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Scarlett H, Wiernik E, van der Waerden J. Longitudinal trajectories and associated risk factors of paternal mental illness in the nine years surrounding the transition to fatherhood. J Affect Disord 2024; 362:363-374. [PMID: 38986876 DOI: 10.1016/j.jad.2024.07.008] [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: 01/09/2024] [Revised: 06/07/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND The arrival of one's first child is a known risk factor for mental illness, yet investigations on fathers' mental health are limited. We conducted a longitudinal investigation on paternal depression and anxiety in the nine years surrounding the transition to fatherhood. METHODS Using a national cohort of French men (CONSTANCES, n = 6299), we investigated the prevalence and associated risk factors of mental illness amongst first-time fathers. Responses to the Center for Epidemiological Studies Depression (CES-D) and 12-item General Health Questionnaire (GHQ-12) scales were used to identify clinically significant symptom scores. Self-declared mental illness was also reported by participants. Group-based modelling was used to identify latent trajectory groups for both measures. RESULTS Levels of self-declared anxiety (averaging 4.9 % pre-fatherhood, 7.8 % post) exceeded that of depression (1.9 % pre- fatherhood, 3.3 % post) or other disorders. However, rates of clinically significant symptom scores (17-27 %) were consistently higher. Participants' mental health appeared to worsen from two-years prior to their child's arrival and improve from two-years after. We identified three trajectory groups for fathers' self-declared mental illness: Low stable (90.3 %); Low risk with high temporary increase (5.6 %); and Consistent high risk (4.1 %). Risk factors associated with worsening mental health trajectories were unemployment, not living with one's partner, having had adverse childhood experiences and foregoing healthcare due to financial reasons. LIMITATIONS All measures of mental illness relied on participant self-reports and are thus subject to bias. CONCLUSIONS This study reveals an important period of heightened psychological vulnerability amongst first-time fathers, emphasising the need for increased and better adapted paternal mental health screening.
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Affiliation(s)
- Honor Scarlett
- UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne University, INSERM, Paris, France.
| | - Emmanuel Wiernik
- UMS 011 Population-based Cohorts Unit, Paris Cité University, Paris Saclay University, Versailles Saint-Quentin-en-Yvelines University, INSERM, Paris, France
| | - Judith van der Waerden
- UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne University, INSERM, Paris, France
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Kiwan M. Beyond mothers: Postpartum depression among fathers in Pakistan. Asian J Psychiatr 2024; 101:104213. [PMID: 39236526 DOI: 10.1016/j.ajp.2024.104213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/28/2024] [Accepted: 08/29/2024] [Indexed: 09/07/2024]
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Zhu J, Ye Y, Liu X, Chen Y, Chen L, Lin Y, Wang Q, Zhang J. The incidence and risk factors of depression across six time points in the perinatal period: a prospective study in China. Front Med (Lausanne) 2024; 11:1407034. [PMID: 39247639 PMCID: PMC11377249 DOI: 10.3389/fmed.2024.1407034] [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: 03/26/2024] [Accepted: 08/01/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction Perinatal depression (PND) affects approximately 15%-20% of women. This study aimed to determine the incidence of PND and identify risk factors. Methods A prospective study was conducted at the Affiliated People's Hospital of Ningbo University. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PND. Classification models were constructed using Extreme Gradient Boosting (XGBoost), Logistic Regression (LR), Random Forest (RF), and Support Vector Machine (SVM), and the optimal model was selected. Results Between March 2019 and August 2021, a total of 485 participants completed all valid questionnaires. Depression was observed in 75 (15.5%), 47 (9.7%), 25 (5.2%), 94 (19.4%), 85 (17.5%), and 43 (8.9%) cases during the first trimester, the second trimester, the third trimester, 1 week postpartum, 6 months postpartum, and 12 months postpartum, respectively. During the prenatal period, factors such as monthly income, employment status, marital status, and thyroid function significantly impacted depression. Additionally, factors including monthly income, employment status, marital status, parity, and unintended pregnancy were found to affect the likelihood of developing postpartum depression. XGBoost was chosen for its accuracy (0.9097) and precision (0.9005) in predicting prenatal depression, as well as for its accuracy (0.9253) and precision (0.9523) in predicting postpartum depression. Discussion In conclusion, the incidence of depression varies throughout the perinatal period, with different factors influencing prenatal and postpartum depression.
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Affiliation(s)
- Jue Zhu
- Department of Gynecology and Obstetrics, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Youchun Ye
- Department of Gynecology and Obstetrics, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Xuan Liu
- Department of Computer and Data Engineering, NingboTech University, Ningbo, Zhejiang, China
| | - Yichen Chen
- Department of Basic Research Laboratory, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Lu Chen
- Department of Gynecology and Obstetrics, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Yi Lin
- Department of Gynecology and Obstetrics, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Qiming Wang
- Department of Gynecology and Obstetrics, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Jing Zhang
- Department of Gynecology and Obstetrics, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China
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Poćwierz-Marciniak I, Bieleninik Ł, Cruz JB, Ardila YMB, Jassem-Bobowicz J, Malaver SAH, Díaz AM, Reina NNM, De la Barrera LIM, Gaona AJC, Ettenberger M. Short-term effectiveness of music therapy songwriting for mental health outcomes of at-risk parents in the NICU: a study protocol of an international multicenter mixed-methods trial. HEALTH PSYCHOLOGY REPORT 2024; 12:260-274. [PMID: 39234024 PMCID: PMC11370736 DOI: 10.5114/hpr/190886] [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: 05/27/2024] [Revised: 06/10/2024] [Accepted: 07/08/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Preterm birth contributes to adverse mental health outcomes of parents dealing with a premature neonate. The main objective of this study is to determine whether music therapy (MT) songwriting during the infants' stay in the neonatal intensive care unit (NICU) is superior to standard care in reducing the risk of postpartum depression in high-risk parents of preterm children throughout the hospital treatment. The secondary objectives include assessment of effectiveness of MT in other aspects of mental health (anxiety level, perceived stress, mental wellbeing, coping, resilience). Furthermore, this trial will evaluate the medical and social factors that may be associated with the effects of MT songwriting. PARTICIPANTS AND PROCEDURE The study design is a sequential mixed method study with a dominant status QUAN to qual. The quantitative trial was designed as a parallel, multicenter, pragmatic, randomized controlled trial. The qualitative study is a descriptive phenomenological study that seeks to understand the lived experiences of participants exposed to songwriting. Participants are parents of premature infants hospitalized in NICU (106 families) in 5 hospitals, in Colombia and Poland. Intervention: 3 MT songwriting sessions per week across 3 weeks. Primary outcome: the risk of postnatal depression; secondary outcomes: anxiety level, mental wellbeing, resilience, stress, coping. RESULTS The results will be analyzed quantitatively and qualitatively. CONCLUSIONS This study will provide a report on the effectiveness of MT songwriting on mental health in at-risk parents of preterm infants.
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Affiliation(s)
| | - Łucja Bieleninik
- Institute of Psychology, University of Gdansk, Gdansk, Poland
- GAMUT – The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
- Institute of Pedagogy and Languages, University of Applied Sciences in Elbląg, Elbląg, Poland
| | | | | | | | | | - Ana M. Díaz
- Music Therapy Service, Clínica Iberoamérica, Barranquilla, Colombia
| | | | | | | | - Mark Ettenberger
- Music Therapy Service, Clínica Reina Sofía Pediátrica y Mujer, Bogotá, Colombia
- SONO – Centro de Musicoterapia, Bogotá, Colombia
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Xiao G, Wang H, Hu J, Zhao Z, Li Q, Qin C. Prevalence of antenatal depression and postpartum depression among Chinese fathers: A systematic review and meta-analysis. Heliyon 2024; 10:e35089. [PMID: 39170297 PMCID: PMC11336420 DOI: 10.1016/j.heliyon.2024.e35089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Background Paternal antenatal depression and postpartum depression are associated with adverse health outcomes in mothers and infants; however, their prevalence among Chinese fathers remains controversial. This meta-analysis aimed to summarize the prevalence of antenatal depression and postpartum depression in Chinese fathers. Methods We conducted a systematic meta-analysis on the prevalence of antenatal depression and postpartum depression among Chinese fathers by searching 11 databases. Pooled estimates and 95 % confidence intervals were calculated. The choice between a random-effects model and a fixed-effects model was based on an assessment of heterogeneity among the studies as well as assumptions regarding the similarity of the studies in terms of clinical characteristics, quality, design, and conduct. Subgroup and meta-regression analyses were conducted based on the scale used to measure antenatal depression and postpartum depression, the region where the study was completed, the time of the study, the study design, the number of children, publication language, the study site, and quality assessment. Results This meta-analysis included 28 studies with 8795 participants. The prevalence of antenatal depression among Chinese fathers was 11 % (95 % CI: 5%-17 %, P < 0.01) using a random-effects model. Heterogeneity was I2 = 91 %. Publication language moderated the prevalence of paternal antenatal depression (the amount of heterogeneity accounted for was 92.13 %). The prevalence of postpartum depression among Chinese fathers was 16 % (95 % CI: 13%-18 %, P < 0.01), using a random-effects model. The heterogeneity was I2 = 94 %. The prevalence of paternal postpartum depression was moderated by the scale used to measure postpartum depression (39.17 % heterogeneity) and the region where the study was completed (33.15 % heterogeneity). Moreover, Egger's test (t = 4.542, P < 0.001) indicated publication bias in studies on postpartum depression among Chinese fathers. However, after applying the trimming correction, the pooled prevalence of postpartum depression had a P value of <0.05, indicating that despite the publication bias, the results remain reliable and unaffected in terms of effect size. Conclusion The prevalence of antenatal depression and postpartum depression among Chinese fathers was similar to those reported in low- and middle-income countries. Fathers should receive regular screening, effective prevention, and appropriate treatment. However, interpreting these results requires consideration of the limitations of the study.
