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Refaeli LB, Rodrigues M, Neaman A, Bertele N, Ziv Y, Talmon A, Enav Y. Supporting the transition to parenthood: a systematic review of empirical studies on emotional and psychological interventions for first-time parents. PATIENT EDUCATION AND COUNSELING 2024; 120:108090. [PMID: 38101088 DOI: 10.1016/j.pec.2023.108090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/26/2023] [Accepted: 11/25/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES The transition to parenthood can evoke a range of concerns in parents, profoundly impacting their psychological well-being. The literature regarding the transition to parenthood focuses primarily on functional aspects of parenthood, generally overlooking the psychological well-being of parents. METHOD This comprehensive review synthesized studies describing emotional and psychological interventions during the transition to parenthood among participants between 2013 and 2022. A rigorous screening process, conducted by three of the authors, resulted in 18 studies that met the inclusion criteria. RESULTS This report provides detailed descriptions of these studies, including their characteristics, demographics, types of interventions, and main outcomes. The majority of interventions focused on mothers and mother-infant dyads, with fewer interventions targeting couples, and none addressing fathers or father-infant dyads. CONCLUSIONS The interventions examined were found to be effective in reducing symptoms such as depression, anxiety, and stress among mothers and had positive effects on infants' behaviors, mother-infant synchrony, and co-parenting. PRACTICE IMPLICATIONS This review stresses the necessity of interventions targeting the transition to parenthood, especially among fathers and marginalized populations, as well as serves to identify barriers faced by vulnerable and minority populations.
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Affiliation(s)
- Lee Barel Refaeli
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Israel.
| | | | - Annaliese Neaman
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Nina Bertele
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Yair Ziv
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Israel
| | - Anat Talmon
- Department of Psychology, Stanford University, Stanford, CA, USA; Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel
| | - Yael Enav
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Israel
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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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Van Uytsel H, Ameye L, Devlieger R, Jacquemyn Y, Van Holsbeke C, Schreurs A, Bogaerts A. Mental Health during the Interpregnancy Period and the Association with Pre-Pregnancy Body Mass Index and Body Composition: Data from the INTER-ACT Randomized Controlled Trial. Nutrients 2023; 15:3152. [PMID: 37513569 PMCID: PMC10384439 DOI: 10.3390/nu15143152] [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: 06/21/2023] [Revised: 07/08/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Mental health problems and obesity are two common complications during pregnancy and postpartum. The preconception period is considered an appropriate period for prevention. Therefore, insights into interpregnancy mental health and the impact on weight and body composition are of interest to developing effective weight management strategies. The primary aim of this study is to assess the difference in women's mental health during the interpregnancy period and the association with pre-pregnancy body mass index (BMI) and body composition. The secondary aim is to study whether this association is affected by socio-demographic factors, interpregnancy interval and sleep. The study is a secondary analysis of the INTER-ACT e-health-supported lifestyle trial. Women were eligible if they had a subsequent pregnancy and mental health measurements at 6 weeks after childbirth and at the start of the next pregnancy (n = 276). We used univariate analyses to assess differences in mental health and performed regression analysis to assess their association with pre-pregnancy BMI and body composition at the start of the next pregnancy. Our results show a statistically significant increase in anxiety and depressive symptoms between 6 weeks after childbirth and the start of the next pregnancy (sSTAI-6 ≥ 40: +13%, p =≤ 0.001; GMDS ≥ 13: +9%, p = 0.01). Of the women who were not anxious at 6 weeks after childbirth (sSTAI < 40), more than one-third (39%) developed anxiety at the start of the next pregnancy (p =≤ 0.001). Regression analysis showed that sense of coherence (SOC-13) at the start of the next pregnancy was independently associated with women's pre-pregnancy BMI and fat percentage. We believe that the development of preconception lifestyle interventions that focus on both weight reduction and support in understanding, managing and giving meaning to stressful events (sense of coherence) may be of added value in optimizing women's preconception health.
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Affiliation(s)
- Hanne Van Uytsel
- REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Lieveke Ameye
- REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
| | - Roland Devlieger
- REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospital Leuven, 3000 Leuven, Belgium
- Department of Obstetrics and Gynecology, GZA Hospitals Sint-Augustinus, 2610 Antwerp, Belgium
| | - Yves Jacquemyn
- Global Health Institute (GHI), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
- Department of Obstetrics and Gynecology, University Hospital Antwerp, 2650 Antwerp, Belgium
| | | | - Annick Schreurs
- Department of Obstetrics and Gynecology, Jessa Hospital, 3500 Hasselt, Belgium
| | - Annick Bogaerts
- REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
- Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
- Faculty of Health, University of Plymouth, Devon PL4 8AA, UK
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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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Kårstad SB, Bjørseth Å, Lindstedt J, Brenne AS, Steihaug H, Elvrum AKG. Parental Coping, Representations, and Interactions with Their Infants at High Risk of Cerebral Palsy. J Clin Med 2022; 12:jcm12010277. [PMID: 36615077 PMCID: PMC9820974 DOI: 10.3390/jcm12010277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/16/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
The aim of this study is to describe parental coping, representations, and interactions during the time of inclusion in the Small Step early intervention program for infants at high risk of cerebral palsy (CP) in Norway (ClinicalTrials.gov: NCT03264339). Altogether, 11 infants (mean age 4.8 months, SD: 1.5) and their parents (mothers: n = 10, fathers: n = 9) were included. Parental coping was assessed using the Parenting Stress Index-Short Form (PSI-SF) and the Hospital Anxiety and Depression Scale (HADS). Parental representations and parent-infant interactions were assessed using the Working Model of the Child Interview (WMCI) and the Parent-Child Early Relational Assessment (PCERA). Parents' PSI-SF and HADS scores were within normal range; however, 26.7% showed symptoms of stress, 52.6% showed symptoms of anxiety, and 31.6% showed symptoms of depression above the cut-off. WMCI results indicate that 73.7% of the parents had balanced representations. For PCERA, the subscale Dyadic Mutuality and Reciprocity was of concern, while two other subscales were in areas of strength and three subscales in some concern areas. There were no differences between mothers and fathers. Most of the parents had balanced representations, some had mental or stress symptoms and many were struggling with aspects of the parent-infant interaction. This knowledge could be useful when developing more family-centered interventions.
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Affiliation(s)
- Silja Berg Kårstad
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7130 Trondheim, Norway
- Child and Adolescent Mental Health Services, St. Olav’s Hospital, Trondheim University Hospital, 7130 Trondheim, Norway
- Correspondence: ; Tel.: +47-9775-2958
| | - Åse Bjørseth
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7130 Trondheim, Norway
| | - Johanna Lindstedt
- Department of Psychology and Speech-Language Pathology, University of Turku, 20500 Turku, Finland
| | - Anne Synnøve Brenne
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7130 Trondheim, Norway
| | - Helene Steihaug
- Child and Adolescent Mental Health Services, St. Olav’s Hospital, Trondheim University Hospital, 7130 Trondheim, Norway
| | - Ann-Kristin Gunnes Elvrum
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7130 Trondheim, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7130 Trondheim, Norway
- Clinical Services, St. Olav’s Hospital, Trondheim University Hospital, 7130 Trondheim, Norway
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Kothari A, Bruxner G, Dulhunty JM, Ballard E, Callaway L. Dads in Distress: symptoms of depression and traumatic stress in fathers following poor fetal, neonatal, and maternal outcomes. BMC Pregnancy Childbirth 2022; 22:956. [PMID: 36550457 PMCID: PMC9773585 DOI: 10.1186/s12884-022-05288-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study aims to explore the prevalence of symptoms of depression and traumatic stress in fathers in the setting of poor fetal, neonatal, and maternal outcomes. METHODS A prospective mixed-methods study was conducted at an outer metropolitan public teaching hospital in Brisbane, Australia, with quantitative results presented here. Subjects included 28 fathers whose male partners had experienced pregnancy or childbirth complicated by a significant congenital abnormality or aneuploidy, termination of pregnancy, fetal death in-utero, stillbirth, admission to the neonatal intensive care unit or special care nursery or significant maternal morbidity, such as a postpartum haemorrhage or an emergency postpartum hysterectomy. These experiences were classified into two groups: anticipatory (time to prepare) and sudden (no warning). The fathers were screened using the Edinburgh Postnatal Depression Scale (EPDS) and the Impact of Events Scale-Revised (IES-R) to assess subjective distress at 2-3 weeks (timepoint 1) and 3-4 months (timepoint 2) after the event. RESULTS Data for both the EPDS and IES-R scales was available for 26 fathers (92.9%) at timepoint 1 and for 15 fathers (53.6%) at timepoint 2. High overall EPDS scores (≥10) were noted in 16/27 (59.3%) fathers at timepoint 1 and 6/15 fathers (40.0%) at timepoint 2. High overall IES-R scores ≥33 were noted in 12/26 (46.2%) fathers at timepoint 1 and 4/15 fathers (26.7%) at timepoint 2. A higher percentage of fathers who experienced anticipatory events had EPDS and IES-R score above these cut-offs at timepoint 1 (8/13 or 61.5%) compared to those experiencing sudden events (8/14 or 57.1%), however, percentages were similar between groups at time point 2 (2/7 or 28.6%% and 4/8 or 50.0%, respectively). More fathers who experienced anticipatory events had IES-R scores ≥33 at timepoint 1 (7/13 or 53.8%) compared to those experiencing sudden events (5/14 or 38.0%). CONCLUSION Our study indicates high rates of distress in fathers exposed to poor fetal, neonatal, and maternal outcomes, which can persist for months after the event. Increased support for fathers in this setting may be required to prevent poor mental health. Further research on the long-term effects of these adverse events is warranted.
