-3.32). The probability of depressive symptoms decreased by 16% for each additional hour of sleep (OR = 0.84; 95% CI: 0.77-0.92). Sleep inertia of 11-30 minutes increased the probability of anxiety on free days (OR = 1.73; 95% CI: 1.27-2.36) and increased the probability of depressive (OR = 2.68; 95% CI: 1.82-3.83) and anxiety symptoms (OR = 1.69; 95%CI: 1.16-2.44) on workdays.

CONCLUSION

Participants with vespertine chronotype or shorter sleep duration were more likely to have depressive symptoms. Those who took more time to fall asleep or get out of bed were more likely to have both anxiety and depressive symptoms, but the association was stronger for depressive symptoms.

Reciprocal associations between parenthood and mental well-being – a prospective analysis from age 16 to 52 years

Objective

The present study examines the bidirectional nature of the associations between parenthood and mental well-being using 36-year longitudinal data.

Background

Mental well-being can affect if and when one becomes a parent (selection hypothesis), and the characteristics of parenthood can affect mental well-being (causation hypothesis). However, life course research has infrequently studied these hypotheses in parallel. Previous studies have also typically only focused on one aspect of parenthood (e.g., having children) and on the negative aspects of the mental well-being construct.

Method

The participants in the Finnish ‘Stress, Development and Mental Health (TAM)’ cohort study were followed up at ages 16, 22, 32, 42, and 52 (N = 1160). The measures of parenthood (having children, timing of parenthood, and number of children) and mental well-being at ages 16 and 52 (depressive symptoms, self-esteem, and meaningfulness) were based on self-report.

Results

For men, higher self-esteem in adolescence was associated with having children, and having children was associated with higher self-esteem in middle age. For women, depressive symptoms at age 16 were associated with becoming a parent at age 24 or younger. For both genders, having children was associated with a higher sense of meaningfulness in middle age.

Conclusion

Studied within the life course perspective, our results indicate that parenthood has a positive effect on mental well-being in mid-adulthood even when accounting for selection effects.

Parenthood and psychological distress among English Millennials during the second wave of the COVID-19 pandemic: evidence from the Next Steps cohort study

PURPOSE

The COVID-19 pandemic led to disproportionate mental health responses in younger adults and parents. The aim of the study was to investigate how Millennial parents' experiences were associated with psychological distress over the first year of the pandemic.

METHODS

We examined data in September 2020 (n men = 994; n women = 1824) and February 2021 (n men = 1054; n women = 1845) from the Next Steps cohort study (started ages 13-14 in 2003-04). In each wave, we examined differences in GHQ-12 scores between parent groups defined by the age and number of children, adjusting for background characteristics at ages 13-14, psychological distress at ages 25-26, and other circumstances during the pandemic. We also examined if differences varied by work status, financial situation before the outbreak and relationship status.

RESULTS

Whereas mothers with one or two children and children aged 0-2 reported less distress than non-mothers in September 2020, there were no such differences in February 2021. Fathers with three or more children reported more distress in February 2021. Compared with non-fathers who worked, fathers were also disproportionally distressed if they were working with one child or with children aged 2 or less in September 2020.

CONCLUSION

The distribution of psychological distress among Millennial parents and non-parents has varied by age, sex, parenting stage, work status and the timing of the pandemic. Generous family policies are needed, with special attention dedicated to parents combining work and family responsibilities.

The effect of parental leave on parents' mental health: a systematic review

Mental health disorders during the post-partum period are a common morbidity, but parental leave might help alleviate symptoms by preventing or reducing stress. We aim to summarise available evidence on the effect of different types of parental leave on mental health outcomes among parents. For this systematic review, we searched Ovid MEDLINE, Web of Science, PsycINFO, CINAHL, and Scopus from database inception to Aug 29, 2022, for peer-reviewed, quantitative studies written in English. We included studies if the exposure was postnatal parental leave; a relevant comparison group was present (eg, paid vs unpaid leave); and if indicators related to general mental health, including depression, anxiety, stress, and suicide, for either parent were evaluated or recorded at any time after childbirth. The Review is registered with PROSPERO (registration number CRD42021227499). Of the 3441 records screened, 45 studies were narratively synthesised. Studies were done in high-income countries, and they examined generosity by any parental leave (n=5), benefit amount (n=13), and leave duration (n=31). 38 studies were of medium or high quality. Improved mental health was generally observed among women (referred to as mothers in this Review) with more generous parental leave policies (ie, leave duration and paid vs unpaid leave). For example, increased duration of leave was generally associated with reduced risk of poor maternal mental health, including depressive symptoms, psychological distress and burnout, and lower mental health-care uptake. However, the association between fathers' leave and paternal mental health outcomes was less conclusive as was the indirect effect of parental leave use on partners' mental health.

