Is there a relationship between a mother's mental state and consulting the doctor by the family? A study in a military general practice

Major paternal depression and child consultation for developmental and behavioural problems

BACKGROUND

It is well established that maternal depression is associated with enhanced child consultation for developmental and behaviour problems, but there is a dearth of research on paternal depression and child outcome.

AIM

To assess the association of major paternal depressed mood and child consultation for developmental and behaviour problems.

DESIGN OF STUDY

Cross-sectional study.

SETTING

General practices in London and Hertfordshire, UK.

METHOD

Fathers of children aged 4-6 years were recruited via 13 general practices. A sample of 248 biological father and mother dyads completed measures on depressive syndrome (Patient Health Questionnaire), child consultations with health professionals for developmental and behaviour problems, fathering, couple relationship quality, alcohol misuse, other psychiatric impairment, and sociodemographic factors.

RESULTS

Eight out of 248 fathers (3%) had a major depressive syndrome. Sixty-five out of 247 (26%) fathers reported they were responsible for taking their child to see the doctor at least half the time compared with mothers. Children of fathers with a major depressive syndrome were almost nine times more likely to have consulted a health professional for speech and language problems (adjusted odds ratio [OR] = 8.67, 95% confidence interval [CI] = 1.99 to 37.67, P = 0.004) and seven times more likely to have consulted for externalising behaviour problems (adjusted OR = 6.98, 95% CI = 1.00 to 48.76, P = 0.05).

CONCLUSION

Children of fathers with major depression were more likely to consult for speech and language problems and externalising behaviour problems. A longitudinal study is recommended to identify causal mechanisms.

What factors are of importance for infants' use of health and medical care during the first 18 months?

OBJECTIVE

To study factors of importance for infants' use of health and medical care.

DESIGN

We studied the medical records of the mother during pregnancy (at the health centre, at the antenatal clinics, and at the department of obstetrics and gynaecology) and of her infant during the first 18 months of life (at the health centre, at the child health clinic, and at the departments of paediatrics and oto-rhino-laryngology). We also interviewed the mother when her infant was 18 months old.

SETTING

Teleborg health centre, Växjö, southern Sweden.

SUBJECTS

206 infants and their mothers.

MAIN OUTCOME MEASURES

Medical visits, to doctor or district nurse, during the infants' first 18 months of life, and factors of potential importance for those visits.

RESULTS

A stepwise linear multiple regression analysis showed that the following factors were of importance for the infant's use of health and medical care: number of mother's visits to the health and medical services during pregnancy, mother being a primipara, and mother being a blue-collar worker. The model (12.98 + 0.52* (no. of mother's visits) + 2.19 (if primipara) + 1.48 (if blue-collar worker)) was able to explain 8.6% of the number of infant's visits.

CONCLUSION

The studied factors explained only a minor part of the infants' use of health and medical care.