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Affiliation(s)
- Gui Xiao
- Health Management Medicine Center and nursing department, The Third Xiangya Hospital, Central South University, Changsha, China
- School of Xiangya Nursing, Central South University, Changsha, China
| | - Hu Wang
- Emergency Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiaji Hu
- School of Xiangya Nursing, Central South University, Changsha, China
| | - Ziran Zhao
- International Nursing School, Hainan Medical University, Haikou, China
| | - Qiyu Li
- The School of Xiangya Medicine, Central South University, Changsha, China
| | - Chunxiang Qin
- Health Management Medicine Center and nursing department, The Third Xiangya Hospital, Central South University, Changsha, China
- School of Xiangya Nursing, Central South University, Changsha, China
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Shorey S, Thilagamangai, Mathews J, Lim SH, Shi L, Chua JS, Du R, Chan YH, Tan TC, Chee C, Chong YS. Effects of Parental Predictors on Postpartum Depression. West J Nurs Res 2024; 46:517-524. [PMID: 38822693 DOI: 10.1177/01939459241254774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
BACKGROUND Postpartum depression (PPD) is highly prevalent and plagues a significant proportion of parents. Postpartum depression also exerts various negative consequences on infant development and parent-infant relationships. Social support is identified as an important factor influencing many parental predictors, and may affect the development of PPD. OBJECTIVE This study aimed to investigate how perceived social support can indirectly influence PPD symptoms in parents at 6 months postpartum by influencing postpartum anxiety, parental satisfaction, and parental self-efficacy (PSE). METHODS A secondary analysis of data from a randomized controlled trial was used with a cross-sectional exploratory design. A total of 400 Singaporean parents (200 couples) were included, and structural equation modeling was used to analyze the relationships between PPD and potential predictors. RESULTS Findings revealed a less adequate fit between the hypothesized model and the data collected. Social support was found to be a significant predictor of postpartum anxiety, PSE, and parental satisfaction. Postpartum anxiety was a significant predictor of PPD, but PSE and parental satisfaction were not. CONCLUSION This study provides an overview of how different parental predictors may be associated with PPD among Asian parents. Postpartum anxiety significantly predicted PPD, but social support had negative effects on postpartum anxiety, parenting satisfaction, and PSE. The findings provide further insight into how parents at risk of PPD can be identified and demonstrated how social support might negatively impact parental outcomes. More qualitative research with Asian parents is needed to further explain these findings and inform the development of future interventions.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Thilagamangai
- Division of Nursing, KK Women's and Children's Hospital, Singapore
| | | | | | - Luming Shi
- Singapore Clinical Research Institute, Singapore
| | - Jing Shi Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ruochen Du
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yiong Huak Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Yap Seng Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Zheng J, Han R, Gao L. Social Support, Parenting Self-Efficacy, and Postpartum Depression Among Chinese Parents: The Actor-Partner Interdependence Mediation Model. J Midwifery Womens Health 2024; 69:559-566. [PMID: 38148288 DOI: 10.1111/jmwh.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/14/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION Postpartum depression affects both mothers and fathers. This study aimed to examine the relationships between social support, parenting self-efficacy, and postpartum depression in Chinese mothers and fathers and assess the mediating effect of parenting self-efficacy using a dyadic perspective. METHODS A cross-sectional study was implemented from December 2020 to July 2021 in Guangzhou, China, with 309 pairs of parents. The Edinburgh Postnatal Depression Scale, Social Support Rating Scale, Parenting Sense of Competence Scale-Efficacy subscale, and sociodemographic data sheet were completed by both parents. Dyadic analysis was conducted using the actor-partner interdependence mediation model. An actor effect is the relationship between variables within an individual, whereas a partner effect is the relationship between variables in the individual and the dyadic partner. RESULTS In total, 20.7% of mothers and 11.7% of fathers had elevated postpartum depressive symptoms at 6 weeks postpartum. The model revealed 6 actor effects: social support was positively associated with parenting self-efficacy for mothers (β, 0.39; 95% CI, 0.28-0.49) and fathers (β, 0.39; 95% CI, 0.30-0.48) and negatively associated with postpartum depression for mothers (β, -0.22; 95% CI, -0.32 to -0.12) and fathers (β, -0.37; 95% CI, -0.48 to -0.26). Parenting self-efficacy was negatively associated with postpartum depression in mothers (β, -0.41; 95% CI, -0.53 to -0.29) and fathers (β, -0.24; 95% CI, -0.37 to -0.12). Maternal social support had a partner effect on paternal parenting self-efficacy (β, 0.14; 95% CI, 0.04-0.24). Parenting self-efficacy mediated between social support and postpartum depression for both parents (mothers: β, -0.16; 95% CI, -0.23 to -0.10; fathers: β, -0.10; 95% CI, -0.16 to -0.05). DISCUSSION Postpartum depression was a dyadic phenomenon. Increasing mother-centered social support has the potential to improve the parenting self-efficacy of both parents and reduce the likelihood of postpartum depression.
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Affiliation(s)
- Jie Zheng
- School of Nursing, Peking University, Beijing, China
| | - Rongrong Han
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Schöch P, Hölzle L, Lampe A, Hörtnagl C, Zechmeister-Koss I, Buchheim A, Paul JL. Towards effective screening for paternal perinatal mental illness: a meta-review of instruments and research gaps. Front Public Health 2024; 12:1393729. [PMID: 38983254 PMCID: PMC11231099 DOI: 10.3389/fpubh.2024.1393729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/04/2024] [Indexed: 07/11/2024] Open
Abstract
Background Paternal perinatal mental illness (PPMI), which affects around one in 10 fathers, is under-recognised despite increasing awareness of men's mental health in the perinatal period. Social stigma and men's reluctance to seek help exacerbate this gap. Neglecting the mental health needs of new fathers not only puts them at increased risk for mental illness themselves, but also has a profound and long-lasting impact on their families, children and their own self-esteem as they navigate their new role in the family dynamic. Objective This meta-review systematically identifies instruments assessing PPMI symptoms, evaluates their psychometric properties and applicability, presents key findings from studies using these tools, and identifies gaps and limitations in the literature on PPMI symptom assessment. Methods A systematic literature review was conducted using search strategies applied to PubMed, PsycNet APA, Cochrane, and Web of Science, supplemented by hand searches. Relevant information was extracted from each included study. Extracted data were analysed narratively to address the research questions. Results Findings identified limitations and gaps in current screening practices. While the Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening tool for both fathers and mothers, it inadequately captures atypical depressive symptoms in men. Cutoff scores lack consensus, and instrument sensitivity varies significantly due to cultural and sociodemographic factors. A number of other screening tools have been identified, most of which are more general and not specifically designed for perinatal mental health. Conclusion This meta-review broadens perspectives on PPMI screening instruments, highlighting key themes, patterns, and differences across the included reviews. While a variety of screening tools are used, the review underscores the necessity for tools specifically tailored to fathers during the perinatal period.
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Affiliation(s)
- Philipp Schöch
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
- Department of Clinical Psychology II, Institute of Psychology, University Innsbruck, Innsbruck, Austria
| | - Laura Hölzle
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
- Department of Clinical Psychology II, Institute of Psychology, University Innsbruck, Innsbruck, Austria
| | - Astrid Lampe
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria
| | - Christine Hörtnagl
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | | | - Anna Buchheim
- Department of Clinical Psychology II, Institute of Psychology, University Innsbruck, Innsbruck, Austria
| | - Jean Lillian Paul
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
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Hölzle L, Schöch P, Hörtnagl C, Buchheim A, Lampe A, Zechmeister-Koss I, Paul JL. Identifying and synthesizing components of perinatal mental health peer support - a systematic review. Front Psychiatry 2024; 15:1389545. [PMID: 38966189 PMCID: PMC11223205 DOI: 10.3389/fpsyt.2024.1389545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/29/2024] [Indexed: 07/06/2024] Open
Abstract
Background Becoming a parent, while often perceived as a joyous event, can also be a vulnerable life transition, with approximately one in five mothers experiencing perinatal mental illness. Peer support is recommended for its preventive and therapeutic benefits. However, relevant program components of perinatal mental health peer support remain to be identified. Objectives This review aims to (1) identify peer support programs in perinatal mental health through existing reviews and to (2) synthesize the components of these programs. Methods A systematic literature review guided by PRISMA was conducted searching four databases, supplemented by hand searches. The Template for Intervention Description and Replication (TIDieR) checklist facilitated the systematic extraction and synthesis of program components. Results Eleven peer support programs were identified from three reviews, largely conducted in English-speaking countries. The identified reviews highlight the benefits of peer support in perinatal mental health. Key components of individual programs were contextual background, materials, provider training and support, delivery modes and locations, and evaluation. Sharing lived experience and providing flexible support were central to all programs. Conclusion Aspects of flexibility, authenticity and the challenges of program evaluation in peer support must be considered. Findings can now inform future planning and implementation efforts of peer support programs in periantal mental health.
