The prevalence of depressive symptoms among fathers and associated risk factors during the first seven years of their child's life: findings from the Millennium Cohort Study

Longitudinal trajectories and associated risk factors of paternal mental illness in the nine years surrounding the transition to fatherhood

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.

Paternal depressive symptoms and factors associated among expectant fathers in a northeastern province of Thailand

Globally, depression is a major mental health problem among expectant fathers. Therefore, factors associated with paternal depressive symptoms (PDS) need investigation. This hospital-based cross-sectional study was aimed to investigate the prevalence of and factors associated with PDS among expectant fathers in a northeastern province of Thailand. In the north-eastern province, Sakon Nakhon, 440 expectant fathers from eight hospitals participated in the study by completing a questionnaire related to socio-demographic characteristics, the Edinburgh Postnatal Depression Scale (EPDS), psychosocial factors and social support. An EPDS score of at least eleven out of 30 was interpreted as having PDS. Multivariable linear regression analysis was applied with a statistical significance at 0.05, and the coefficient β was presented. In total, 81 expectant fathers (18.4%, 95% confidence interval 14.6-22.3) had PDS, and the mean (standard deviation) of the EPDS score was 6.65 (4.25). Insufficient money (β = - 0.099, p = 0.016), marital adjustment (β = - 0.098, p = 0.027), self-esteem (β = - 0.150, p < 0.001), wife's stress (β = 0.079, p = 0.049), and expectant father's stress (β = 0.400, p < 0.001) were factors independently associated with PDS. In conclusion, screening expectant fathers during the pregnancy period of their wives is essential, and factors associated with PDS should not be neglected by healthcare providers. Also, there is need of an intervention program to prevent the symptoms, especially for expectant fathers having insufficient money or having stress.

Relationship between personality traits and postpartum depression in Pakistani fathers

The previous studies have found an association between Big Five personality traits and postpartum depression in women. The present study aimed to find out an association between Big Five personality traits and postpartum depression in a sample of Pakistani fathers. A total of 400 Pakistani fathers who had birth of a child in the past 1 month to 1 year period and had been living with their married partners were recruited purposively by using Google Form based survey from the major cities of Pakistan. The Urdu translated versions of Big Five Personality Inventory (BFI) and Edinburgh Postnatal Depression Scale (EPDS) were used as the main outcome measures to assess the relationship between personality traits and postpartum depression. The results found a significant negative and moderate association between Big Five personality traits and paternal postpartum depression except openness which had a weak association and neuroticism which had a positive and moderate association with PPPD (r(398) = .45). The multiple linear regression analysis found that Big Five personality traits significantly predicted paternal postpartum depression (F(5, 394) = 53.33, p = .001) except openness (B = .007, p = .98). The analysis of variance (ANOVA) found significant differences in paternal postpartum depression for age of father (F(2, 397) = 6.65, p = .001, ηp2 = .03), spouse age (F(2, 393) = 5.97, p = .003, ηp2 = .02), employment type (F(2, 395) = 9.69, p = .001, ηp2 = .04) and time spent at home (F(2, 397) = 6.23, p = .002, ηp2 = .03) while there were found no significant differences for education (F(2, 397) = 1.29, p = .27, ηp2 = .006), marital duration (F(2, 397) = 2.17, p = .11, ηp2 = .01), and birth number of recent child (F(2, 397) = 1.48, p = .22, ηp2 = .007). The study concluded that Big Five personality traits are significantly correlated with and predict paternal postpartum depression except openness which did not predict paternal postpartum depression. The occurrence of paternal postpartum depression varied significantly for age of father, age of spouse, type of employment and time spent at home.

Mothers' and fathers' depressive symptoms across four years postpartum: An examination of between- and bidirectional within-person relations

BACKGROUND

Both mothers and fathers are at risk for experiencing postpartum depressive symptoms shortly after the birth of a child. Previous studies suggest mothers' and fathers' depressive symptoms to be interrelated. This study examined bidirectional relations between mothers' and fathers' depressive symptoms across four years postpartum.

METHODS

Longitudinal data for this study were collected across five waves from 485 mothers and 359 fathers of infants when infants were on average 6 months-old until children were 54 months-old (1-year lags). Mothers and fathers reported on their depressive symptoms using the Center for the Epidemiological Studies Short Depression Scale (CES-D 10). A random intercept cross-lagged panel model (RICLPM) was specified to examine the bidirectional relations between mothers' and fathers' depressive symptoms over time.