Factors That Shape Women's Physical Activity: Development of the Reasons to Participate in Physical Activity Scale (RPPAS)

(1) Background: Obesity could deepen women's susceptibility to COVID-19 infections and deaths. While physical activity has the potential to improve women's physical and psychological resilience to the pandemic, there is a dearth of research on factors that motivate women's participation in physical activity. Thus, to bridge the research gap, this study aims to identify factors that motivate women's participation in physical activity. (2) Methods: An online survey on motivations for physical activity was developed and distributed to the participants. A total of 108 women offered complete answers (N = 108, 18-33 years old, Mage = 20.34 ± 2.42 years). Participants selected factors that promote their physical activity from a list of 34 factors from the Reasons to Participate in Physical Activity Scale (RPPAS) developed in this study. (3) Results: Exploratory factor analysis revealed that factors that motivate women's participation in physical activity are: enjoyment and gratification, consideration for other activities (i.e., exergaming), health benefits, networking opportunities, and appearance and performance. Multiple linear regression analyses indicate that only consideration for appearance and performance was significantly associated with participants' physical activity levels after controlling for compounding factors. (4) Conclusions: The findings of this study underscore the importance of appearance and performance in shaping women's participation in physical activity. Furthermore, the results also emphasize the need for a nuanced understanding of factors that influence women's physical activity levels. Future research could investigate how to leverage these motivators in tailored health interventions that aim to improve women's physical activity.

Anxiety among multiparous women in the Al-Qatif sector of KSA: A mixed-method study

Objective

Anxiety disorders are among the leading causes of disability worldwide. Generalised anxiety disorder (GAD) is characterised as a state of excessive anxiety for six months or more, which is difficult to control and is not triggered by a specific situation or stressor. This study aims to assess the relationship between GAD and multiparity.

Method

This was a mixed-method study in which the quantitative phase was conducted by administering a structured questionnaire involving a GAD-7 screening tool. The qualitative phase involved a semi-structured focus group discussion (FGD) to gather participants' opinions regarding multiparity and its impact on life. This study was conducted on 513 participants from 16 primary health care centres (PHCs) in the Al-Qatif region of the KSA. The target population comprised multiparous women of childbearing age. Pregnant and postpartum women were excluded from this study. A two-sample t-test, a chi-square test, and logistic regressions were used to assess the required associations.

Results

Almost 75% of the participants considered themselves to be anxious. The association between GAD and multiparity was not statistically significant. The variables significantly associated with anxiety were found to be marital status, educational level, marital conflict, stressful life events, family member assistance, mothers' health issues, and children's health issues. The qualitative analysis showed that two-thirds of the women identified no relationship between multiparity and anxiety.

Conclusion

There was no significant association between GAD and multiparity. However, through use of multivariable modelling, anxiety was significantly associated with marital conflicts, stressful life events, and educational level.

Determinants and Consequences of Adolescent Fatherhood: A Longitudinal Study in Ethiopia, India, Peru, and Vietnam

PURPOSE

Adolescent parenthood is a major challenge in low- and middle-income countries (LMICs). However, the vast majority of the evidence has focused on adolescent motherhood. Little is known about adolescent fatherhood in LMICs. The aim of this study was to examine the determinants of early fatherhood and its consequences on a range of outcomes among adolescent males.

METHODS

This study used three waves of longitudinal data from the multicountry Young Lives cohort study, specifically following a sample of 1,779 adolescent boys at ages 15, 19, and 22 years in Ethiopia, India, Peru, and Vietnam. Individual fixed effects models were conducted to investigate the sociodemographic determinants of adolescent fatherhood and the consequences of adolescent fatherhood on males' education, health, psychosocial well-being, and time use outcomes.

RESULTS

The results indicated that lower educational attainment, absence of the adolescent's mother and father from the home, larger household size, and poverty increased the likelihood of becoming an adolescent father by age 22 years. The results revealed that becoming an adolescent father was associated with a higher likelihood of school dropout, being overweight, smoking, greater internalizing problems, and less time spent on leisure activities and more time spent on caregiving responsibilities.

CONCLUSIONS

Highlighting the experiences of young men as adolescent parents in LMICs, findings underscore the importance of prevention strategies to delay early parenthood for adolescent boys and multicomponent interventions to support young fathers and their unique health, socioeconomic, psychosocial, and behavioral needs.