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Affiliation(s)
- Laura Hölzle
- Department of Psychiatry, Medical University Innsbruck, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Innsbruck, Austria
- University of Innsbruck, Institute of Psychology, Innsbruck, Austria
| | - Philipp Schöch
- Department of Psychiatry, Medical University Innsbruck, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Innsbruck, Austria
- University of Innsbruck, Institute of Psychology, Innsbruck, Austria
| | - Christine Hörtnagl
- Department of Psychiatry, Medical University Innsbruck, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Innsbruck, Austria
| | - Anna Buchheim
- University of Innsbruck, Institute of Psychology, Innsbruck, Austria
| | - Astrid Lampe
- Ludwig Boltzmann Gesellschaft Institute for Rehabilitation, Vienna, Austria
| | | | - Jean Lillian Paul
- Department of Psychiatry, Medical University Innsbruck, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Innsbruck, Austria
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Estlein R, Shai D. Dyadic Prenatal Coparenting Interaction Behaviors Predicting Postpartum Depressive Symptoms during the Transition to Parenthood. Eur J Investig Health Psychol Educ 2024; 14:1722-1734. [PMID: 38921080 PMCID: PMC11203113 DOI: 10.3390/ejihpe14060114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
Postpartum depressive symptoms constitute a common yet serious complication of pregnancy and childbirth, but research on its association with coparenting is scarce. Furthermore, although coparenting dynamics start forming prior to the child's birth, no research has explored dyadic prenatal coparenting dynamics as a predictor of postpartum depressive symptoms. The current study assessed how dyadic prenatal coparenting behaviors predicted postpartum depressive symptoms in first-time parents. We conducted a dyadic mixed-method longitudinal study of 107 expectant couples with data collected prenatally, and at 3, 6, and 24 months post-birth. The results indicated that prenatal coparenting dyadic synchrony predicted low levels of depressive symptoms among first-time fathers 3 and 6 months after the birth, and a prenatal coparenting dynamic of dyadic negative escalation predicted high levels of depressive symptoms among first-time mothers at 3 and 24 months postpartum. The theoretical and practical implications are discussed.
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Affiliation(s)
- Roi Estlein
- School of Social Work, University of Haifa, Haifa 3498838, Israel
| | - Dana Shai
- School of Psychology, The Academic College of Tel Aviv Yaffo, Tel Aviv-Yafo 6818211, Israel;
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11
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Alvarez D, Adynski H, Harris R, Zou B, Taylor JY, Santos HP. Social Support Is Protective Against the Effects of Discrimination on Parental Mental Health Outcomes. J Am Psychiatr Nurses Assoc 2024:10783903241243092. [PMID: 38600825 DOI: 10.1177/10783903241243092] [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] [Indexed: 04/12/2024]
Abstract
BACKGROUND Discrimination, or unfair treatment based on individual characteristics such as gender, race, skin color, and or sexual orientation, is a pervasive social stressor that perpetuates health disparities by limiting social and economic opportunity and is associated with poor mental and physical health outcomes. AIMS The purpose of the present study is to (1) examine the association between maternal experiences of discrimination and paternal experiences of discrimination; (2) explore how discrimination relates to parental (maternal and paternal) stress and depressive symptoms; and (3) examine whether social support exerts protective effects. METHODS The sample was 2,510 mothers and 1,249 fathers from the Child Community Health Network study. Linear regression models were conducted to explore associations between maternal and paternal discrimination. In addition, mediation analyses were conducted to explore if social support functioned as a mediator between discrimination on parental stress and depressive symptoms. RESULTS Most mothers (40.3%) and fathers (50.7%) identified race as the predominant reason for discrimination. Experiencing discrimination was significantly related to stress and depressive symptoms for both parents, and all forms of social support mediated these relationships. Our findings suggest that social support can act as a protective factor against the negative association between discrimination and both stress and depressive symptoms. CONCLUSIONS These findings highlight the need to integrate social support into existing interventions and include fathers in mental health screenings in primary-care settings. Finally, we briefly describe the role of nurses and other allied health professionals in addressing discrimination in health care and health policy implications.
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Affiliation(s)
- Dallis Alvarez
- Dallis Alvarez, BSN, RN, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Harry Adynski
- Harry Adynski, PhD, RN, PMH-BC, University of California San Francisco, San Francisco, CA, USA
| | - Rebeca Harris
- Rebeca Harris BSN, RN, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Baiming Zou
- Baiming Zou, PhD, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jacquelyn Y Taylor
- Jacquelyn Y. Taylor, PhD, RN, FAHA, FAAN, Columbia University, New York, NY, USA
| | - Hudson P Santos
- Hudson P. Santos Jr, PhD, RN, FAAN, University of Miami, Coral Gables, FL, USA
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12
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Radoš SN, Akik BK, Žutić M, Rodriguez-Muñoz MF, Uriko K, Motrico E, Moreno-Peral P, Apter G, den Berg MLV. Diagnosis of peripartum depression disorder: A state-of-the-art approach from the COST Action Riseup-PPD. Compr Psychiatry 2024; 130:152456. [PMID: 38306851 DOI: 10.1016/j.comppsych.2024.152456] [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: 10/16/2023] [Revised: 12/26/2023] [Accepted: 01/28/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Peripartum depression (PPD) is a major depression disorder (MDD) episode with onset during pregnancy or within four weeks after childbirth, as defined in DSM-5. However, research suggests that PPD may be a distinct diagnosis. The goal of this study was to summarize the similarities and differences between PPD and MDD by synthesizing the current research on PPD diagnosis concerning different clinical features and give directions for improving diagnosis of PPD in clinical practice. METHODS To lay the groundwork for this narrative review, several databases were searched using general search phrases on PPD and its components of clinical diagnosis. RESULTS When compared to MDD, peripartum depression exhibits several distinct characteristics. PPD manifests with a variety of symptoms, i.e., more anxiety, psychomotor symptoms, obsessive thoughts, impaired concentration, fatigue and loss of energy, but less sad mood and suicidal ideation, compared to MDD. Although PPD and MDD prevalence rates are comparable, there are greater cross-cultural variances for PPD. Additionally, PPD has some distinct risk factors and mechanisms such as distinct ovarian tissue expression, premenstrual syndrome, unintended pregnancy, and obstetric complications. CONCLUSION There is a need for more in-depth research comparing MDD with depression during pregnancy and the entire postpartum year. The diagnostic criteria should be modified, particularly with (i) addition of specific symptoms (i.e., anxiety), (ii) onset specifier extending to the first year following childbirth, (iii) and change the peripartum onset specifier to either "pregnancy onset" or "postpartum onset". Diagnostic criteria for PPD are further discussed.
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Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | | | - Maja Žutić
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Maria F Rodriguez-Muñoz
- Department of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Kristiina Uriko
- Department of Psychology and Behavioural Sciences, Tallinn University, Tallinn, Estonia
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
| | - Patricia Moreno-Peral
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA), Málaga, Spain
| | - Gisèle Apter
- Child and Perinatal Psychiatric Department, Le Havre University Hospital, University Rouen Normandie, Le Havre, France
| | - Mijke Lambregtse-van den Berg
- Departments of Psychiatry and Child & Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
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13
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Jeong J, McCann JK, Joachim D, Ahun MN, Kabati M, Kaaya S. Fathers' mental health and coping strategies: a qualitative study in Mwanza, Tanzania. BMJ Open 2024; 14:e080933. [PMID: 38417960 PMCID: PMC10900361 DOI: 10.1136/bmjopen-2023-080933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/02/2024] [Indexed: 03/01/2024] Open
Abstract
OBJECTIVES To investigate the nature of paternal mental health problems, their causes and the coping strategies used by fathers of young children under the age of 2 years. DESIGN AND SETTING We conducted in-depth interviews with fathers, mothers, community leaders and community health workers as well as focus group discussions with fathers-only, mothers-only and mixed groups of fathers and mothers. Respondents provided their perspectives on the psychosocial challenges affecting fathers and how fathers responded to their mental health problems. Data were triangulated across stakeholders and analysed using thematic content analysis. SETTING The study was conducted in four communities in Mwanza, Tanzania. PARTICIPANTS The total sample included 56 fathers, 56 mothers and 8 community stakeholders that were equally distributed across the four communities. RESULTS Respondents highlighted a spectrum of mental health concerns affecting fathers, including elevated parenting stress, depressive symptoms, and anxiety. Causes of paternal mental health problems included poverty, child-related concerns, marital problems and family illness. When asked about paternal coping strategies, both fathers and mothers shared that fathers mostly turned to negative coping strategies to manage their distress, such as paternal alcohol use and poor conflict resolution strategies. However, respondents also shared how some fathers used positive coping strategies, such as seeking out social support from their family and friends, engaging in exercise and leisure activities and relying on their faith. CONCLUSIONS Overall, this study highlights the importance of supporting positive mental health among fathers. Our findings can inform the design of psychosocial programme components that can be integrated within parenting interventions to promote the well-being of specifically fathers and ultimately improve the family caregiving environment.