RESULTS

At the between-person level, mothers' and fathers' depressive symptoms were positively associated. At the within-person level, unique carry-over effects were found for mothers and fathers in that when reporting higher depressive symptoms than their trait levels, they were more likely to report higher depressive symptoms one year later. Moreover, intermittent cross-lagged effects were observed from mothers' depressive symptoms to fathers' depressive symptoms during toddlerhood.

LIMITATIONS

The sample was not racially or structurally diverse thereby limiting the generalizations of the findings.

CONCLUSIONS

After the birth of a child, mothers and fathers are at risk for experiencing chronic depressive symptoms which can have implications for individual, couple and child health. Mothers' depressive symptoms are related to fathers' depressive symptoms over time.

Postpartum Mental Health and Perceptions of Discrimination Among Asian Fathers During the COVID-19 Pandemic

PURPOSE

The purpose of this study was twofold: (1) to examine the prevalence of postpartum depression and anxiety symptomatology among fathers of Asian descent living in North America during the COVID-19 pandemic, and (2) to identify the occurrences of online racial discrimination.

STUDY DESIGN AND METHODS

Using a cross-sectional design and convenience sampling methods, we recruited fathers online via social media sites (Facebook, Instagram) between March 12 and July 31, 2022. The Edinburgh Postnatal Depression Scale, General Anxiety Scale, and the Online Victimization Scale assessed mental health well-being and discrimination outcomes. Data were analyzed using descriptive statistics, two sample t-test, chi-square test of independence, and Pearson's correlation analysis.

RESULTS

Our sample included 61 fathers within 6 months postpartum living in the United States and Canada. Participants were on average 34 years old, married, and represented 17 Asian ethnic groups, including Asian Indian (41%), Filipino (11.3%), and Korean (8.1%). One-third of our participants (31.1%, n = 19) were at high risk of developing postpartum depression and scores of three (4.9%) fathers indicated they had clinically significant anxiety. Overall, 26.3% reported experiencing direct online racial discrimination and 65% reported occurrences of indirect online racial discrimination.

CLINICAL IMPLICATIONS

There was a high rate of depressive symptoms and occurrences of online racial discrimination among fathers of Asian descent living in North America. These rates are higher than the general perinatal population and further research is warranted to examine risk factors and preventive strategies among this unique paternal ethnic group.

Impact of Parental Mental Health and Poverty on the Health of the Next Generation: A Multi-Trajectory Analysis Using the UK Millennium Cohort Study

PURPOSE

Exposure to parental mental ill-health and poverty in childhood impact health across the lifecourse. Both maternal and paternal mental health may be important influences, but few studies have unpicked the complex interrelationships between these exposures and family poverty for later health.

METHODS

We used longitudinal data on 10,500 children from the nationally representative UK millennium cohort study. Trajectories of poverty, maternal mental health, and secondary caregiver mental health were constructed from child age of 9 months through to 14 years. We assessed the associations of these trajectories with mental health outcomes at the age of 17 years. Population-attributable fractions were calculated to quantify the contribution of caregivers' mental health problems and poverty to adverse outcomes at the country level.

RESULTS

We identified five distinct trajectories. Compared with children with low poverty and good parental mental health, those who experienced poverty and poor primary or secondary caregiver mental health (53%) had worse outcomes. Children exposed to both persistent poverty and poor caregiver mental health were at markedly increased risk of socioemotional behavioural problems (aOR 4.2; 95% CI 2.7-6.7), mental health problems (aOR 2.5; CI 1.6-3.9), and cognitive disability (aOR 1.7; CI 1.1-2.5). We estimate that 40% of socioemotional behavioural problems at the age of 17 were attributable to persistent parental caregivers' mental health problems and poverty.

DISCUSSION

More than half of children growing up in the UK are persistently exposed to either one or both of poor caregiver mental health and family poverty. The combination of these exposures is strongly associated with adverse health outcomes in the next generation.

Paternal peripartum depression: emerging issues and questions on prevention, diagnosis and treatment. A consensus report from the cost action Riseup-PPD

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.

