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Xiao G, Wang H, Hu J, Zhao Z, Li Q, Qin C. Prevalence of antenatal depression and postpartum depression among Chinese fathers: A systematic review and meta-analysis. Heliyon 2024; 10:e35089. [PMID: 39170297 PMCID: PMC11336420 DOI: 10.1016/j.heliyon.2024.e35089] [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] [Received: 05/11/2023] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Background Paternal antenatal depression and postpartum depression are associated with adverse health outcomes in mothers and infants; however, their prevalence among Chinese fathers remains controversial. This meta-analysis aimed to summarize the prevalence of antenatal depression and postpartum depression in Chinese fathers. Methods We conducted a systematic meta-analysis on the prevalence of antenatal depression and postpartum depression among Chinese fathers by searching 11 databases. Pooled estimates and 95 % confidence intervals were calculated. The choice between a random-effects model and a fixed-effects model was based on an assessment of heterogeneity among the studies as well as assumptions regarding the similarity of the studies in terms of clinical characteristics, quality, design, and conduct. Subgroup and meta-regression analyses were conducted based on the scale used to measure antenatal depression and postpartum depression, the region where the study was completed, the time of the study, the study design, the number of children, publication language, the study site, and quality assessment. Results This meta-analysis included 28 studies with 8795 participants. The prevalence of antenatal depression among Chinese fathers was 11 % (95 % CI: 5%-17 %, P < 0.01) using a random-effects model. Heterogeneity was I2 = 91 %. Publication language moderated the prevalence of paternal antenatal depression (the amount of heterogeneity accounted for was 92.13 %). The prevalence of postpartum depression among Chinese fathers was 16 % (95 % CI: 13%-18 %, P < 0.01), using a random-effects model. The heterogeneity was I2 = 94 %. The prevalence of paternal postpartum depression was moderated by the scale used to measure postpartum depression (39.17 % heterogeneity) and the region where the study was completed (33.15 % heterogeneity). Moreover, Egger's test (t = 4.542, P < 0.001) indicated publication bias in studies on postpartum depression among Chinese fathers. However, after applying the trimming correction, the pooled prevalence of postpartum depression had a P value of <0.05, indicating that despite the publication bias, the results remain reliable and unaffected in terms of effect size. Conclusion The prevalence of antenatal depression and postpartum depression among Chinese fathers was similar to those reported in low- and middle-income countries. Fathers should receive regular screening, effective prevention, and appropriate treatment. However, interpreting these results requires consideration of the limitations of the study.
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Affiliation(s)
- Gui Xiao
- Health Management Medicine Center and nursing department, The Third Xiangya Hospital, Central South University, Changsha, China
- School of Xiangya Nursing, Central South University, Changsha, China
| | - Hu Wang
- Emergency Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiaji Hu
- School of Xiangya Nursing, Central South University, Changsha, China
| | - Ziran Zhao
- International Nursing School, Hainan Medical University, Haikou, China
| | - Qiyu Li
- The School of Xiangya Medicine, Central South University, Changsha, China
| | - Chunxiang Qin
- Health Management Medicine Center and nursing department, The Third Xiangya Hospital, Central South University, Changsha, China
- School of Xiangya Nursing, Central South University, Changsha, China
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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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Chen J, Zhao J, Chen X, Zou Z, Ni Z. Paternal perinatal depression: A concept analysis. Nurs Open 2023. [PMID: 37147794 DOI: 10.1002/nop2.1797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/18/2023] [Accepted: 04/20/2023] [Indexed: 05/07/2023] Open
Abstract
AIM Our aim is to clarify the concept of paternal perinatal depression including its definition, attributes, antecedents and consequences. DESIGN A concept analysis. METHODS To obtain relevant evidence, several databases were searched systematically including PubMed, EMBASE, Web of Science, CINAHL, PsycINFO and the Cochrane Library. Qualitative or quantitative articles published in English that focused on paternal perinatal depression were included. After the literature quality assessment, Walker and Avant's concept analysis strategy was used. RESULTS Five defining attributes (i.e. symptoms occur during the partner's pregnancy or 1-year postpartum and last at least 2 weeks, emotional symptoms, somatic symptoms, negative parenting behaviours and 'masked' symptoms), four antecedents (i.e. personal issues, pregnancy-related issues, infant-related issues, social issues) and three consequences (i.e. offspring outcomes, marital relationship, maternal negative emotions) were identified.