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Affiliation(s)
- Joshua Jeong
- Hubert Department of Global Health and Population, Emory University, Atlanta, Georgia, USA
| | - Juliet K McCann
- Hubert Department of Global Health and Population, Emory University, Atlanta, Georgia, USA
| | - Damas Joachim
- Tanzania Home Economics Organization, Mwanza, Tanzania, United Republic of
| | - Marilyn N Ahun
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Mary Kabati
- Tanzania Home Economics Organization, Mwanza, Tanzania, United Republic of
| | - Sylvia Kaaya
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
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Pillai L, Srivastava S, Ajin A, Rana SS, Mathkor DM, Haque S, M Tambuwala M, Ahmad F. Etiology and incidence of postpartum depression among birthing women in the scenario of pandemics, geopolitical conflicts and natural disasters: a systematic review. J Psychosom Obstet Gynaecol 2023; 44:2278016. [PMID: 38050938 DOI: 10.1080/0167482x.2023.2278016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023] Open
Abstract
Postpartum depression (PPD) is classified under postpartum psychiatric disorders and initiates soon after birthing, eliciting neuropsychological and behavioral deficits in mothers and offspring. Globally, PPD is estimated to be associated with 130-190 per 1000 birthing. The severity and incidences of PPD have aggravated in the recent years due to the several unfavorable environmental and geopolitical circumstances. The purpose of this systematic review hence is to explore the contributions of recent circumstances on the pathogenesis and incidence of PPD. The search, selection and retrieval of the articles published during the last three years were systematically performed. The results from the primary studies indicate that unfavorable contemporary socio-geopolitical and environmental circumstances (e.g. Covid-19 pandemic, political conflicts/wars, and natural calamities; such as floods and earthquakes) detrimentally affect PPD etiology. A combination of socio-economic and psychological factors, including perceived lack of support and anxiousness about the future may contribute to drastic aggravation of PPD incidences. Finally, we outline some of the potential treatment regimens (e.g. inter-personal psycho- and art-based therapies) that may prove to be effective in amelioration of PPD-linked symptoms in birthing women, either alone or in complementation with traditional pharmacological interventions. We propose these psychological and art-based intervention strategies may beneficially counteract the negative influences of the unfortunate recent events across multiple cultures, societies and geographical regions.
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Affiliation(s)
- Lakshmi Pillai
- Department of Biotechnology, School of Bio Sciences and Technology (SBST), Vellore Institute of Technology, Vellore, India
| | - Shayna Srivastava
- Department of Biotechnology, School of Bio Sciences and Technology (SBST), Vellore Institute of Technology, Vellore, India
| | - Akhil Ajin
- Department of Biotechnology, School of Bio Sciences and Technology (SBST), Vellore Institute of Technology, Vellore, India
| | - Sandeep Singh Rana
- Department of Biosciences, School of Bio Sciences and Technology (SBST), Vellore Institute of Technology, Vellore, India
| | - Darin Mansor Mathkor
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Shafiul Haque
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Murtaza M Tambuwala
- Lincoln Medical School, University of Lincoln, Brayford Pool Campus, Lincoln, UK
| | - Faraz Ahmad
- Department of Biotechnology, School of Bio Sciences and Technology (SBST), Vellore Institute of Technology, Vellore, India
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Abstract
Fathers have been an important source of child endurance and prosperity since the dawn of civilization, promoting adaptation to social rules, defining cultural meaning systems, teaching daily living skills, and providing the material background against which children developed; still, the recent reformulation in the role of the father requires theory-building. Paternal caregiving is rare in mammals, occurring in 3-5% of species, expresses in multiple formats, and involves flexible neurobiological accommodations to ecological conditions and active caregiving. Here, we discuss father contribution to resilience across development. Our model proposes three tenets of resilience - plasticity, sociality, and meaning - and discussion focuses on father-specific contributions to each tenet at different developmental stages; newborn, infant, preschooler, child, and adolescent. Father's style of high arousal, energetic physicality, guided participation in daily skills, joint adventure, and conflict resolution promotes children's flexible approach and social competence within intimate bonds and social groups. By expanding children's interests, sharpening cognitions, tuning affect regulation, encouraging exploration, and accompanying the search for identity, fathers support the sense of meaning, enhancing the human-specific dimension of resilience. We end by highlighting pitfalls to paternal contribution, including absence, abuse, rigidity, expectations, and gender typing, and the need to formulate novel theories to accommodate the "involved dad."
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Affiliation(s)
- Ruth Feldman
- Center for Developmental Social Neuroscience, Reichman University,Israel
- Yale Child Study Center, New Haven, USA
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Lewkowitz AK, Guille C, Rubin-Miller L, Jahnke HR, Ayala NK, Miller ES, Henrich N. Association between nonbirthing parent's perinatal education and mental health support desires and perinatal anxiety among either parent. Am J Obstet Gynecol MFM 2023; 5:101177. [PMID: 37806649 PMCID: PMC10842621 DOI: 10.1016/j.ajogmf.2023.101177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/19/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Although perinatal anxiety is common in birthing and nonbirthing parents, little is known about the mental health or educational needs of nonbirthing parents during the perinatal period and whether perinatal anxiety in the birthing parent is associated with nonbirthing parent educational preferences. OBJECTIVE This study aimed to examine the desired digital perinatal educational preferences of nonbirthing parents and whether these preferences differed by (1) endorsement of high parenthood-related anxiety in the nonbirthing partner and (2) mental health of the birthing parent (including both identified mental health conditions and presence of pregnancy-related anxiety). STUDY DESIGN In this cross-sectional study, nonbirthing and birthing parents using Maven, a digital perinatal health platform, selected the areas in which they wanted education or support from a list of options. In addition, the participants reported their experience of parenthood or pregnancy-related anxiety through a 5-item Likert scale in response to the prompt, "On a scale of 1 (not at all) to 5 (extremely), how anxious are you feeling about parenthood or pregnancy?" High parenthood or pregnancy-related anxiety was defined as being very (scale: 4) or extremely (scale: 5) anxious. Furthermore, birthing parents reported whether they had a current or previous mood disorder, but this information was not reported by nonbirthing parents. Survey responses for birthing and nonbirthing parents were linked through the digital platform. Descriptive analyses were used to assess nonbirthing parent demographics and perinatal support interests, stratified by high parenthood-related anxiety, high pregnancy-related anxiety in their partner, and perinatal mood disorders or high pregnancy-related anxiety in their partner. RESULTS Among 382 nonbirthing parents, most (85.6%) desired to receive digital support during their partner's pregnancy: the most commonly endorsed support interests were infant care (327 [85.6%]) and understanding their partner's emotional (313 [81.9%]) or physical (294 [77.0%]) experience during pregnancy. Overall, 355 nonbirthing parents (93.9%) endorsed any parenthood-related anxiety, and 63 nonbirthing parents (16.5%) were categorized as having high parenthood-related anxiety. Those with high parenthood-related anxiety were more likely to desire digital support for each topic. Among birthing parents, 124 (32.4%) had a mental health condition, and 45 (11.8%) had high pregnancy-related anxiety. When nonbirthing parents were stratified by the presence of their partner having a mental health condition or high pregnancy-related anxiety alone, no difference in desired perinatal education was identified. Although nonbirthing parents had higher rates of high parenthood-related anxiety if the birthing parent reported high pregnancy anxiety (17 [27.0%] vs 28 [8.8%]; P<.001), no difference was found with other conditions within the mental health composite. CONCLUSION In this cross-sectional study, many nonbirthing parents who engaged with a perinatal digital platform desired education on their or their partner's emotional health during the perinatal period, and most endorsed parenthood-related anxiety. Our findings suggest that perinatal mental health support is needed for nearly all parents and that nonbirthing parents who use digital health platforms are amenable to receiving comprehensive perinatal education via these platforms.