Postpartum Paternal Depression: Its Impact on Family and Child Development

The postpartum period is when parents undergo great changes and gain new responsibilities. Factors such as the changes that come with having a baby, not meeting the expectations about parenthood, having a child with a difficult temperament or health problems, or relational problems can be quite challenging in this period. These problems can deeply affect the psychological well-being of the parents. Although studies on depressive symptoms of mothers during pregnancy and postpartum are at an important level, studies aiming to examine the psychological state of fathers for the same period are still limited. However, perceptions that postpartum depression develops due to hormonal changes during pregnancy have been reshaped by the findings that this situation may also develop due to psychosocial factors. Relatedly, the number of studies on postpartum depression experienced by fathers has increased over time. Results of those studies show that fathers' psychological state also influences their parenting and the development of children. Fathers may experience paternal depression due to a lack of social support, economic conditions, relationship dynamics, and changing living conditions in the postpartum period. This situation may cause fathers to avoid parenting duties, spend less time with their children, be unable to cooperate with the mother, and have anger problems or deterioration in the relationship with the mother. The effects of depression on individuals' parenting styles negatively affect child-parent attachment and may cause children to develop emotional and behavioral problems. Therefore, it is very important to examine fathers' psychological state for children's development and the healthy progress of family dynamics. This review aims to address the effect of paternal depression on parenting and child development.

Paternal postnatal depression: prevalence and the associated demographic and maternal reproductive factors among Iranian fathers

BACKGROUND

Paternal postnatal depression (PPND) is a critical mental health issue that may harm family members' health and relationships. The Edinburgh Postpartum Depression Scale (EPDS) is the most common self-reported questionnaire for postnatal depression screening among mothers and fathers worldwide. However, identifying fathers with postnatal depression and determining the related factors have been neglected in some countries.

AIMS

The present study aimed to determine the prevalence of PPND and then to identify its predictive demographic and reproductive factors. Two cut-off points (10 and 12) for the EPDS were used to detect PPND.

METHODS

This cross-sectional study was conducted on 400 eligible fathers selected via multistage sampling. Data were collected using a demographic checklist and the EPDS.

RESULTS

None of the participants had previously been screened for PPND. The mean age of the participants was 35.53 ± 5.47 years, and most of them were self-employed and had university degrees. The prevalence of PPND was 24.5% and 16.3% using the EPDS cut-off scores 10 and 12, respectively. An unwanted pregnancy and an abortion history were the predictors of PPND at both EPDS cut-off scores, with gravidity and the number of abortions also being associated with PPND at the cut-off score of 10.

CONCLUSION

In line with the related literature, our results revealed a fairly high prevalence of PPND and its related factors. This indicates the need for a screening program for fathers during the postnatal period to detect and adequately manage PPND and prevent its adverse effects.

Explaining gaps by parental education in children’s early language and social outcomes at age 3–4 years: evidence from harmonised data from three countries

Child outcomes vary by family’s socioeconomic status (SES). Research on explanatory factors underlying early SES-related disparities has mainly focused on specific child outcomes (e.g., language skills) and selected influencing factors in single countries often with a focus on individual differences but not explicitly on early SES-related gaps. This study uses harmonised data from longitudinal large-scale studies conducted in the United Kingdom, United States, and Germany to examine parental education-related gaps in early child language and social skills. Twelve theoretically proposed family-, child-, and childcare-related factors were systematically evaluated as explanatory factors. In all countries, parental education-related gaps were particularly pronounced for early child language compared to social skills. In the decomposition analyses, the home learning environment was the only measure that significantly explained gaps in all child outcomes across all countries. Early centre-based care attendance, family income, and maternal age at childbirth contributed to gaps in child outcomes with the specific pattern of results varying across outcomes and countries. Maternal depressive feelings significantly contributed only to explaining gaps in children’s social skills. Thus, while some mechanisms found to underpin early parental education-related gaps can be generalized from single-country, single-domain studies, others are outcome- and context-specific.

A systematic review and meta-analysis of studies validating Edinburgh Postnatal Depression Scale in fathers

The Edinburgh Postnatal Depression Scale (EPDS) is a reliable measure for detecting paternal postpartum depression. The study's purpose is to determine the appropriate cut-off scores of EPDS for fathers. Our research was conducted using PubMed, Embase, Web of Science, and Scopus. The time frame of the search was from the issuance of EPDS in 1987 until January 2021. The analysis comprised of studies that compared EPDS scores for depression from validated diagnostic interviews. For EPDS cut-off values of 7–13, a bivariate random-effects meta-analysis was used to estimate pooled sensitivity and specificity, as well as the diagnostic odds ratio. Seven studies with a total of 2393 participants were identified. The pooled sensitivity and specificity were satisfactory at cut-off values of 7–10, with significant diagnostic odds ratio. The EPDS accuracy was unaffected by the prevalence of depression, the fathers' mean age, or the translated language. The Edinburgh Postnatal Depression Scale has acceptable properties for detecting paternal postpartum depression, with cut-off scores ranging from 7 to 10.