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Affiliation(s)
- A. Kothari
- grid.490424.f0000000406258387Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia
| | - G. Bruxner
- grid.490424.f0000000406258387Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia
| | - J. M. Dulhunty
- grid.490424.f0000000406258387Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia
| | - E. Ballard
- grid.1049.c0000 0001 2294 1395QIMR Berghofer Medical Research Institute, Brisbane, Queensland Australia
| | - L. Callaway
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia ,grid.416100.20000 0001 0688 4634The Royal Brisbane and Women’s Hospital, Brisbane, Queensland Australia
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Van Uytsel H, Ameye L, Devlieger R, Bijlholt M, Jacquemyn Y, Catry V, Schreurs A, Bogaerts A. Mental health after childbirth and the impact on postpartum weight retention and body composition. Data from the INTER-ACT randomized controlled trial. Clin Obes 2022; 12:e12550. [PMID: 36161779 DOI: 10.1111/cob.12550] [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: 05/18/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study the evolution of maternal mental health during the first year after childbirth in women with previous excessive gestational weight gain, and the relationship with postpartum weight retention and body composition. METHODS Anthropometric and mental health data of 505 women of the INTER-ACT RCT control group were collected and assessed using descriptive statistics and mixed model analyses. RESULTS At 6 weeks postpartum 28% of women reported depressive symptoms, 46% anxiety, 47% low sense of coherence and 48% low quality of life. From 6 weeks to 12 months postpartum there was a monthly increase (+0.38, p = .003) in anxiety and a monthly decrease (-0.39, p = .008) in quality of life. High levels of depressive symptoms at 6 weeks postpartum predicted higher body fat (+0.9%, p = .01) and higher waist circumference (+1.3 cm, p = .02) in the first year postpartum. High sense of coherence at 6 weeks postpartum predicted lower body fat (-0.8%, p = .01) the first year postpartum. CONCLUSIONS In women with a history of excessive gestational weight gain, the first year after childbirth is characterized by a high prevalence of mental health problems in which levels of anxiety and quality of life deteriorate over time. Moreover, high levels of depressive symptoms and low sense of coherence in the first weeks postpartum predict unfavourable body composition outcomes in the year after childbirth.
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Affiliation(s)
- Hanne Van Uytsel
- REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Lieveke Ameye
- REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Roland Devlieger
- REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospital Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, GZA Hospitals Sint- Augustinus, Antwerp, Belgium
| | - Margriet Bijlholt
- REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Yves Jacquemyn
- Global Health Institute (GHI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Obstetrics and Gynecology, University Hospital Antwerp, Antwerp, Belgium
| | - Vincent Catry
- Department of Obstetrics and Gynecology, GZA Hospitals Sint- Augustinus, Antwerp, Belgium
| | - Annick Schreurs
- Department of Obstetrics and Gynecology, Jessa Hospital, Hasselt, Belgium
| | - Annick Bogaerts
- REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Faculty of Health, University of Plymouth, Devon, UK
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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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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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Shafian AK, Mohamed S, Nasution Raduan NJ, Hway Ann AY. A systematic review and meta-analysis of studies validating Edinburgh Postnatal Depression Scale in fathers. Heliyon 2022; 8:e09441. [PMID: 35663736 PMCID: PMC9156997 DOI: 10.1016/j.heliyon.2022.e09441] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/01/2022] [Accepted: 05/11/2022] [Indexed: 11/17/2022] Open
Abstract
The Edinburgh Postnatal Depression Scale (EPDS) is a reliable measure for detecting paternal postpartum depression. The study's purpose is to determine the appropriate cut-off scores of EPDS for fathers. Our research was conducted using PubMed, Embase, Web of Science, and Scopus. The time frame of the search was from the issuance of EPDS in 1987 until January 2021. The analysis comprised of studies that compared EPDS scores for depression from validated diagnostic interviews. For EPDS cut-off values of 7–13, a bivariate random-effects meta-analysis was used to estimate pooled sensitivity and specificity, as well as the diagnostic odds ratio. Seven studies with a total of 2393 participants were identified. The pooled sensitivity and specificity were satisfactory at cut-off values of 7–10, with significant diagnostic odds ratio. The EPDS accuracy was unaffected by the prevalence of depression, the fathers' mean age, or the translated language. The Edinburgh Postnatal Depression Scale has acceptable properties for detecting paternal postpartum depression, with cut-off scores ranging from 7 to 10.
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Affiliation(s)
| | - Salina Mohamed
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi, MARA, Malaysia
- Department of Psychiatry, Hospital Universiti Teknologi, MARA, Malaysia
| | - Nor Jannah Nasution Raduan
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi, MARA, Malaysia
- Department of Psychiatry, Hospital Universiti Teknologi, MARA, Malaysia
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Pedersen SC, Maindal HT, Ryom K. "I Wanted to Be There as a Father, but I Couldn't": A Qualitative Study of Fathers' Experiences of Postpartum Depression and Their Help-Seeking Behavior. Am J Mens Health 2021; 15:15579883211024375. [PMID: 34116610 PMCID: PMC8202277 DOI: 10.1177/15579883211024375] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Postpartum depression (PPD) is one of the most common mental health problems among new parents. Past studies have examined PPD in women; however, the condition is less understood in men. This study aimed to explore the lived experiences of men or fathers with PPD and to understand the barriers and facilitators of help-seeking among fathers with PPD. Eight fathers with PPD were interviewed and data were subsequently analyzed through interpretative phenomenological analysis. The fathers perceived fatherhood as an overwhelming experience and feelings of inadequacy and powerlessness were two of the main themes in the fathers' experiences of PPD. The feeling of inadequacy and powerlessness was related to the fathers' expectations for themselves and their role as a father. The fathers' sense of inadequacy and powerlessness sometimes turned into anger and frustrations. In addition, the fathers experienced a variety of contributing stressors around the birth of their child. Further, the analysis revealed how the fathers' help-seeking behavior was influenced by five contributing factors: recognition and perception of depressive symptoms; knowledge and beliefs about PPD; taboo, stigma and conforming to masculine norms; the fathers' partner; screening and perinatal healthcare services. Paternal PPD has a significant impact on the fathers' wellbeing and everyday lives. Findings indicate that parents-to-be may benefit from education on paternal PDD, and they highlight the importance of screening for paternal PPD and support tailored to the needs of fathers with signs of PPD.
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Affiliation(s)
- Sarah Christine Pedersen
- Department of Public Health, Section for Health Promotion and Population Health, Aarhus University, Denmark
| | - Helle Terkildsen Maindal
- Department of Public Health, Section for Health Promotion and Population Health, Aarhus University, Denmark.,Steno Diabetes Center Copenhagen, Health Promotion, Copenhagen, Denmark
| | - Knud Ryom
- Department of Public Health, Section for Health Promotion and Population Health, Aarhus University, Denmark
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12
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The development and validation of the Multidimensional Paternal Perinatal Scale (MPPS). Heliyon 2021; 7:e06978. [PMID: 34027180 PMCID: PMC8131251 DOI: 10.1016/j.heliyon.2021.e06978] [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: 05/14/2020] [Revised: 10/18/2020] [Accepted: 04/27/2021] [Indexed: 12/03/2022] Open
Abstract
The limited availability of screening tools for assessing fathers' emotional well-being during the perinatal period warrants the development of a new measure, especially since the existing measurements did not specifically focus on fathers' perinatal experiences. These existing measurements focus on the assessment of clinical symptoms rather than precursors that may negatively impact on perinatal father's well-being. Based on the paternal perinatal conceptual framework, the Multidimensional Paternal Perinatal Scale (MPPS) was developed to identify precursors that contribute to the father's emotional well-being during the perinatal period. This paper examines three steps of measurement development. The first step comprised item development based on the literature and qualitative findings. The second step comprised conducting the qualitative and quantitative judgment analysis of the MPPS content validity. The third step assessed inter-rater reliability. Two versions of the MPPS were developed: the antenatal and postnatal versions. The antenatal version of the MPPS includes 75 items and targets 11 precursors of paternal perinatal emotional well-being, while the postnatal version includes 103 items and targets 13 precursors of poor emotional well-being. The validity analysis showed that both the antenatal and postnatal subscales met content validity requirements. The overall Content Validity Index (CVI) of the antenatal version was equal to .95 for clarity and .99 for relevance, while the postnatal version showed a CVI of .98 for clarity and .93 for relevance. The inter-rater reliability for each of the antenatal and postnatal versions of the MPPS showed an AC2 of .67. The exploratory factor analysis derived a five-factor solution for the ANT-MPPS, and eight-factor solution for POST-MPPS. Both versions of the MPPS showed acceptable internal consistency. Overall, the findings showed adequate indices for content validity and inter-rater reliability of the new Multidimensional Paternal Perinatal Scales. Additionally, the MPPS demonstrated an acceptable construct validity and internal consistency. Results demonstrate that both versions of the scale successfully characterised antecedents of emotional well-being and as such can be used to identify fathers at risk of poor emotional well-being in the antenatal and postnatal environments.