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Affiliation(s)
- Adam K Lewkowitz
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI (Drs Lewkowitz, Ayala, and Miller); Center for Digital Health, Brown University School of Public Health, Providence, RI (Dr Lewkowitz).
| | - Constance Guille
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (Dr Guille); Maven Clinic, New York, NY (Dr Guille, Ms Rubin-Miller, and Drs Jahnke and Henrich)
| | - Lily Rubin-Miller
- Maven Clinic, New York, NY (Dr Guille, Ms Rubin-Miller, and Drs Jahnke and Henrich)
| | - Hannah R Jahnke
- Maven Clinic, New York, NY (Dr Guille, Ms Rubin-Miller, and Drs Jahnke and Henrich)
| | - Nina K Ayala
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI (Drs Lewkowitz, Ayala, and Miller)
| | - Emily S Miller
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI (Drs Lewkowitz, Ayala, and Miller)
| | - Natalie Henrich
- Maven Clinic, New York, NY (Dr Guille, Ms Rubin-Miller, and Drs Jahnke and Henrich)
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Aviv EC, Preston EG, Waizman YH, Dews AA, Flores G, Saxbe DE. Fathers' subjective childbirth stress predicts depressive symptoms at six months postpartum. J Affect Disord 2023; 339:593-600. [PMID: 37459973 PMCID: PMC10923195 DOI: 10.1016/j.jad.2023.07.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/13/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Childbirth is a seminal experience in parents' lives. However, little research has investigated the link between fathers' birth experiences and their postpartum mental health. We hypothesized that a more subjectively stressful birth will predict greater self-reported depressive symptoms in fathers at six months postpartum. We also investigated the association between mode of delivery and paternal subjective stress. METHODS Seventy-seven heterosexual fathers expecting their first child and cohabiting with their pregnant partners participated in the study. Depressive symptoms were assessed in pregnancy and again at six months postpartum. Subjective birth stress was measured within the first few days of the birth, and birth charts were collected to examine mode of delivery. RESULTS Fathers' ratings of subjective birth stress significantly predicted postpartum depressive symptoms at six months postpartum. Subjective birth stress ratings varied significantly for fathers whose partners delivered via emergency cesarean section compared to those whose partners gave birth via both medicated and the unmedicated vaginal delivery. LIMITATIONS The study was limited by its small community (non-clinical) sample, which was restricted to heterosexual, cohabitating couples. Additionally, births were mostly uncomplicated and only 14 mothers underwent emergency cesarean section. CONCLUSION These findings highlight that the days immediately following childbirth are a window of opportunity for early intervention in new fathers at risk for postpartum depression.
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Affiliation(s)
- Elizabeth C Aviv
- University of Southern California Los Angeles, CA, United States.
| | - Emma G Preston
- University of Southern California Los Angeles, CA, United States
| | - Yael H Waizman
- University of Southern California Los Angeles, CA, United States
| | - Aridenne A Dews
- University of Southern California Los Angeles, CA, United States
| | - Genesis Flores
- University of Southern California Los Angeles, CA, United States
| | - Darby E Saxbe
- University of Southern California Los Angeles, CA, United States
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18
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Smith I, O'Dea G, Demmer DH, Youssef G, Craigie G, Francis LM, Coles L, D'Souza L, Cain K, Knight T, Olsson CA, Macdonald JA. Associations between unintended fatherhood and paternal mental health problems: A systematic review and meta-analysis. J Affect Disord 2023; 339:22-32. [PMID: 37393953 DOI: 10.1016/j.jad.2023.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Unintended pregnancies are linked to adverse parental mental health, yet little attention has been given to this relationship in fathers specifically. We aimed to meta-analyse associations between unintended pregnancies and mental health problems in fathers with children aged ≤36 months. METHODS We conducted keyword searches of Medline, CINAHL, Academic Search Complete, PsycInfo and Embase to February 2, 2022, and hand searched included reference lists. RESULTS Of 2826 records identified, 23 studies (N = 8085 fathers), reporting 29 effects, were eligible for meta-analysis. Included studies assessed depression, anxiety, stress, parenting stress, post-traumatic stress disorder (PTSD), alcohol misuse and psychological distress. Pooled estimates, from random effects meta-analyses, for all mental health outcomes (k = 29; OR = 2.28) and depression only (k = 19; OR = 2.36), showed that the odds of reporting mental health difficulties were >2-fold higher in men reporting unintended births compared with those reporting intended births. However, there was no evidence of association with anxiety (k = 2) or stress (k = 2). Overall, mental health problems were greater in low-income countries. No differences were found across parity, timepoint of mental health assessment, or instruments used to measure mental health symptoms. LIMITATIONS Analyses were limited by the use of retrospective assessment of pregnancy intention, and heterogeneity of measures used. Further, assessment of fathers' mental health was restricted to the first year postpartum. This review was limited to English language studies. CONCLUSIONS Unintended pregnancies present an identifiable risk for postpartum mental health problems in fathers.
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Affiliation(s)
- Imogene Smith
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia; The Cairnmillar Institute, East Hawthorn, Australia.
| | - Gypsy O'Dea
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - David Hilton Demmer
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - George Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Georgia Craigie
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Lauren M Francis
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - Laetitia Coles
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Levita D'Souza
- Faculty of Education, Monash University, Clayton, Australia
| | - Kat Cain
- Library Client Services, Deakin University, Geelong, Australia
| | - Tess Knight
- The Cairnmillar Institute, East Hawthorn, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
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Uriko K, Christoforou A, Motrico E, Moreno-Peral P, Kömürcü Akik B, Žutić M, Lambregtse-van den Berg MP. Paternal peripartum depression: emerging issues and questions on prevention, diagnosis and treatment. A consensus report from the cost action Riseup-PPD. J Reprod Infant Psychol 2023:1-19. [PMID: 37818835 DOI: 10.1080/02646838.2023.2266470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Paternal peripartum depression (P-PPD) is a serious and understudied public health problem associated with impaired family functioning and child development. The lack of recognition of P-PPD may result in limited access to both information and professional help. OBJECTIVE The aim of the study was to review studies on paternal peripartum depression and to identify issues and questions where future research and theory formation are needed. METHODS A literature search for systematic reviews, meta-analyses and primary studies was conducted using PubMed, Web of Science, Embase, Scopus, Medline, PsychInfo and Informit databases. Key results within the retrieved articles were summarised and integrated to address the review objectives. RESULTS Based on the literature, the knowledge related to prevalence, screening, risk factorsunique to fathers, management strategies and outcomes of P-PPD is lacking. Currently, there is no consensual understanding of the definition of P-PPD and recommendations for dealing with P-PPD. Limited data were available regarding the barriers preventing fathers from accessing support systems. CONCLUSION Emerging issues that need to be addressed in future research include: P-PPD definition and pathogenetic pathways; prevention strategies and assessment tools; self-help seeking and engagement with interventions; the cost-effectiveness of P-PPD management; needs of health professionals; effect on child development, and public awareness. Future studies and clinical practice should account the complexities that may arise from the father's perceptions of health care services. Results from this review highlights the critical issues on how to plan, provide and resource health services, to meet the health needs of fathers.
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Affiliation(s)
- Kristiina Uriko
- School of Natural Sciences and Health, Department of Psychology and Behavioural Sciences, Tallinn University, Tallinn, Estonia
| | - Andri Christoforou
- Department of Social and Behavioural Sciences, European University Cyprus, Nicosia, Cyprus
| | - Emma Motrico
- Department of Psychology, University Loyola Andalucia, Seville, Spain
| | - Patricia Moreno-Peral
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA). Biomedical Research Institute of Malaga (IBIMA plataforma Bionand), Malaga, Spain
| | | | - Maja Žutić
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
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Wainwright S, Caskey R, Rodriguez A, Holicky A, Wagner-Schuman M, Glassgow AE. Screening fathers for postpartum depression in a maternal-child health clinic: a program evaluation in a midwest urban academic medical center. BMC Pregnancy Childbirth 2023; 23:675. [PMID: 37726664 PMCID: PMC10508033 DOI: 10.1186/s12884-023-05966-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Postpartum depression (PPD) impacts fathers as well as mothers, and is estimated to affect between 8 and 13% of fathers. Paternal PPD is a risk factor for worsened quality of life, poor physical and mental health, and developmental and relational harms in the father-mother-child triad. There are no current recommendations for PPD screening among fathers. Paternal PPD screening was piloted in an intergenerational postpartum primary care clinic. METHODS The pilot was carried out in an intergenerational postpartum primary care clinic located at a Midwest urban academic safety net health system from October 2021 to July 2022. Fathers actively involved in relationships with mothers or infants receiving primary care in the clinic were approached with mothers' permission. A novel survey instrument was used to collect demographic/social data, as well as mental health history and current stress levels; an Edinburgh Postnatal Depression Scale (EPDS) was also administered. Screenings were completed by social workers; data were collected in REDCap and descriptive statistics were calculated in SAS. RESULTS 29 fathers were contacted and 24 completed screening (83%). Mean age was 31 years (range 19-48). Most (87%) identified as belonging to a racial or ethnic minority group. Fathers self-reported low rates of stress and preexisting mental health conditions, but 30% screened positive for PPD on EPDS (score of ≥ 8, or suicidal ideation). Gaps in health care were found, as one-quarter (26%) of fathers were uninsured and half (54%) did not have a primary care provider. After screening, two requested mental health services, and three established new primary care with a physician. CONCLUSIONS Participation was high in a PPD screening pilot for fathers in a primary care setting. This small sample of fathers demonstrated significant peripartum mental health challenges unlikely to have been identified otherwise. For some participants, engaging in PPD screening was an effective tool to prompt their subsequent engagement with general health care. This pilot is a step toward incorporating the health of fathers into models for supporting the health of families. Expanding screening for paternal PPD into routine primary care is necessary to reach more affected fathers.