Interventions for Perinatal Depression and Anxiety in Fathers: A Mini-Review

Background and Objectives

Up to 10% of fathers experience perinatal depression, often accompanied by anxiety, with a detrimental impact on the emotional and behavioural development of infants. Yet, few evidence-based interventions specifically for paternal perinatal depression or anxiety exist, and few depressed or anxious fathers engage with support. This mini-review aims to build on the evidence base set by other recent systematic reviews by synthesising more recently available studies on interventions for paternal perinatal depression and anxiety. Secondarily, we also aimed to identify useful information on key implementation strategies, if any, that increase the engagement of men.

Methods

We drew upon three major previous systematic reviews and performed an updated search of PubMed/Medline; Psycinfo; Cochrane Database; Embase and Cinahl. The search was limited to trials, feasibility studies or pilot studies of interventions published between 2015 and 2020 that reported on fathers' perinatal mental health. We included psychological, educational, psychosocial, paternal, couple-focused, or group therapies, delivered face-to-face, via telephone and/or online that reported on either paternal depression, anxiety or both.

Results

Eleven studies satisfied search criteria (5 of which were not included in previous reviews). The majority were randomised controlled trials. Most interventions incorporated counselling, therapy or psychoeducation and took an indirect approach to perinatal mental health through antenatal or postnatal education and were couple-focused. No studies reported a presence of diagnosed depression or anxiety at baseline, although five studies reported a positive effect on sub-threshold symptoms.

Discussion

There was some evidence that these approaches may be useful in the initial engagement of fathers with perinatal supports and improve depression and anxiety scores. No studies targeted the explicit treatment of clinically depressed or anxious men, and this remains the most substantial gap in the peer-reviewed evidence base. Our results highlight the need to deliver perinatal interventions specifically designed for men and evaluate them in populations with clinical levels of depressive and anxious symptomatology.

Relations between Early Childhood Paternal Depression and Preschool- and School-age Psychosocial Functioning

Objective: The present study used a longitudinal design to examine associations between paternal depressive symptoms in toddlerhood and children's psychosocial adjustment during the preschool and school-age periods. Maternal depressive symptoms and intervention status were tested as moderators of associations between paternal depressive symptoms and child maladjustment.Method: The sample (n = 264, 48% female, 62% White, 14% Black, 14% bi-racial, 11% another racial group, and 86% non-Hispanic/Latinx) represented a subsample of families from the Early Steps Multisite Study, a clinical randomized trial testing the effectiveness of the Family Check-Up among low-income families using Women, Infants, and Children Nutritional Supplement Services in three communities varied in urbanicity. Fathers and mothers reported their levels of depressive symptoms at child age 2, primary caregivers (mostly mothers) contributed measures of child adjustment at ages 5, 8.5, and 9.5, and teachers completed questionnaires about child adjustment at ages 8.5 and 9.5.Results: Direct relations were found between paternal depressive symptoms and primary caregivers' reports of children's preschool and school-age internalizing problems. Furthermore, higher levels of paternal depression were associated with higher levels of children's later adjustment problems at preschool-age when maternal depressive symptoms were mild or higher. The Family Check-Up attenuated relations between paternal depressive symptoms and children's internalizing problems at school-age.Conclusions: These findings have important implications for future research on preventing children's early-emerging problem behaviors at home, suggesting that addressing paternal depressive symptoms in early childhood may be an important intervention target, especially in the context of maternal depression.

Timing of parental depression on risk of child depression and poor educational outcomes: A population based routine data cohort study from Born in Wales, UK

Background

Maternal depression is a risk factor for depression in children, though the influence of paternal depression has been less well examined. We examined the association between maternal and paternal depression, and the timing of their depression (before or after the child’s birth) and outcomes for the child including incidence of child depression and poor educational attainment.

Methods

A linked routine data cohort study linking General Practitioner(GP), hospital and education records of young people (aged 0 to 30 years) in Wales. Parental and child diagnosis of depression was identified from GP data. Regression analysis examined the association of maternal and paternal depression with time to diagnosis of depression in the child and odds of attaining educational milestones.

Outcomes

In adjusted models, the relative risk of offspring developing depression was 1.22 if the mother had depression before the child was born, 1.55 if the mother had depression after the child was born and 1.73 if she had depression both before and after the child was born (chronic depression), compared to those were there was no maternal depression history. For achieving milestones at end of primary school, odds were 0.92, 0.88 and 0.79 respectively. Association of depression in the child was similar if the male living in the household had depression with risk ratios of 1.24 (before), 1.43 (after) and 1.27 (before and after) for child diagnosed depression and 0.85, 0.79 and 0.74 for achieving age 11 milestones.