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13
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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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14
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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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15
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Terrone G, Mangialavori S, Lanza di Scalea G, Cantiano A, Temporin G, Ducci G, Gori A, Cacioppo M, Schimmenti A, Caretti V. The relationship between dyadic adjustment and psychiatric symptomatology in expectant couples: An actor-partner interdependency model approach. J Affect Disord 2020; 273:468-475. [PMID: 32560942 DOI: 10.1016/j.jad.2020.05.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/20/2020] [Accepted: 05/10/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Many researchers who evaluated psychological distress during the transition to parenthood agree in identifying pregnancy as the most sensitive period for the onset of psychiatric symptomatology for both parents. Furthermore, research highlights a correlation between symptoms experienced by fathers in relation to those experienced by mothers. OBJECTIVE The aim of this study was to investigate whether dyadic functioning influences the level of psychiatric symptomatology in couples expecting their first child. Participants were 137 couples expecting their first child; they were recruited at the San Filippo Neri and the Santo Spirito hospitals in Rome (ASLROMA1). We used an Actor-Partner Interdependence Model (APIM) to test the interdependence of both partners and the effect of dyadic relationships on psychiatric symptoms in the couple. RESULTS The overall test of distinguishability yielded a chi square value of 122.167 (23 df; p < .001). The actor-partner interdependence model showed significant paths between couple coping and psychiatric symptomatology. Specifically, we found that the quality of couple coping perceived by the mother negatively predicted maternal psychiatric symptomatology, and the quality of couple coping perceived by the father negatively predicted paternal psychiatric symptomatology. Furthermore, the quality of couple coping perceived by the father negatively predicted maternal psychiatric symptomatology. CONCLUSIONS The results of this study confirm that dyadic adjustment is an important element for the development of effective interpersonal relationships. These data highlight the importance of promoting psycho-educational and clinical courses and programs for the development of social support with future parents.
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Affiliation(s)
- Grazia Terrone
- Department of Humanities, Literature, and Cultural Heritage, University of Foggia, Foggia, Italy.
| | | | | | - Arianna Cantiano
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy
| | | | | | - Alessio Gori
- Department of Health Sciences, University of Florence, Firenze, Italy
| | - Marco Cacioppo
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
| | - Vincenzo Caretti
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy
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16
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Fredriksen E, von Soest T, Smith L, Moe V. Parenting Stress Plays a Mediating Role in the Prediction of Early Child Development from Both Parents' Perinatal Depressive Symptoms. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:149-164. [PMID: 29623542 DOI: 10.1007/s10802-018-0428-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Maternal postnatal depression has been associated with a broad range of developmental risk among children. However, there has been less focus on disentangling the effects of pre- and postnatal depressive symptoms, as well as examining the symptoms of both parents. This study aims to investigate the separate effects of pre- and postnatal depressive symptoms in mothers and fathers, and parents' differential effects on child social-emotional, cognitive, and language development at 18 months of age. Further, we investigate whether effects of depressive symptomatology on child outcomes are particularly strong when both parents evinced high symptom loads and whether parenting stress mediates associations between perinatal depressive symptoms and child developmental outcomes. The study used data from 1036 families participating in a community-based study from mid-pregnancy until 18 months postpartum. Depressive symptoms were assessed at seven time points (four prenatally). Within a structural equation framework, we found that parental perinatal depressive symptoms predicted child social-emotional functioning, specifically externalizing, internalizing, and dysregulation problems, as well as language developmental delay at 18 months. Controlling for postnatal symptoms we found no independent effect of prenatal depressive symptoms on any child outcomes. A differential effect was evident, linking maternal symptoms to social-emotional outcomes, and paternal symptoms to language outcomes. There was no evidence of stronger associations between depressive symptoms and child outcomes when both parents showed high symptom loads. However, parenting stress mediated most relations between parental depressive symptoms and child outcomes. Findings demonstrate the importance of including paternal depressive symptoms in both clinical and research contexts.
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Affiliation(s)
- Eivor Fredriksen
- Department of Psychology, University of Oslo, PO Box 1094, Blindern, 0317, Oslo, Norway. .,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
| | - Tilmann von Soest
- Department of Psychology, University of Oslo, PO Box 1094, Blindern, 0317, Oslo, Norway
| | - Lars Smith
- Department of Psychology, University of Oslo, PO Box 1094, Blindern, 0317, Oslo, Norway
| | - Vibeke Moe
- Department of Psychology, University of Oslo, PO Box 1094, Blindern, 0317, Oslo, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
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17
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Rao WW, Zhu XM, Zong QQ, Zhang Q, Hall BJ, Ungvari GS, Xiang YT. Prevalence of prenatal and postpartum depression in fathers: A comprehensive meta-analysis of observational surveys. J Affect Disord 2020; 263:491-499. [PMID: 31757623 DOI: 10.1016/j.jad.2019.10.030] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/03/2019] [Accepted: 10/25/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Increasing attention has been paid to maternal prenatal and postpartum depressive symptoms (depression thereafter), but little is known about the prevalence of paternal prenatal and postpartum depression. To fill this gap, the current study meta-analyzed the worldwide prevalence of prenatal and postpartum depression in fathers. METHODS Studies that reported paternal depression occurring between the first trimester and the first postpartum year were identified by searching both international (PubMed, PsycINFO, Web of Science and EMBASE) and Chinese (WanFang and CNKI) databases between their inception date and July 1, 2018. A random-effects model was used to calculate pooled estimates and 95% confidence intervals. RESULTS Forty-seven studies with 20,728 subjects were included in the meta-analysis. The prevalence of prenatal depression in fathers was 9.76% in all three trimesters, 13.59% in the first, 11.31% in the second and 10.12% in the third trimester. The prevalence of postpartum depression was 8.75% within a whole year, 8.98% within one-month, 7.82% between one- and three months, 9.23% between three months and six months and 8.40% between six months to twelve months after child-birth. The prevalence of paternal postpartum depression was moderated by year of publication, study area, age of fathers of ≥18 years, quality assessment score and mean age (all P<0.05). CONCLUSIONS This meta-analysis found that the prevalence of prenatal and postpartum depression in fathers was relatively common. Regular screening, effective prevention and appropriate treatment need to be implemented in this population.
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Affiliation(s)
- Wen-Wang Rao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
| | - Xiao-Min Zhu
- Department of Psychiatry, Suzhou Guangji Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Qian-Qian Zong
- School of Nursing, Capital Medical University, Beijing, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China
| | - Brian J Hall
- Department of Psychology, Global and Community Mental Health Research Group, University of Macau, Macao SAR, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia; The University of Notre Dame Australia, Fremantle, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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18
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Darwin Z, Domoney J, Iles J, Bristow F, Siew J, Sethna V. Assessing the Mental Health of Fathers, Other Co-parents, and Partners in the Perinatal Period: Mixed Methods Evidence Synthesis. Front Psychiatry 2020; 11:585479. [PMID: 33510656 PMCID: PMC7835428 DOI: 10.3389/fpsyt.2020.585479] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/21/2020] [Indexed: 01/17/2023] Open
Abstract
Introduction: Five to 10 percentage of fathers experience perinatal depression and 5-15% experience perinatal anxiety, with rates increasing when mothers are also experiencing perinatal mental health disorders. Perinatal mental illness in either parent contributes to adverse child and family outcomes. While there are increasing calls to assess the mental health of both parents, universal services (e.g., maternity) and specialist perinatal mental health services usually focus on the mother (i.e., the gestational parent). The aim of this review was to identify and synthesize evidence on the performance of mental health screening tools and the acceptability of mental health assessment, specifically in relation to fathers, other co-parents and partners in the perinatal period. Methods: A systematic search was conducted using electronic databases (MEDLINE, PsycINFO, Maternity, and Infant Care Database and CINAHL). Articles were eligible if they included expectant or new partners, regardless of the partner's gender or relationship status. Accuracy was determined by comparison of screening tool with diagnostic interview. Acceptability was predominantly assessed through parents' and health professionals' perspectives. Narrative synthesis was applied to all elements of the review, with thematic analysis applied to the acceptability studies. Results: Seven accuracy studies and 20 acceptability studies were included. The review identified that existing evidence focuses on resident fathers and assessing depression in universal settings. All accuracy studies assessed the Edinburgh Postnatal Depression Scale but with highly varied results. Evidence on acceptability in practice is limited to postnatal settings. Amongst both fathers and health professionals, views on assessment are mixed. Identified challenges were categorized at the individual-, practitioner- and service-level. These include: gendered perspectives on mental health; the potential to compromise support offered to mothers; practitioners' knowledge, skills, and confidence; service culture and remit; time pressures; opportunity for contact; and the need for tools, training, supervision and onward referral routes. Conclusion: There is a paucity of published evidence on assessing the mental health of fathers, co-mothers, step-parents and other partners in the perinatal period. Whilst practitioners need to be responsive to mental health needs, further research is needed with stakeholders in a range of practice settings, with attention to ethical and practical considerations, to inform the implementation of evidence-based assessment.