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Affiliation(s)
- Sam Wainwright
- Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, 820 S. Wood Street, CSN 440, M/C 718, Chicago, IL, 60612, USA.
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
| | - Rachel Caskey
- Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, 820 S. Wood Street, CSN 440, M/C 718, Chicago, IL, 60612, USA
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Aida Rodriguez
- Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, 820 S. Wood Street, CSN 440, M/C 718, Chicago, IL, 60612, USA
| | - Abigail Holicky
- Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, 820 S. Wood Street, CSN 440, M/C 718, Chicago, IL, 60612, USA
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Wagner-Schuman
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago, IL, USA
| | - Anne Elizabeth Glassgow
- Division of Academic Internal Medicine, College of Medicine, University of Illinois at Chicago, 820 S. Wood Street, CSN 440, M/C 718, Chicago, IL, 60612, USA
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
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21
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Garthus-Niegel S, Kittel-Schneider S. [Fathers and peripartum mental illness: the neglected parent?]. DER NERVENARZT 2023; 94:779-785. [PMID: 37389668 DOI: 10.1007/s00115-023-01508-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 07/01/2023]
Abstract
Fathers also play an important role during pregnancy and the postpartum period, both for the partner and for the child. With changes in society and increasing early involvement in the care of infants, the father-child relationship has become increasingly more important in recent years. There is growing evidence that fathers can also suffer from mental illnesses during their partner's pregnancy and especially after the birth of a child. As the transition to the role of a father is a major change in a man's life, the birth of a child can be a life event that contributes to a first time mental illness or triggers a new episode of an already existing illness. For example, birth complications can also traumatize the attendant fathers and result in trauma sequelae. Peripartum anxiety disorders and depression probably affect approximately 5% of all men and can among other things have a negative impact on the development of exposed children. Specific screening or even treatment services for affected men are still very rare and little research has been performed. Much less is known about the prevalence, risk factors, and treatment of other mental illnesses in fathers, and there is still a great need for research in this respect.
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Affiliation(s)
- Susan Garthus-Niegel
- Institut und Poliklinik für Arbeits- und Sozialmedizin, Technische Universität Dresden, Dresden, Deutschland
- Abteilung für Epidemiologie und Frauen- & Familiengesundheit, Medical School Hamburg, Hamburg, Deutschland
| | - Sarah Kittel-Schneider
- Department of Psychiatry and Neuobehavioural Science, Acute Mental Health Unit, Cork University Hospital, Wilton, University College Cork, Cork, Irland.
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22
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Kittel-Schneider S. [Mental illnesses in the postpartum period: an interdisciplinary and intersectoral challenge]. DER NERVENARZT 2023; 94:777-778. [PMID: 37702766 DOI: 10.1007/s00115-023-01509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Sarah Kittel-Schneider
- Department of Psychiatry and Neurobehavioural Science, University College Cork, Acute Mental Health Unit, Cork University Hospital, Wilton, Cork, Ireland.
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23
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Zamir O, Szepsenwol O, Shahar B, Lassri D, Shai D. The multifaceted role of empathy in the transmission of postpartum depressive symptoms between parents. FAMILY PROCESS 2023; 62:851-864. [PMID: 36104760 DOI: 10.1111/famp.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 07/12/2022] [Accepted: 07/20/2022] [Indexed: 06/08/2023]
Abstract
Postpartum depression is a common challenge faced by mothers and fathers and can be transmitted between them. Despite the well-documented adverse effects of postpartum depressive symptoms (PPDS) on parents and children, not much is known about risk factors pertaining to the transmission of PPDS between parents. Guided by The Social Functions of Emotions theory, the current study tested the moderating effects of different forms of empathy, including perspective-taking, empathic concern, and personal distress on the transmission of PPDS between parents. Pairs of first-time Israeli parents (N = 105) completed self-report questionnaires assessing emotional (personal distress and empathic concern) and cognitive (perspective-taking) empathy during the third trimester and PPDS at three and six months postpartum. The results showed that in both parents, greater PPDS at 6 months were predicted by one's own greater personal distress. Also, lower perspective-taking and greater empathic concern of fathers predicted their own PPDS. Furthermore, the associations of PPDS at 3 months with PPDS at 6 months between parents occurred when fathers reported lower levels of personal distress and when mothers reported greater perspective-taking. Also, when mothers were lower in perspective-taking, greater PPDS at 3 months in fathers predicted lower levels of PPDS in mothers at 6 months. The study reflects the multifaceted role of empathy in the development of PPDS in new parents and highlights the potentially adverse effects of emotional and cognitive empathy on the development of PPDS in parents.
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Affiliation(s)
- Osnat Zamir
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University, Jerusalem, Israel
| | - Ohad Szepsenwol
- The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Ben Shahar
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University, Jerusalem, Israel
| | - Dana Lassri
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University, Jerusalem, Israel
| | - Dana Shai
- The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
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24
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Baldy C, Piffault E, Chopin MC, Wendland J. Postpartum Blues in Fathers: Prevalence, Associated Factors, and Impact on Father-to-Infant Bond. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105899. [PMID: 37239624 DOI: 10.3390/ijerph20105899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/09/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023]
Abstract
In this study we explored, in men, one of the most common postpartum syndromes in women: the postpartum blues. The aims of the study were (a) to evaluate the prevalence of postpartum blues in fathers, (b) to explore the sociodemographic and perinatal factors that may be associated with its intensity, and (c) to investigate the relationship between the intensity of blues symptoms and the quality of father-to-infant bonding. Three hundred and three French-speaking fathers living in France completed a sociodemographic and obstetrical questionnaire, the Maternity Blues Questionnaire, and the Postpartum Bonding Questionnaire. The fathers were recruited from two maternity hospitals and a Child and Maternal Health Centre within 10 days of their infant's birth, or from online forums devoted to parenting. At least 17.5% of fathers experienced postpartum blues. A high level of education was associated with a higher level of postpartum blues symptoms. Dissatisfaction with the maternity care and significant father involvement during pregnancy and delivery predicted more severe postpartum blues symptoms. Symptoms of postpartum blues were positively correlated with impairment in the father-to-infant bond. This study lends support to the existence of postpartum blues among fathers and highlights its possible consequences on early father-infant relationships.
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Affiliation(s)
- Claire Baldy
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100 Boulogne-Billancourt, France
| | - Eloi Piffault
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100 Boulogne-Billancourt, France
| | - Margaux Chabbert Chopin
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100 Boulogne-Billancourt, France
- Laboratory QualiPsy, University of Tours, F-37000 Tours, France
| | - Jaqueline Wendland
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100 Boulogne-Billancourt, France
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25
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Wells MB, Jeon L. Paternal postpartum depression, coparenting, and father-infant bonding: Testing two mediated models using structural equation modeling. J Affect Disord 2023; 325:437-443. [PMID: 36640810 DOI: 10.1016/j.jad.2022.12.163] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 12/26/2022] [Accepted: 12/31/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Impaired father-infant bonding is a mental health issue that has been understudied. The current study aimed to examine the extent to which fathers' depression symptoms and coparenting relationship, respectively, are associated with infant bonding, as well as how these two variables mediate in the association with infant bonding. METHODS Cross-sectional data from 612 fathers of infants (0-24 months) were used in this study. Path analyses on two competing mediation models were used to examine the direct and indirect associations between fathers' depression symptoms, coparenting relationship, and infant bonding, after controlling for several known covariates. RESULTS Whether fathers reported depression symptoms (Model 1) or reported lower levels of coparenting relationships (Model 2), they also reported higher levels of impaired infant bonding, rejection and anger, and anxiety about care after controlling for the covariates. The analysis further found significant indirect associations between father depression symptoms and father-infant bonding via the coparenting relationship (Model 1) as well as significant indirect associations between the coparenting relationship and father-infant bonding via father depression symptoms (Model 2). LIMITATIONS The cross-sectional data cannot show causal links. Specific efforts were made to recruit fathers with depression symptoms, and therefore prevalence rates may appear skewed. CONCLUSIONS Decreasing depression symptoms and improving coparenting quality can potentially improve father-infant bonding. Fathers' depression symptoms and coparenting quality can be bi-directionally related in the association with father-infant bonding. Early detection and preventive treatments for paternal depression symptoms and coparenting are warranted.