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Affiliation(s)
- Jianfei Chen
- School of Nursing, Wuhan University, Wuhan, China
| | - Jing Zhao
- School of Nursing, Wuhan University, Wuhan, China
| | - Xiaoli Chen
- School of Nursing, Wuhan University, Wuhan, China
| | - Zhijie Zou
- School of Nursing, Wuhan University, Wuhan, China
| | - Zhao Ni
- School of Nursing, Yale University, New Haven, Connecticut, USA
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, USA
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Berg RC, Solberg BL, Glavin K, Olsvold N. Instruments to Identify Symptoms of Paternal Depression During Pregnancy and the First Postpartum Year: A Systematic Scoping Review. Am J Mens Health 2022; 16:15579883221114984. [PMID: 36124356 PMCID: PMC9490477 DOI: 10.1177/15579883221114984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Men often experience depressive symptoms during the transition to parenthood, but there is a lack of synthesized knowledge of instruments used to identify such symptoms. The aim of this scoping review was to identify instruments used to measure symptoms of depressive symptoms among fathers in pregnancy and the postpartum period, and to describe the instruments' characteristics and measurement properties. We identified studies published since 1990 through searches in databases such as MEDLINE, EMBASE, and PsycINFO and in gray literature. Pairs of reviewers selected relevant studies based on predetermined inclusion criteria. For each included study, we collected information relevant to the review question, guided by the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN). We included 13 instruments, described in 59 studies with about 29,000 participants across 25 countries. There were 12 validation studies. None of the instruments were uniquely developed for assessing paternal depressive symptoms related to fatherhood. The three most extensively examined instruments were the Edinburgh Postnatal Depression Scale (EPDS), Center for Epidemiologic Studies Depression Scale, and Beck Depression Inventory. For seven of the 13 instruments, there was no information reported about the instruments' properties beyond internal consistency, but for the other six instruments the 12 validation studies reported on both reliability and validity. No studies reported on measurement error or responsiveness. EPDS was both the most extensively assessed instrument and reported to be the most reliable and valid. Further research on instruments for identifying men with depression in pregnancy and the postpartum period is warranted.
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Affiliation(s)
- Rigmor C. Berg
- UiT The Arctic University of Norway, Tromsø, Norway,Norwegian Institute of Public Health, Oslo, Norway,Rigmor C. Berg, UiT The Arctic University of Norway, PO Box 6050 Langnes, N-9037 Tromsø, Norway.
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Duan Z, Wang Y, Jiang P, Wilson A, Guo Y, Lv Y, Yang X, Yu R, Wang S, Wu Z, Xia M, Wang G, Tao Y, Xiaohong L, Ma L, Shen H, Sun J, Deng W, Yang Y, Chen R. Postpartum depression in mothers and fathers: a structural equation model. BMC Pregnancy Childbirth 2020; 20:537. [PMID: 32933502 PMCID: PMC7493423 DOI: 10.1186/s12884-020-03228-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 09/01/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Post-partum depression (PPD) is a growing mental health concern worldwide. There is little evidence in the Chinese context of the relationship between paternal PPD and maternal PPD. Given the growing global concerns this relationship requires further exploration. METHODS A survey was conducted with 950 total couples from March 2017 to December 2018. The study was conducted using a standardized questionnaire that included basic demographic information, information on the relationship between the mother-in-law and daughter-in-law, marital satisfaction (both maternal and paternal), and PPD symptoms. Structural Equation Modelling (SEM) analysis was used to explore the underlying mechanism for PPD symptoms in mothers and fathers. RESULTS In 4.4% of the couples both the wife and the husband showed depressive symptoms. Maternal marital satisfaction showed a significant mediating effect on paternal PPD (B = -0.114, p < 0.01), and there was a direct effect of maternal PPD on paternal PPD (B = 0.31, p < 0.001). CONCLUSIONS This is the first study to investigate the possible correlation between maternal PPD, mother-in-law and daughter-in-law relationship satisfaction, maternal marital satisfaction, paternal marital satisfaction, and paternal PPD. It is important for future PPD interventions to target both maternal and paternal mental health, as well as the mechanisms identified that can lead to PPD.
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Affiliation(s)
- Zhizhou Duan
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
- School of Health Sciences, Wuhan university, 430072, Wuhan, Hubei Province, China
| | - Yuanyuan Wang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Ping Jiang
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yan Guo
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
| | - Yongliang Lv
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
| | - Xiaonan Yang
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
| | - Renjie Yu
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
| | - Shuilan Wang
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
| | - Zhengyan Wu
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
| | - Mengqing Xia
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
| | - Guosheng Wang
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
| | - Ye Tao
- Suzhou science & technology town hospital, Suzhou, China
| | - L Xiaohong
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China
| | - Ling Ma
- Suzhou science & technology town hospital, Suzhou, China
| | - Hong Shen
- Suzhou science & technology town hospital, Suzhou, China
| | - Jue Sun
- Gusu District Wumenqiao Street Canglang Xincheng Community Health Service Center, Suzhou, China
| | - Wei Deng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, PR China
| | - Yong Yang
- Institute of Mental Health, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Soochow University, No. 11 Guangqian Road, Jiangsu Province, 215137, Suzhou, PR China.
| | - Runsen Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China
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