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Affiliation(s)
- Zoe Darwin
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Jill Domoney
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Jane Iles
- Department of Psychology, University of Surrey, Surrey, United Kingdom
| | - Florence Bristow
- Community Perinatal Mental Health Service for Croydon, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jasmine Siew
- Department of Experimental Clinical and Health Psychology, Research in Developmental Disorders Lab, Ghent University, Ghent, Belgium.,Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Vaheshta Sethna
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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19
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Baldwin S, Malone M, Sandall J, Bick D. A qualitative exploratory study of UK first-time fathers' experiences, mental health and wellbeing needs during their transition to fatherhood. BMJ Open 2019; 9:e030792. [PMID: 31519681 PMCID: PMC6747673 DOI: 10.1136/bmjopen-2019-030792] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To develop an understanding of men's experiences of first-time fatherhood, their mental health and wellbeing needs. DESIGN A qualitative study using semi-structured interviews. Data were analysed using framework analysis. SETTING Two large National Health Service integrated care trusts covering four London (UK) local authority boroughs. PARTICIPANTS First-time fathers with children under 12 months of age were included. Maximum variation sampling was used, with 21 fathers recruited. Ten of these men described their ethnic background as Indian, seven as White British, one as Spanish, one as Black African, one as Black Caribbean and one as Pakistani. Participants' ages ranged from 20 to over 60 years; completion of full-time education ranged from high school certificate to doctorate level; and annual income ranged from £15 000 to over £61 000. Non-English speaking fathers, those experiencing bereavement following neonatal death, stillbirth, pregnancy loss, sudden infant death, and fathers with existing severe mental illnesses were excluded. RESULTS Nine major categories were identified: 'preparation for fatherhood', 'rollercoaster of feelings', 'new identity', 'challenges and impact', 'changed relationship: we're in a different place', 'coping and support', 'health professionals and services: experience, provision and support', 'barriers to accessing support', and 'men's perceived needs: what fathers want'. Resident (residing with their partner and baby) and non-resident fathers in this study highlighted broadly similar needs, as did fathers for whom English was their first language and those for whom it was not. A key finding of this study relates to men's own perceived needs and how they would like to be supported during the perinatal period, contributing to the current evidence. CONCLUSIONS This study provides insight into first-time fathers' experiences during their transition to fatherhood, with important implications for healthcare policy makers, service providers and professionals for how perinatal and early years services are planned and provided for both new parents.
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Affiliation(s)
- Sharin Baldwin
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care/ Learning and Development, King's College London/ London North West University Healthcare Trust, London, UK
| | - Mary Malone
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK
| | - Jane Sandall
- Department of Women and Children's Health, School of Life Course Science, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Debra Bick
- Warwick Clinical Trials Unit, University of Warwick, and University Hospitals Coventry & Warwickshire, Warwick, UK
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20
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Fentz HN, Simonsen M, Trillingsgaard T. General, Interpersonal, and Gender Role Specific Risk Factors of Postpartum Depressive Symptoms in Fathers. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2019. [DOI: 10.1521/jscp.2019.38.7.545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: Paternal postnatal depression has significant negative consequences for the family and child. Still, only little attention has been paid to potential unique risk factors of depression in fathers and the theoretical grounding of such research is sparse. Method: This study examined prenatal risk factors derived from three theoretical models: the cognitive vulnerability-stress model, the interpersonal model, and the gender role risk model of paternal postnatal depression. The sample consisted of 211 expectant fathers, of whom 5.7% scored above the clinical cut-off on the Edinburgh Postnatal Depression Scale, and 235 mothers were included as a reference group. Participants filled in questionnaires during pregnancy and four months postpartum. Results: The study results suggest that prenatal depressive score is the strongest risk factor for both paternal and maternal postnatal depressive symptoms. In addition, childhood separation from parents, unemployment, financial strain, and doubts about having the child were unique risk factors for paternal depressive symptoms, while lower marital satisfaction was a unique risk factor for maternal depression. Discussion: These findings highlight that beyond the strong role of prenatal depressive symptoms for both genders, specific risk factors for father depression exist. This may be informative to health care professionals in increasing the reach and prevention of depression in new fathers.
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21
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Shaheen NA, AlAtiq Y, Thomas A, Alanazi HA, AlZahrani ZE, Younis SAR, Hussein MA. Paternal Postnatal Depression Among Fathers of Newborn in Saudi Arabia. Am J Mens Health 2019; 13:1557988319831219. [PMID: 30776946 PMCID: PMC6775555 DOI: 10.1177/1557988319831219] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Paternal postnatal depression (PPND) is not a commonly recognized phenomenon. The aim of the study was to identify the Edinburgh Postnatal Depression Scale (EPDS) cutoff for Saudi fathers, to estimate PPND prevalence and to determine the risk factors of PPND among fathers of newborn in Saudi Arabia. A cross-sectional study of fathers with babies born up to 6 months prior to the survey was conducted. Fathers were screened using EPDS and demographic questionnaire. The fathers were selected using systematic random sampling from visitors to the birth registration office. A subsample of participants from the postnatal wards in a tertiary care was invited for additional evaluation by a psychologist using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for major depressive disorders. Receiver operating characteristic curve was utilized to identify fathers with depression; a cutoff of 8/9 was optimal to achieve sensitivity 77.8% and specificity 81.3%. Adjusted prevalence of PPND was reported with corresponding Wilson 95% confidence interval. Two hundred and ninety fathers completed the EPDS and demographic questionnaire. Of 72 invited participants, 57 (79.16%) attended the diagnostic interview. The average age of fathers was 34.97 ± 8.56 years, the average maternal age was 29.18 ± 7.41 years, average age of the newborn was 43.13 ± 35.88 days. PPND adjusted prevalence was 16.6% (95% CI [8.5, 25.6]). Paternal mental health needs equal attention during and postdelivery of newborn. Fathers should receive perinatal and postnatal mental health assessment to prevent behavioral problems in their children and disruption of relationship with their spouse.
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Affiliation(s)
- Naila A Shaheen
- 1 Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.,2 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.,3 Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Yousra AlAtiq
- 2 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.,3 Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.,4 Department of Psychiatry, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Abin Thomas
- 1 Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.,2 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.,3 Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | | | - Ziad E AlZahrani
- 2 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.,3 Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.,6 Research Office/Research Quality Management Section, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Samah Abdul Ra'ouf Younis
- 2 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.,3 Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.,6 Research Office/Research Quality Management Section, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed A Hussein
- 1 Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.,2 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.,3 Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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22
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Hicks LM, Dayton CJ, Victor BG. Depressive and trauma symptoms in expectant, risk-exposed, mothers and fathers: Is mindfulness a buffer? J Affect Disord 2018; 238:179-186. [PMID: 29885607 DOI: 10.1016/j.jad.2018.05.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 04/02/2018] [Accepted: 05/27/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Perinatal depression is reported in 15-20% of women (Marcus, 2009), 8-16% of men (Paulson and Bazemore, 2010) and low-SES, diverse populations are particularly at risk (Sareen, 2011). Trauma symptoms are commonly comorbid with depression, especially when individuals are exposed to risk factors such as community violence and poverty (Kastello et al., 2015; WenzGross et al., 2016). Parental mental illness places infants at risk for negative outcomes (Junge et al., 2016). Evidence supports that dispositional mindfulness is linked to mental health in many populations, however, a gap lies in the understanding of the relationship between mindfulness, trauma and depression in risk-exposed, pregnant populations, especially with fathers. We hypothesize that dispositional mindfulness is negatively associated with lower depression and trauma symptoms in pregnancy, in mothers and fathers. METHODS Dispositional mindfulness, depressive and trauma symptoms were examined in women and men, exposed to adversity who were expecting a baby (N = 102). Independent t-tests, and bivariate correlations examined the relationships between these variables. Hierarchical regression was utilized to understand how mindfulness and trauma symptoms may contribute to antenatal depression symptoms. RESULTS Significant differences were observed with mindfulness and depressive symptoms, with no differences reported across gender. Mindfulness, depressive and trauma symptoms were associated in the expected directions. Total mindfulness, specifically being non-reactive to one's own thoughts and trauma symptoms predicted depressive symptoms. LIMITATIONS Limitations include small sample size, cross-sectional data and self-report measures. CONCLUSION Mindfulness and trauma symptoms were found to be significant predictors of depressive symptoms in parents-to-be. Those with lower mindfulness exhibited higher levels of depression. These findings may be helpful in disseminated mindfulness-based interventions aimed at treating antenatal depression in both expectant mothers and fathers who are exposed to adversity. Further research is necessary to understand the mechanisms of mindfulness in risk-exposed, expectant parents.