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Affiliation(s)
- Michael B Wells
- Women's and Children's Health, Karolinska Institutet, Sweden.
| | - Lieny Jeon
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
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26
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Low SR, Bono SA, Azmi Z. Prevalence and Factors of Postpartum Depression During the COVID-19 Pandemic: A Review. CURRENT PSYCHOLOGY 2023:1-18. [PMID: 36643791 PMCID: PMC9825082 DOI: 10.1007/s12144-022-04181-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 01/09/2023]
Abstract
The COVID-19 (Coronavirus Disease 2019) pandemic has led to several mandatory prevention regulations, changes in healthcare services, unprecedented unemployment rates, financial stress, and emotional worries. Given the increasing cases of COVID-19, coupled with the drastic physical and psychological changes within postpartum mothers during the postpartum period, this paper aims to present an overview of the postpartum depression (PPD) among postpartum women during the COVID-19 pandemic. The postpartum period is characterized by drastic physical changes and substantial demands on parental role adjustment, and it places enormous stress on the mothers and makes them vulnerable to mental health problems. A literature search was conducted in four electronic databases (ScienceDirect, Scopus, Wiley, and SAGE) with different combinations of keywords were used. As the result, 25 articles that involved 10,515 postpartum women from 14 countries were extracted. Results have recorded PPD prevalence ranged from 6.4% to 56.9% during the COVID-19 pandemic. Limited social support, social isolation, fear of COVID-19 exposure, or infection for themselves, newborns, have worsening PPD symptoms among postpartum women. In brief, early detection, appropriate and timely intervention is needed to prevent and identify PPD among postpartum women during the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-04181-w.
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Affiliation(s)
- Su Rou Low
- School of Social Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Zaireeni Azmi
- Unit for Research on Women and Gender (KANITA), School of Social Sciences, Universiti Sains Malaysia, Penang, Malaysia
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27
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Köse Tuncer S, Kaloğlu Binici D. The correlation between spousal support and postpartum depression in fathers. Perspect Psychiatr Care 2022; 58:2407-2413. [PMID: 35388478 DOI: 10.1111/ppc.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/04/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study was conducted using a descriptive design to examine the correlation between spousal support and postpartum depression (PPD) in fathers. DESIGN AND METHODS The participants of the study were the fathers of infants born in the obstetrics and gynecology clinic of a state hospital affiliated with the Ministry of Health in a province in Turkey. FINDINGS It was determined that while the possibility of paternal PPD was lower in the early postpartum period (p < 0.001), it increased in the late postpartum period (p < 0.001). A negative statistically significant correlation was identified between the Edinburgh Postnatal Depression Scale (EPDS) scores and the Spouse Support Scale (SSS) scores of the participants in the early postpartum period (p = 0.031). There was a highly negative significant correlation between late postpartum EPDS scores and the early (p < 0.001) and late period (p < 0.001) SSS scores. A highly negative significant correlation was observed between the mean score of the early spousal support period and the mean score of the late spousal support period (p < 0.001). In this study, spousal support decreased PPD in fathers. PRACTICE IMPLICATIONS This study indicated the necessity of routinely screening men for PPD symptoms. Early diagnosis and spousal support would contribute to reducing early and late paternal PPD, thus protecting the family's integrity.
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Affiliation(s)
- Sevinç Köse Tuncer
- Department of Nursing, Erzincan Binali Yıldırım University Faculty of Health Sciences, Erzincan, Turkey
| | - Dilek Kaloğlu Binici
- Department of Nursing, Artvin Çoruh University Faculty of Health Sciences, Artvin, Turkey
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28
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Association between perinatal pain and postpartum depression: A systematic review and meta-analysis. J Affect Disord 2022; 312:92-99. [PMID: 35716784 DOI: 10.1016/j.jad.2022.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION In recent years, clinical studies have shown that perinatal pain could increase the risk of postpartum depression, while such a conclusion appears controversial. Therefore, we conducted this systematic review and meta-analysis to explore the association between perinatal pain and postpartum depression, and to evaluate the effectiveness of epidural labor analgesia in reducing the risk of postpartum depression. METHODS PubMed, Web of Science, Embase and Cochrane Library were searched from inception to Jan 30th, 2022. The effect size of the meta-analysis was calculated using odds ratio and 95 % confidence interval. Statistical analysis was performed using Stata 15.0 software. RESULTS There were 19 studies included with a total of 96,378 patients. Among the included studies, 10 investigated the association between perinatal pain and the risk of postpartum depression, and 9 reported that between labor analgesia and the risk of postpartum depression. The results of meta-analysis showed that perinatal pain increased the risk of postpartum depression [OR = 1.43, 95% CI (1.23, 1.67), p<0.05], and epidural analgesia could reduce the risk of postpartum depression [OR = 0.42, 95% CI (0.33, 0.55), p < 0.05]. LIMITATIONS Source of heterogeneity in the association between perinatal pain and PPD could not be identified due to the limitations of the original studies. There were mainly cohort studies included in the assessment for effectiveness of epidural analgesia in reducing the incidence of postpartum pain. Therefore, we look forward to more RCTs to confirm our results. CONCLUSION Perinatal pain is one of the risk factors for postpartum depression, and epidural analgesia could reduce the risk of PPD. This result might provide guidance for clinical practice. However, psychological health counseling should be combined with epidural analgesia for perinatal pain to reduce the risk of PPD.
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29
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Chua JYX, Shorey S. Effectiveness of mobile application-based perinatal interventions in improving parenting outcomes: A systematic review. Midwifery 2022; 114:103457. [PMID: 35985142 PMCID: PMC9364944 DOI: 10.1016/j.midw.2022.103457] [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: 01/10/2022] [Revised: 07/25/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022]
Abstract
Objective Parents face many challenges during the perinatal period and are at risk for mental health issues, especially during the current coronavirus (COVID-19) pandemic. Mobile application-based interventions can help parents to improve their psychosocial well-being in a convenient and accessible manner. This review aims to examine the effectiveness of mobile application-based perinatal interventions in improving parenting self-efficacy, anxiety, and depression (primary outcomes), as well as stress, social support, and parent-child bonding (secondary outcomes) among parents. Methods Seven electronic databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, and ProQuest Thesis and Dissertations) were searched from their respective inception dates until August 2021. The Cochrane Risk of Bias-2 tool was used to conduct quality appraisals. Results were narratively synthesized due to the high heterogeneity of intervention and participant types. Findings A total of 6164 articles were retrieved from the seven electronic databases and citation searching. After excluding duplicate records and irrelevant titles/abstracts, 105 full texts were examined. Full-text screening excluded another 93 articles, leaving 12 included studies in this review. All studies were rated as having some concerns or a high overall risk of bias. Mobile application-based interventions were found to be feasible and promising in improving parents’ overall well-being post-intervention during the perinatal period. Further research would be needed to determine their long-term effects. Key conclusions and implications for practice Parental well-being was shown to improve using the following intervention components: educational resources on perinatal and infant care, psychotherapy, and support from peers and healthcare professionals. Hence, future interventions could aim to include these components and evaluate all inter-related parenting outcomes (parenting self-efficacy, stress, anxiety, depression, social support, and parent-child bonding). Parents could be provided with experiential learning exposure by using computer animations and virtual reality. Future research could be conducted on more fathers and parents from varied geographical regions.
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Affiliation(s)
- Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive 117597, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive 117597, Singapore.
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30
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Kazmerski TM, West NE, Jain R, Uluer A, Georgiopoulos AM, Aitken ML, Taylor-Cousar JL. Family-building and parenting considerations for people with cystic fibrosis. Pediatr Pulmonol 2022; 57 Suppl 1:S75-S88. [PMID: 34407321 PMCID: PMC9292426 DOI: 10.1002/ppul.25620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 01/24/2023]
Abstract
As people with cystic fibrosis (CF) live longer and healthier lives, increasing numbers are considering the full range of reproductive options for their futures, including parenthood, pregnancy, or pregnancy prevention. As the face of CF changes, the CF care model must adapt to meet the reproductive health needs of both parents and nonparents with CF. This article summarizes the reproductive goals and family-building concerns faced by people with CF, including fertility, pregnancy, and alternative paths to parenthood, the impact of parenthood on mental and physical health, and important future research.
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Affiliation(s)
- Traci M Kazmerski
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Natalie E West
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Raksha Jain
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ahmet Uluer
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anna M Georgiopoulos
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Moira L Aitken
- Department of Medicine, University of Washington, Seattle, Washington, USA
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31
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Effect of peer support intervention on perinatal depression: A meta-analysis. Gen Hosp Psychiatry 2022; 74:78-87. [PMID: 34942447 DOI: 10.1016/j.genhosppsych.2021.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/06/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND To assess the effect of peer support on preventing or treating perinatal depression. METHODS Eight databases (Wanfang, VIP, CNKI, CBM, Pubmed, Embase, PsycINFO, and Cochrane) were systematically searched for eligible randomized controlled trials from inception to July 2021. Two reviewers critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed extraction form. RESULTS A total of 16 studies (including 3154 participants, peer support group: 1568, control group: 1586) were included in this meta-analysis. The intervention group (peer support) had significantly better effect on preventing or treating perinatal depression than the control group [SMD = -0.39, 95% CI (-0.54, -0.24), P < 0.00001, I2 = 78%]. The results of subgroup analyses showed that peer support interventions provided in the perinatal period [SMD = -0.51, 95% CI (-0.93, -0.09), P = 0.02] or only in the postpartum period could improve the depression of mothers [SMD = -0.44, 95% CI (-0.62, -0.26), P < 0.00001]. Face-to-face interventions [SMD = -0.28, 95% CI (-0.40, -0.15), P < 0.0001] and telephone/internet-based interventions [SMD = -0.73, 95% CI (-0.95, -0.50), P < 0.00001] were both effective for perinatal depression. As for form of intervention, the combination of individual and group sessions had the best effect on improving perinatal depression [SMD = -0.63, 95% CI (-1.04, -0.23), P = 0.002]. Peer support with the frequency of at least once a week had a significant effect on perinatal depression [SMD = -0.88, 95% CI (-1.32, -0.44), P < 0.0001]. Interventions with a length of ≤3 months [SMD = -2.20, 95% CI (-3.35, -1.04), P = 0.0002] worked better than those lasting for 3-36 months [SMD = -1.64, 95% CI (-2.38, -0.90), P < 0.0001] in perinatal depression management. Peer support could improve perinatal depression both in low- and middle-income countries [SMD = -0.70, 95% CI (-0.95, -0.45), P < 0.00001] and high-income countries [SMD = -0.15, 95% CI (-0.28, -0.02), P = 0.03]. CONCLUSIONS Providing peer support during the perinatal period or only postpartum period, using Internet or telephone approaches, a combination of group and individual, at least once a week can be regarded as an effective measure to manage perinatal depression.