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23
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Carlberg M, Edhborg M, Lindberg L. Paternal Perinatal Depression Assessed by the Edinburgh Postnatal Depression Scale and the Gotland Male Depression Scale: Prevalence and Possible Risk Factors. Am J Mens Health 2018; 12:720-729. [PMID: 29350097 PMCID: PMC6131440 DOI: 10.1177/1557988317749071] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Several studies have used the Edinburgh Postnatal Depression Scale (EPDS),
developed to screen new mothers, also for new fathers. This study aimed to
further contribute to this knowledge by comparing assessment of possible
depression in fathers and associated demographic factors by the EPDS and the
Gotland Male Depression Scale (GMDS), developed for “male” depression screening.
The study compared EPDS score ≥10 and ≥12, corresponding to minor and major
depression, respectively, in relation to GMDS score ≥13. At 3–6 months after
child birth, a questionnaire was sent to 8,011 fathers of whom 3,656 (46%)
responded. The detection of possibly depressed fathers by EPDS was 8.1% at score
≥12, comparable to the 8.6% detected by the GMDS. At score ≥10, the proportion
detected by EPDS increased to 13.3%. Associations with possible risk factors
were analyzed for fathers detected by one or both scales. A low income was
associated with depression in all groups. Fathers detected by EPDS alone were at
higher risk if they had three or more children, or lower education. Fathers
detected by EPDS alone at score ≥10, or by both scales at EPDS score ≥12, more
often were born in a foreign country. Seemingly, the EPDS and the GMDS are
associated with different demographic risk factors. The EPDS score appears
critical since 5% of possibly depressed fathers are excluded at EPDS cutoff 12.
These results suggest that neither scale alone is sufficient for depression
screening in new fathers, and that the decision of EPDS cutoff is crucial.
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Affiliation(s)
- Magdalena Carlberg
- 1 Health and Medical Care Administration, Stockholm County Council, Stockholm, Sweden
| | - Maigun Edhborg
- 2 Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lene Lindberg
- 3 Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.,4 Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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24
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Abstract
Men are a numerical minority group receiving a diagnosis of, and treatment
for, depression. However, community surveys of men and of their mental
health issues (e.g. suicide and alcoholism) have led some to suggest that
many more men have depression than are currently seen in healthcare
services. This article explores current approaches to men and depression,
which draw on theories of sex differences, gender roles and hegemonic
masculinity. The sex differences approach has the potential to provide
diagnostic tools for (male) depression; gender role theory could be used to
redesign health services so that they target individuals who have a
masculine, problem-focused coping style; and hegemonic masculinity
highlights how gender is enacted through depression and that men's
depression may be visible in abusive, aggressive and violent practices.
Depression in men is receiving growing recognition, and recent policy
changes in the UK may mean that health services are obliged to incorporate
services that meet the needs of men with depression.
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Fletcher R, Dowse E, St George J, Payling T. Mental health screening of fathers attending early parenting services in Australia. J Child Health Care 2017; 21:498-508. [PMID: 29110526 DOI: 10.1177/1367493517732166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Paternal perinatal depression and anxiety is a common, though under-recognized mental health condition experienced by men during their transition to fatherhood. An opportunity to screen for paternal mental health issues occurs when parents present for assistance with the care of their baby at early parenting services (EPSs). There are 10 EPSs located across Australia that provide specialist, multidisciplinary interventions to support parents experiencing complex parenting difficulties. Using structured telephone interviews, this qualitative study explored the views of 18 professional staff from nine EPSs regarding screening, referral processes and acceptability of screening fathers for mental health issues. A thematic analysis revealed that most EPSs screened fathers for depression. Participants agreed screening was important and that routine approaches to screening would help normalize the process for both men and services. Despite this, no uniform, comprehensive approach to identifying the mental health needs of fathers was found. EPSs provide a unique opportunity to address the mental health needs of fathers. Results from this study point to the need for a national approach to the development of father-specific screening guidelines for EPSs to improve family well-being, in parallel to those informing the Australian National Perinatal Mental Health Initiative for mothers.
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Affiliation(s)
- Richard Fletcher
- 1 Family Action Centre, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Eileen Dowse
- 2 School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Jennifer St George
- 3 Family Action Centre, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Tara Payling
- 4 Family Action Centre, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
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Psouni E, Agebjörn J, Linder H. Symptoms of depression in Swedish fathers in the postnatal period and development of a screening tool. Scand J Psychol 2017; 58:485-496. [DOI: 10.1111/sjop.12396] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 09/05/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Elia Psouni
- Department of Psychology; Lund University; Sweden
| | | | - Hanne Linder
- Department of Psychology; Lund University; Sweden
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Gentile S, Fusco ML. Untreated perinatal paternal depression: Effects on offspring. Psychiatry Res 2017; 252:325-332. [PMID: 28314228 DOI: 10.1016/j.psychres.2017.02.064] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 02/18/2017] [Accepted: 02/24/2017] [Indexed: 11/17/2022]
Abstract
Transition to parenthood represents an important life event which increases vulnerability to psychological disorders. Aim of this article is to analyze all studies which investigated the effects of untreated perinatal paternal depression in offspring. We searched pertinent, peer-reviewed articles published in English (January 1980 to April 2016) on MEDLINE, PsycINFO, and Science.gov. Twenty-three studies met the inclusion criteria. Most of the reviewed studies suffer from methodological limitations, including the small sample, the lack of a structured psychiatric diagnosis, and inclusion bias. Despite such limitations, paternal depression seems to be associated with an increased risk of developmental and behavioural problems and even psychiatric disorders in offspring. In particular, in infants and toddlers such problems vary from increased crying to hyperactivity and conduct problems to psychological and developmental impairment, and poor social outcomes. School-age children of depressed fathers have a doubled risk for suffering from specific psychiatric disorders. Hence, facilitating access to vigorous and evidence based treatments is a public health opportunity for improving the quality of life of depressed parents and their children. Evidences emerging from this review actually suggest that the traditional gender-focused approach to perinatal mood disorders should be completed by a family-centred approach, in order to improve the effectiveness of perinatal mental health programs.
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Affiliation(s)
- Salvatore Gentile
- Department of Mental Health ASL Salerno, Piazza Galdi, 841013 Cava de' Tirreni, Salerno, Italy; University of Naples, Medical School "Federico II", Department of Neurosciences, Perinatal Psychiatry, Via S. Pansini, 5, 80131 Naples, Italy.
| | - Maria Luigia Fusco
- Mental Health Institute, Via Dante Alighieri 1, 80058 Torre Annunziata, Naples, Italy; Post-graduate School of Psychology (SIPGI Campania), Via Dante Alighieri 1, 80058 Torre Annunziata, Naples, Italy.
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28
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What do dads want? Treatment preferences for paternal postpartum depression. J Affect Disord 2017; 215:62-70. [PMID: 28319693 DOI: 10.1016/j.jad.2017.03.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/16/2017] [Accepted: 03/08/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is prevalent, occurring in 8 to 13% of new fathers. Identifying effective and acceptable treatments for paternal PPD is important to prevent negative family outcomes. Participation in a patient preferred treatment for depression increases treatment adherence and effectiveness. Thus, developing and delivering interventions that are preferred by the target population is an important aspect of successful treatment. The current study investigated treatment preferences for paternal PPD. METHODS Men (N=140) who were within the first year postpartum were recruited from low-risk maternity clinics, baby shows, and partner referrals. Participants completed a 20-minute online survey that included three expert validated treatment descriptions for depression and a series of questionnaires. RESULTS Participants reported preferring individual and couple psychotherapy to pharmacotherapy for treatment of PPD. Men perceived both individual and couple psychotherapy as being more credible and reported more favourable personal reactions towards them when compared to pharmacotherapy. LIMITATIONS Participants were not required to meet diagnostic criteria for depression. The majority of participants were asked to respond to a hypothetical scenario of what they would do if faced with PPD. CONCLUSIONS These findings suggest that fathers prefer psychological interventions over pharmacotherapy for treatment of PPD. Future research should investigate efficacious treatment options for paternal PPD based on treatment preferences.
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29
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Fisher SD. Paternal Mental Health: Why Is It Relevant? Am J Lifestyle Med 2017; 11:200-211. [PMID: 30202331 PMCID: PMC6125083 DOI: 10.1177/1559827616629895] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/02/2015] [Accepted: 01/11/2016] [Indexed: 01/23/2023] Open
Abstract
Father's mental health is an emerging area of interest that is beginning to be recognized in research, and to a lesser extent in clinical practice and society. Fathers are part of a parenting dyad with 2 partners who are responsible for their children's emotional development. Similar to mothers, the risk for mental health problems increases once a male becomes a father, but there is limited research examining this issue. The purpose of this review is to present the available literature on father's mental health and its effect on child emotional health through various mechanisms. In general, father's mental health was found to be related to increased child internalizing and externalizing behaviors, but each disorder had different risk factors, and a unique effect on parenting behaviors and the child's emotional health. The most developed paternal mental health literature is focused on depression. However, key conceptual and methodological problems exist that may limit our understanding of paternal depression. Additionally, the focus on paternal depression may not accurately represent the largest risk for paternal psychopathology and the resultant child mental health outcomes because men have an increased likelihood of displaying externalizing behaviors. Implications for research, clinical practice, and policy are discussed.
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Affiliation(s)
- Sheehan D. Fisher
- Department of Psychiatry and Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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30
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Bateson K, Darwin Z, Galdas P, Rosan C. Engaging fathers: Acknowledging the barriers. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/johv.2017.5.3.126] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Zoe Darwin
- Research fellow in maternal wellbeing and women's health, University of Leeds
| | - Paul Galdas
- Reader, Department of Health Sciences, University of York
| | - Camilla Rosan
- Head of children, families and young people's programmes, Mental Health Foundation
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Darwin Z, Galdas P, Hinchliff S, Littlewood E, McMillan D, McGowan L, Gilbody S. Fathers' views and experiences of their own mental health during pregnancy and the first postnatal year: a qualitative interview study of men participating in the UK Born and Bred in Yorkshire (BaBY) cohort. BMC Pregnancy Childbirth 2017; 17:45. [PMID: 28125983 PMCID: PMC5270346 DOI: 10.1186/s12884-017-1229-4] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 01/19/2017] [Indexed: 11/10/2022] Open
Abstract
Background The prevalence of fathers’ depression and anxiety in the perinatal period (i.e. from conception to 1 year after birth) is approximately 5–10%, and 5–15%, respectively; their children face increased risk of adverse emotional and behavioural outcomes, independent of maternal mental health. Critically, fathers can be protective against the development of maternal perinatal mental health problems and their effects on child outcomes. Preventing and treating paternal mental health problems and promoting paternal psychological wellbeing may therefore benefit the family as a whole. This study examined fathers’ views and direct experiences of paternal perinatal mental health. Methods Men in the Born and Bred in Yorkshire (BaBY) epidemiological prospective cohort who met eligibility criteria (baby born <12 months; completed Mental Health and Wellbeing [MHWB] questionnaires) were invited to participate. Those expressing interest (n = 42) were purposively sampled to ensure diversity of MHWB scores. In-depth interviews were conducted at 5–10 months postpartum with 19 men aged 25–44 years. The majority were first-time fathers and UK born; all lived with their partner. Data were analysed using thematic analysis. Results Four themes were identified: ‘legitimacy of paternal stress and entitlement to health professionals’ support’, ‘protecting the partnership’, ‘navigating fatherhood’, and, ‘diversity of men’s support networks’. Men largely described their ‘stress’ with reference to exhaustion, poor concentration and irritability. Despite feeling excluded by maternity services, fathers questioned their entitlement to support, noting that services are pressured and ‘should’ be focused on mothers. Men emphasised the need to support their partner and protect their partnership as central to the successfully navigation of fatherhood; they used existing support networks where available but noted the paucity of tailored support for fathers. Conclusions Fathers experience psychological distress in the perinatal period but question the legitimacy of their experiences. Men may thus be reluctant to express their support needs or seek help amid concerns that to do so would detract from their partner’s needs. Resources are needed that are tailored to men, framed around fatherhood, rather than mental health or mental illness, and align men’s self-care with their role as supporter and protector. Further research is needed to inform how best to identify and manage both parents’ mental health needs and promote their psychological wellbeing, in the context of achievable models of service delivery. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1229-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Z Darwin
- School of Healthcare, University of Leeds, Leeds, LS2 9JT, UK.
| | - P Galdas
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - S Hinchliff
- School of Nursing and Midwifery, University of Sheffield, Sheffield, S10 2LA, UK
| | - E Littlewood
- Hull York Medical School, University of York, York, YO10 5DD, UK
| | - D McMillan
- Department of Health Sciences, University of York, York, YO10 5DD, UK.,Hull York Medical School, University of York, York, YO10 5DD, UK
| | - L McGowan
- School of Healthcare, University of Leeds, Leeds, LS2 9JT, UK
| | - S Gilbody
- Department of Health Sciences, University of York, York, YO10 5DD, UK.,Hull York Medical School, University of York, York, YO10 5DD, UK
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32
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Cameron EE, Sedov ID, Tomfohr-Madsen LM. Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. J Affect Disord 2016; 206:189-203. [PMID: 27475890 DOI: 10.1016/j.jad.2016.07.044] [Citation(s) in RCA: 282] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/30/2016] [Accepted: 07/09/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Research in paternal prenatal and postpartum depression has nearly doubled since prevalence rates were last meta-estimated in October 2009. An updated meta-analysis allows additional questions to be answered about moderators that influence risk. METHODS Studies reporting paternal depression between the first trimester and one-year postpartum were obtained for the period from January 1980 to November 2015. In total 74 studies with 41,480 participants were included, and data was extracted independently by two authors. Moderator analyses included measurement method, timing of assessment, study location, publication year, age, education, parity, history of depression, and maternal depression. RESULTS The meta-estimate for paternal depression was 8.4% (95% confidence interval [CI], 7.2-9.6%) with significant heterogeneity observed among prevalence rates. Prevalence significantly varied based on publication year, study location, measurement method, and maternal depression. Prevalence was not conditional on paternal age, education, parity, history of paternal depression, and timing of assessment. LIMITATIONS Analyses were limited by variability in assessment measures, countries from which studies were available, extant data for the first trimester and 6- to 9-month postpartum, and method of reporting sociodemographic information. CONCLUSIONS Paternal depression was present in 8% of men in the included studies. Future screening policies and interventions should consider moderating risk factors for depression throughout the transition to parenthood.
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Affiliation(s)
- Emily E Cameron
- Department of Psychology, University of Calgary, Calgary, AB, Canada.
| | - Ivan D Sedov
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Lianne M Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute for Child and Maternal Health (ACHRI), Calgary, AB, Canada; Department of Pediatrics, Alberta Children's Hospital, Calgary, AB, Canada
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Molgora S, Fenaroli V, Malgaroli M, Saita E. Trajectories of Postpartum Depression in Italian First-Time Fathers. Am J Mens Health 2016; 11:880-887. [PMID: 27885145 PMCID: PMC5675320 DOI: 10.1177/1557988316677692] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Paternal postpartum depression (PPD) has received little attention compared with maternal prenatal and postpartum depression, despite research reporting that paternal PPD concerns a substantial number of fathers. History of depression and antenatal depression have been identified as important PPD’s risk factors, underlining the continuity of depressive symptoms during the transition to parenthood. However, only few studies have focused on the evolution of depressive symptoms with longitudinal research design. The present study aims at analyzing the longitudinal trajectories of depressive symptoms from the third trimester of pregnancy to 1 year after childbirth. One hundred and twenty-six first-time fathers completed the Edinburgh Postnatal Depression Scale at four time points (7-8 months of pregnancy, 40 days, 5-6 months, and 12 months after childbirth). Data were analyzed throughout latent growth mixture modeling. Latent growth mixture modeling analysis indicated a three-class model as the optimal solution. The three-class solution included a trajectory of low, stable depressive symptoms across the four time points (resilient, 52%); a trajectory of moderate, relatively stable depressive symptomatology (distress, 37%); and a trajectory of emergent clinical depression following a pattern of high depressive symptoms (emergent depression, 11%). This study allowed to identify different subpopulation within the sample, distinguishing among mental well-being, emotional distress, and high-risk conditions when—1 year after childbirth—fathers report the highest scores to the Edinburgh Postnatal Depression Scale. These results underline the importance to analyze fathers’ well-being over the time during the transition to fatherhood.