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32
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Chhabra J, Li W, McDermott B. Predictive Factors for Depression and Anxiety in Men During the Perinatal Period: A Mixed Methods Study. Am J Mens Health 2022; 16:15579883221079489. [PMID: 35225057 PMCID: PMC8882954 DOI: 10.1177/15579883221079489] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 12/03/2022] Open
Abstract
The purpose of this study was to identify the risk factors associated with paternal perinatal mental distress in a sample of Australian men. A mixed-methods design was used. The qualitative component (N = 13) using thematic analysis identified maternal depression, marital distress, masculine gender role stress, unplanned pregnancy, work-family conflict, and sleep disturbance as risk factors for paternal perinatal mental distress. The quantitative component (N = 525) expanded on the qualitative findings and examined the associations between the identified risk factors and mental distress of fathers in the perinatal period measured by Edinburgh postnatal depression scale. Hierarchical multiple regression analysis revealed six significant predictors of paternal perinatal mental distress with masculine gender role stress being the most significant risk factor for paternal perinatal mental distress. The results from this study provide an insight into how masculine gender role may affect the expression and experience of mental distress in fathers within the perinatal period. Implications of research findings are discussed.
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Affiliation(s)
- Jasleen Chhabra
- Department of Psychology, College of
Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Wendy Li
- Department of Psychology, College of
Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Brett McDermott
- Department of Medicine, College of
Medicine and Dentistry, James Cook University, Townsville, Queensland,
Australia
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33
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Doi S, Isumi A, Fujiwara T. Association of adverse childhood experiences with postpartum depression and anxiety in fathers: A prospective study. Psychiatry Clin Neurosci 2022; 76:35-36. [PMID: 34726331 DOI: 10.1111/pcn.13312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/21/2021] [Accepted: 10/27/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
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34
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Li D, Cui Y, Liu Y, Zheng Y, Zeng Y, Cheng ASK. A Chain Mediation Model of Perceived Stress, Neuroticism, and Psychological Inflexibility on Depressive Symptoms of Chinese New Fathers. Am J Mens Health 2021; 15:15579883211054351. [PMID: 34719998 PMCID: PMC8559288 DOI: 10.1177/15579883211054351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
There is a growing concern about mental health issues in new fathers, such as postpartum depression (PPD). Factors associated with PPD in men include personality traits and perceived stress. This study examined a set of hypothesized paths using perceived stress, neuroticism, and psychological inflexibility to predict depressive symptoms. A total of 189 participants took part. The mean age of these first-time fathers was 36.12 years (SD = 2.39). Perceived stress, neuroticism, and psychological inflexibility positively predicted new fathers’ depressive symptoms (B = 0.13, 0.37, and 0.31, respectively). These predictors explained 48% (R2 = 0.48) of the variance in the measured outcome of depressive symptoms in these new Chinese fathers. The total standardized direct effects of the three variables on depressive symptoms were 0.47 (95% CI [0.38, 0.53]). In conclusion, this study provides novel information about the chain mediating role played by neuroticism and psychological inflexibility in the relationship between perceived stress and PPD. Perceived stress significantly predicted neuroticism and psychological inflexibility, which in turn significantly predicted depressive symptoms in new Chinese fathers. The relationship between perceived stress and depressive symptoms was also mediated by each of psychological inflexibility or neuroticism alone.
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Affiliation(s)
- Danian Li
- Department of Brain Diseases, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, P. R. China
| | - Ying Cui
- Department of Psychiatry, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, P. R. China
| | - Yujie Liu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, P. R. China
| | - Yanting Zheng
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, P. R. China
| | - Yingchun Zeng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, P. R. China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, P. R. China
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35
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Ferber SG, Braun K, Weller A. The roots of paternal depression: Experienced and nonexperienced trauma or Folie a Deux? Dev Psychobiol 2021; 63:e22197. [PMID: 34674247 DOI: 10.1002/dev.22197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 08/19/2021] [Accepted: 08/30/2021] [Indexed: 12/14/2022]
Abstract
The transition to fatherhood may be challenged with anxiety and trepidation. A high prevalence has been found for paternal depression and it is reactive to maternal depression. This review aims to address potential sources of paternal depression, which may have adverse consequences on child development. We describe through three hypotheses how fathers may be at risk of depression during the transition to fatherhood: (1) psychological (interacting with ecological systems); (2) brain functional∖structural changes; and (3) (epi)genomic. We propose that paternal stressful experiences during the transition to fatherhood may be the source for paternal depression through direct stressful paternal experiences or via (potential, currently debated) nonexperienced (by the father) epigenomic transgenerational transmission. On the other hand, we suggest that resilient fathers may undergo a transient dysphoric period affected by identifying with the newborn's vulnerability as well as with the mother's postpartum vulnerability resulting in "paternity blues." In accordance with recent views on paternal "heightened sensitivity" toward the infant, we propose that the identification of both parents with the vulnerability of the newborn creates a sensitive period of Folie a Deux (shared madness) which may be a healthy transient, albeit a quasi-pathological period, recruited by the orienting response of the newborn for survival.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychology and the Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Katharina Braun
- Department of Zoology and Developmental Neurobiology, Otto von Guericke University Magdeburg, Magdeburg, Germany.,Center for Behavioral and Brain Science, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Aron Weller
- Department of Psychology and the Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel
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36
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Tandon SD, Hamil J, Gier EE, Garfield CF. Examining the Effectiveness of the Fathers and Babies Intervention: A Pilot Study. Front Psychol 2021; 12:668284. [PMID: 34335380 PMCID: PMC8319568 DOI: 10.3389/fpsyg.2021.668284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/21/2021] [Indexed: 01/21/2023] Open
Abstract
There is increasing recognition of the importance of addressing the mental health of fathers, including during the perinatal period. Fathers exhibiting mental health concerns during the perinatal period are at heightened risk for future negative mental health outcomes and are less likely to engage in nurturing relationships with their children, leading to a sequalae of negative child outcomes during infancy and into adolescence. Although interventions have been developed for perinatal fathers, they typically do not focus directly on addressing paternal mental health. To fill this gap, we developed the Fathers and Babies intervention to be delivered to perinatal fathers whose partners (mothers) were enrolled in home visiting programs. A pre-post longitudinal study was conducted in which 30 father-mother dyads were recruited from home visiting programs. Fathers received the 12-session Fathers and Babies intervention while the mother concurrently received the Mothers and Babies intervention delivered to her by a home visitor. Baseline, 3- and 6-month self-report surveys were conducted with both fathers and mothers. Fathers and mothers had statistically significant decreases in perceived stress between baseline and both follow-up time points, with moderate effect sizes generated for both sexes. No statistically significant differences were found for depressive symptoms, anxiety symptoms, or perceived partner support, although we found small effects for reductions in depressive symptoms among fathers, as well as increases in the percentage of fathers and mothers who reported high levels of emotional and instrumental support post-intervention. While preliminary, these findings suggest the potential for Fathers and Babies to positively impact the mental health of fathers in the perinatal period, and also signal the viability of home visiting as a setting for delivering this intervention. Future research should employ a comparison group to generate stronger evidence of intervention effectiveness and include measurement of dyadic relationships and paternal parenting practices.
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Affiliation(s)
- S Darius Tandon
- Center for Community Health, Northwestern Feinberg School of Medicine, Institute of Public Health and Medicine, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, United States
| | - Jaime Hamil
- Center for Community Health, Northwestern Feinberg School of Medicine, Institute of Public Health and Medicine, Chicago, IL, United States
| | - Emma E Gier
- Center for Community Health, Northwestern Feinberg School of Medicine, Institute of Public Health and Medicine, Chicago, IL, United States
| | - Craig F Garfield
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, United States.,Family and Child Health Innovations Program, Department of Pediatrics, Lurie Children's Hospital of Chicago, Chicago, IL, United States
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