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Massoudi P, Hwang CP, Wickberg B. Fathers’ depressive symptoms in the postnatal period: Prevalence and correlates in a population-based Swedish study. Scand J Public Health 2016; 44:688-694. [DOI: 10.1177/1403494816661652] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: The aim of this study was to investigate the prevalence and correlates of depression in new fathers. Methods: A population-based sample of 885 Swedish fathers and their partners completed a questionnaire, including the Edinburgh Postnatal Depression Scale at three months postpartum. Correlates of depressive symptoms were analysed with univariate and multiple variable regression models. Results: Symptoms of depression were found in 6.3% of the fathers and 12.0% of the mothers, and the point prevalence of major depression in fathers was 1.3%. The strongest correlates of depressive symptoms in fathers were problems in the partner relationship, a low educational level, previous depression, stressful life events and low partner support. The cross-sectional design could affect the magnitude of the results, and causal inferences cannot be made. Conclusions: Although the rate of depressive symptoms is lower in fathers than in mothers at three months postpartum, the associated factors are similar to those found in studies of mothers. The first visits at the child health centre could include a discussion with both parents about normal transition problems; balancing work, personal and family needs; and distress. When signs of distress or partner relationship difficulties are picked up, this should be followed up and support interventions offered.
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Affiliation(s)
- Pamela Massoudi
- Department of Research and Development, Region Kronoberg, Sweden
- Department of Psychology, University of Gothenburg, Sweden
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35
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Freitas CJ, Williams-Reade J, Distelberg B, Fox CA, Lister Z. Paternal depression during pregnancy and postpartum: An international Delphi study. J Affect Disord 2016; 202:128-36. [PMID: 27262634 DOI: 10.1016/j.jad.2016.05.056] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/21/2016] [Accepted: 05/25/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Fathers are at risk for depression during a mother's gestation and postpartum. Assessment, detection, and treatment are hampered by the lack of consensus on this issue. The purpose of this study was to reach expert consensus through the Delphi method on the defining factors of depression in peripartum fathers. METHODS Purposive sampling resulted in the surveying of 14 international expert panelists. The study used a modified Delphi approach in which experts participated in two rounds of open-ended and scale questionnaires, followed by two rounds of opportunities to adjust their responses and/or comment on evolving data until consensus was achieved. RESULTS Experts responded to 10 questions on terminology, diagnostics, symptomology, risk/protective factors, biological factors, assessment tools/protocol, cost implications, and key stakeholders. Of these 10 questions presented for discussion, the analysis resulted in 197 coded themes. Consensus was met for 119 of the 197 coded responses (60.41%). LIMITATIONS Diversity of opinion within this Delphi Study was excluded for the sake of consensus. Regression to the mean may have occurred after continuous surveying and when evolving results were shared with panelists. Critics of Delphi methodologies have pointed to the issue of small expert samples typically used and the subjectivity of "expert." CONCLUSION Consensus identified diagnostic criteria and symptomology that differentiates the paternal experience of peripartum depression. Experts indicated the importance of a father's social context, biological risk factors, limitations of current assessment tools, key stakeholders, and potential financial costs. Stakeholders on this issue would benefit from translating consensus into assessment and treatment.
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Affiliation(s)
- Cassidy J Freitas
- School of Leadership and Education Sciences, Department of Counseling and Marital and Family Therapy, University of San Diego, 4540 Kearny Villa Road Suite 210, San Diego, CA 92123, United States.
| | - Jacqueline Williams-Reade
- School of Behavioral Health, Department of Counseling and Family Sciences, Loma Linda University, United States
| | - Brian Distelberg
- School of Behavioral Health, Department of Counseling and Family Sciences, Loma Linda University, United States
| | - Curtis A Fox
- School of Behavioral Health, Department of Counseling and Family Sciences, Loma Linda University, United States
| | - Zephon Lister
- Collaborative Care Program, Department of Family Medicine, University of California, San Diego, United States
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Paulson JF, Bazemore SD, Goodman JH, Leiferman JA. The course and interrelationship of maternal and paternal perinatal depression. Arch Womens Ment Health 2016; 19:655-63. [PMID: 26790687 PMCID: PMC4957140 DOI: 10.1007/s00737-016-0598-4] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 01/09/2016] [Indexed: 11/27/2022]
Abstract
The aims of the study were to describe course of depression in both mothers and fathers from the third trimester of pregnancy through 6 months postpartum and to examine the relationship between maternal and paternal depression. Hypotheses were as follows: (a) Depressive symptoms would be correlated between parents and (b) earlier depressive symptoms in one parent would predict later increases in depression in the other. Eighty cohabitating primiparous couples were recruited from prenatal OBGYN visits and community agencies and enrolled during pregnancy, between 28-week gestation and delivery. Participants completed measures of depression on four occasions: baseline and 1, 3, and 6 months postpartum. Ninety-eight percent of the enrolled couples (78; 156 individuals) completed the study. For both mothers and fathers, symptom severity ratings and classification as a probable case were stable across time, with prenatal depression persisting through 6 months in 75 % of mothers and 86 % of fathers. Prenatal depression in fathers predicted worsening depressive symptom severity in mothers across the first six postpartum months but not vice versa. In both expecting/new mothers and fathers, depression demonstrates a stable pattern of occurrence and symptom severity between 28-month gestation and 6 months postpartum. Although prenatal maternal depression is not predictive of symptom change in fathers, mothers with prenatally depressed partners showed significant worsening in overall symptom severity during the first six postpartum months.
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Affiliation(s)
- James F Paulson
- Department of Psychology, Old Dominion University, MGB 250, Norfolk, VA, 23529, USA.
| | - Sharnail D Bazemore
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
| | - Janice H Goodman
- School of Nursing, MGH Institute of Health Professions, Boston, MA, USA
| | - Jenn A Leiferman
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA
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Ahlqvist-Björkroth S, Korja R, Junttila N, Savonlahti E, Pajulo M, Räihä H, Aromaa M. MOTHERS’ AND FATHERS’ PRENATAL REPRESENTATIONS IN RELATION TO MARITAL DISTRESS AND DEPRESSIVE SYMPTOMS. Infant Ment Health J 2016; 37:388-400. [DOI: 10.1002/imhj.21578] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 01/18/2016] [Accepted: 05/12/2016] [Indexed: 11/08/2022]
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38
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Fathers Matter: Family Therapy’s Role in the Treatment of Paternal Peripartum Depression. CONTEMPORARY FAMILY THERAPY 2015. [DOI: 10.1007/s10591-015-9347-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Edward KL, Castle D, Mills C, Davis L, Casey J. An integrative review of paternal depression. Am J Mens Health 2014; 9:26-34. [PMID: 24626601 DOI: 10.1177/1557988314526614] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The aim of this project was to review current research regarding postnatal depression in fathers and to present potential screening and referral options. The search was limited to scholarly (peer reviewed) journals and all articles were retrieved with date limits. Initial search parameters were the following: antenatal depression OR pregnancy depression OR postnatal depression OR perinatal depression AND father* OR men OR paternal. The search yielded 311 abstracts returned. With reference to the inclusion criteria and primary and secondary outcomes intended for the focus of this review, N=63 articles were retrieved and read in full by the researchers. These articles were included in the final integrative review. Depression in fathers following the birth of their child was associated with a personal history of depression and with the existence of depression in their partner during pregnancy and soon after delivery. Based on the review the authors suggest routine screening and assessment of both parents should occur across the pregnancy and postnatal period. The use of the Edinburgh Postnatal Depression Scale for screening of depression in men needs to be linked to referral guidelines for those individuals who require further investigation and care.
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Affiliation(s)
- Karen-leigh Edward
- Australian Catholic University, Australia St. Vincent's Private Hospital Melbourne, Fitzroy, Victoria, Australia
| | - David Castle
- St. Vincent's Private Hospital Melbourne, Fitzroy, Victoria, Australia The University of Melbourne, Parkville, Victoria, Australia
| | - Cally Mills
- Australian Catholic University, Australia St. Vincent's Private Hospital Melbourne, Fitzroy, Victoria, Australia
| | | | - June Casey
- Australian Catholic University, Australia
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Wynter K, Rowe H, Fisher J. Common mental disorders in women and men in the first six months after the birth of their first infant: a community study in Victoria, Australia. J Affect Disord 2013; 151:980-5. [PMID: 24119921 DOI: 10.1016/j.jad.2013.08.021] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 08/17/2013] [Accepted: 08/17/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Studies of postpartum mental health have focused predominantly on women and on depression. There is limited evidence regarding men's postpartum mental health and about other common mental disorders, such as anxiety and adjustment disorders, which may also be relevant at this life phase. The main aim of this study was to establish the period prevalence of depression, anxiety, and adjustment disorders in primiparous women and their male partners in the first six months postpartum METHODS English-speaking couples were recruited in five local government areas in Victoria, Australia. Women and men completed separate telephone interviews which included the Edinburgh Postnatal Depression Scale (EPDS) and selected Depression and Anxiety modules of the Composite International Diagnostic Interview. DSM-IV criteria were used to classify adjustment disorders, based on subclinical symptoms not meeting criteria for diagnoses of major or minor depression or generalised anxiety disorder. The main outcome was any common mental disorder (depression, anxiety or adjustment disorder) in the first six months postpartum RESULTS Complete data were available for 172 couples. The 6-month period prevalence of mental health problems was 33% for women and 17% for men. The most common diagnosis in both women and men was adjustment disorder with anxiety symptoms LIMITATIONS Unpartnered women and men, women whose partners were not willing to participate and those who did not have sufficient English fluency to complete the interviews were excluded from the sample. The results of this study cannot be generalised to these populations. CONCLUSION The most common postnatal mental health problem in both women and men in this community sample was anxiety.
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Affiliation(s)
- Karen Wynter
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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41
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Wee KY, Pier C, Milgrom J, Richardson B, Fisher J, Skouteris H. Fathers' mental health during the ante-and postnatal periods: Knowledge, recommendations and interventions. ACTA ACUST UNITED AC 2013. [DOI: 10.12968/bjom.2013.21.5.342] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kim Yiong Wee
- Kim Yiong Wee, Ph.D. Psychology Student Deakin University, Australia
| | - Ciaran Pier
- Ciaran Pier, Lecturer in Psychology University of Melbourne, Australia
| | - Jeannette Milgrom
- Jeannette Milgrom, Professor in Psychology University of Melbourne and Parent-Infant Research Institute
| | - Ben Richardson
- Ben Richardson, Senior Lecturer in Psychology Deakin University, Australia
| | - Jane Fisher
- Jane Fisher, Jean Hailes Professor of Women’s Health, Monash University, Australia
| | - Helen Skouteris
- Helen Skouteris, Associate Professor in Developmental Psychology Deakin University, Australia
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Bergström M. Depressive symptoms in new first-time fathers: associations with age, sociodemographic characteristics, and antenatal psychological well-being. Birth 2013; 40:32-8. [PMID: 24635422 DOI: 10.1111/birt.12026] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/27/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND New fathers may be as vulnerable as new mothers to depression, and their symptoms also can affect the mother and child. The purpose of this study was to investigate depressive symptoms and associations with paternal age, sociodemographic characteristics, and antenatal psychological well-being in Swedish first-time fathers. METHODS Depressive symptoms, defined as scores of 11 or greater on the Edinburgh Postnatal Depression Scale, were investigated in 812 men 3 months after their first baby was born. The study sample included primarily Swedish-born, married or cohabiting men who participated in antenatal education classes during the partner's pregnancy. RESULTS In all, 10.3 percent of study men suffered from depressive symptoms. Compared with fathers aged 29-33 years (sample mean age ± 2 yr), the younger fathers had an increased risk for depressive symptoms (OR 2.55; 95% CI 1.50-4.35). Low educational level, low income, poor partner relationship quality, and financial worry increased the risk for depressive symptoms, but these factors could not explain the increased risk among the young. CONCLUSIONS New fathers in their twenties seem to have an increased risk for depressive symptoms that cannot be explained solely by socioeconomic factors. Support should be offered to new fathers with particular focus on the young.
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Affiliation(s)
- Malin Bergström
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
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44
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Jensen HV, Munk KP, Madsen SA. Gendering late-life depression? The coping process in a group of elderly men. NORDIC PSYCHOLOGY 2012. [DOI: 10.1027/1901-2276/a000011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ramchandani PG, Psychogiou L, Vlachos H, Iles J, Sethna V, Netsi E, Lodder A. Paternal depression: an examination of its links with father, child and family functioning in the postnatal period. Depress Anxiety 2011; 28:471-7. [PMID: 21506206 PMCID: PMC3128925 DOI: 10.1002/da.20814] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 02/16/2011] [Accepted: 02/16/2011] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Maternal depression is common and is known to affect both maternal and child health. One of the mechanisms by which maternal depression exerts its effects on child health is through an increased rate of parental disharmony. Fathers also experience depression, but the impact of this on family functioning has been less studied. The aim of this study was to investigate the association between paternal depressive disorder and family and child functioning, in the first 3 months of a child's life. METHODS A controlled study comparing individual and familial outcomes in fathers with (n = 54) and without diagnosed depressive disorder (n = 99). Parental couple functioning and child temperament were assessed by both paternal and maternal report. RESULTS Depression in fathers is associated with an increased risk of disharmony in partner relationships, reported by both fathers and their partners, controlling for maternal depression. Few differences in infant's reported temperament were found in the early postnatal period. CONCLUSIONS These findings emphasize the importance of considering the potential for men, as well as women, to experience depression in the postnatal period. Paternal symptoms hold the potential to impact upon fathers, their partners, and their children.
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Ridge D, Emslie C, White A. Understanding how men experience, express and cope with mental distress: where next? SOCIOLOGY OF HEALTH & ILLNESS 2011; 33:145-159. [PMID: 21039617 DOI: 10.1111/j.1467-9566.2010.01266.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In line with the shift towards prioritising lay accounts and narratives of chronic illness in sociology, there is an emerging literature on men, their subjectivities and experiences of mental distress. We argue in this paper that subjectivities and distress among men are an important area for critical sociological research. Very little is known about men's subjectivities or the meanings they give to - and how they cope with or seek help for - distress. At the same time, current theories of gender relations, performativity and wellbeing as they pertain to men are likely to shed further light on subjectivity and distress. However, current theories (and qualitative research involving men and women) are pointing to considerable complexity. In this paper, we outline what is known about distress and men, and consider the utility of gender relations, performativity, subjectivities and wellbeing for a better understanding of distress. We also ask: What other factors influence distress, and how should these be considered in relation to men and masculinities? What are the implications for research and policy?
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Affiliation(s)
- Damien Ridge
- School of Life Sciences, University of Westminster, London.
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Edmondson OJ, Psychogiou L, Vlachos H, Netsi E, Ramchandani PG. Depression in fathers in the postnatal period: assessment of the Edinburgh Postnatal Depression Scale as a screening measure. J Affect Disord 2010; 125:365-8. [PMID: 20163873 PMCID: PMC2927780 DOI: 10.1016/j.jad.2010.01.069] [Citation(s) in RCA: 157] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Revised: 01/19/2010] [Accepted: 01/19/2010] [Indexed: 11/16/2022]
Abstract
BACKGROUND Postnatal depression commonly affects women after the birth of a child, and is associated with an increased risk of adverse outcomes for their children. A wide variety of measures have been used to screen for depression in the postnatal period but little research has investigated such measures with men. However depression can also affect men at this time, and this is associated with an independently increased risk of adverse child outcomes. The present study aimed to determine whether a reliable cut off point for the Edinburgh Postnatal Depression Scale (EPDS) can be established to screen fathers. METHOD A sample of fathers was sent the EPDS at 7 weeks after the birth of their child. A structured clinical interview was conducted with 192 men to determine whether they were suffering from depression. RESULTS Fathers with depression scored significantly higher on the EPDS than non-depressed fathers. A score of greater than 10 was found to be the optimal cut off point for screening for depression, with a sensitivity of 89.5% and a specificity of 78.2%. LIMITATIONS The relatively modest participation rate means the results may not be fully generalisable to the whole population. CONCLUSION The EPDS is shown to have reasonable sensitivity and specificity at a cut off score of over 10. The study shows that it is possible to screen fathers for depression in the postnatal period and it may be valuable to administer this measure to new fathers.
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Affiliation(s)
| | - Lamprini Psychogiou
- Section of Child and Adolescent Psychiatry, University of Oxford, Oxford, UK
| | | | - Elena Netsi
- Section of Child and Adolescent Psychiatry, University of Oxford, Oxford, UK
| | - Paul G. Ramchandani
- Section of Child and Adolescent Psychiatry, University of Oxford, Oxford, UK,Corresponding author. University of Oxford Department of Psychiatry, Warneford Hospital, Headington, Oxford, OX3 7JX, UK. Tel.: + 44 1865 226491.
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Shelton N, Herrick K. Comparison of scoring methods and thresholds of the General Health Questionnaire-12 with the Edinburgh Postnatal Depression Scale in English women. Public Health 2009; 123:789-93. [DOI: 10.1016/j.puhe.2009.09.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 09/08/2009] [Accepted: 09/22/2009] [Indexed: 10/20/2022]
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Doucet S, Dennis CL, Letourneau N, Blackmore ER. Differentiation and clinical implications of postpartum depression and postpartum psychosis. J Obstet Gynecol Neonatal Nurs 2009; 38:269-79. [PMID: 19538615 DOI: 10.1111/j.1552-6909.2009.01019.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Postpartum depression and postpartum psychosis are serious mood disorders encountered by nurses working in a variety of settings. Postpartum depression refers to a nonpsychotic depressive episode, while postpartum psychosis refers to a manic or affective psychotic episode linked temporally with childbirth. The nursing profession plays a crucial role in the early identification and treatment of these postpartum mood disorders. This article explains the classification, clinical presentation, epidemiology, management, and long-term outcomes of postpartum depression and postpartum psychosis.
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Affiliation(s)
- Shelley Doucet
- University of New Brunswick, Department of Nursing, P.O. Box 5050, Saint John, NB E2L 4L5, Canada.
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