Interpretation

Children who live with a parent who has depression are more likely to develop depression and not achieve educational milestones, compared to children who live with a parent who has a history of depression (but no active depression in child’s lifetime) and compared to those with no depression. This finding suggests that working closely with families where depression (particularly chronic depression) is present in either parent and treating parental depression to remission is likely to have long-term benefits for children’s mental health and educational attainment.

The association between caesarean and postnatal psychological distress: Effect modification by mental health history

BACKGROUND

The association between mode of delivery and postnatal depression is uncertain. Mental health history may modify the association.

OBJECTIVES

The objective of this study was to determine whether the association between caesarean and postnatal psychological distress (PPD) differs according to long-standing depression/anxiety.

METHODS

Analysis of the UK-based Millennium Cohort Study of women who gave birth 2000-2002 was carried out. The outcomes were PPD at 9 months by Rutter Malaise Inventory and actively treated physician-diagnosed depression/severe anxiety at 3 years. The exposure was mode of delivery. Adjusted relative risks were estimated using Poisson regression. Effect modification according to long-standing depression/anxiety was investigated multiplicatively and additively.

RESULTS

We included 15,936 women, of whom 2346 (13.4%, weighted) reported PPD. Women with long-standing depression/anxiety were at 34% lower risk of PPD following elective caesarean, compared with vaginal birth: relative risk (RR) 4.36 (95% confidence interval [CI] 3.76, 5.05), RR 3.25 (95% CI 2.23, 4.75) and RR 4.92 (95% CI 3.67, 6.59) for vaginal, elective and emergency caesarean births, respectively, with relative excess risk due to interaction (RERI) -1.28 (95% CI -2.73, 0.16), ratio of RRs 0.66 (95% CI 0.42, 1.05). Women with long-standing depression/anxiety were at greatest risk of later treatment following emergency caesarean, with RR 4.95 (95% CI 3.86, 6.34), RR 4.09 (95% CI 2.51, 6.65) and RR 6.74 (95% CI 4.87, 9.32), for vaginal, elective and emergency caesarean births, respectively; RERI 1.79 (95% CI -0.13, 3.71), ratio of RRs 1.36 (95% CI 0.94, 1.99); all RRs with reference to vaginal birth in the absence of long-standing depression/anxiety. There was no evidence of a similar association between emergency caesarean and PPD nor elective caesarean and later treatment.

CONCLUSIONS

Women with long-standing depression or anxiety who had elective caesarean had a lower risk of postnatal distress. When this group had emergency caesarean, there was greater risk of actively treated depression/anxiety at 3 years. These associations were not observed in women without long-standing depression/anxiety.

Factors Influencing Paternal Postpartum Depression: A Systematic Review and Meta-Analysis

BACKGROUND

Postpartum period is a critical time that requires adjustments not only for mothers but also for fathers and may pose risk for depression. Studies show that the prevalence of paternal postpartum depression (PPD) is between 1.2% and 25.5%. PPD is an under-recognized public health issue and its reported influencing factors are still inconclusive.

OBJECTIVE

The purpose of this paper is to extend the literature by examining influencing factors that affect paternal PPD and describe the strength their associations.

METHODS

We conducted keyword search of Web of Science, PubMed, Embase, the Cochrane Library and PsycARTICLES electronic databases up to Jan 17, 2020, without language restrictions, for observational studies investigating the factors influencing paternal PPD and its effects. Fixed or random effect model was used to pool odds ratio (OR) and 95% confidence intervals (CI) with Stata software 12.0. Heterogeneity between studies was evaluated using Cochran's chi-squared test (Cochran's Q) and I² values.

RESULTS

Nineteen cross-sectional studies and eighteen cohort studies published from 1996 to 2019 were included in this review and seventeen studies in the meta-analysis. Factors affecting paternal PPD can be classified into paternal, maternal, infant and family factors. In Meta-analysis, 9 of 17 influencing factors were revealed to be statistically significant: 1) paternal factors: unemployment OR= 2.59 (95%CI:1.42-4.74), low social support OR=1.05 (95%CI:1.03-1.08), negative life events OR=1.45 (95%CI:1.13-1.87), perceived stress OR=1.08 (95%CI:1.03-1.12), financial strain OR=2.07 (95%CI:1.13-3.81), history of mental illness OR=3.48 (95%CI:2.49-4.86); 2) maternal factors: parity OR=1.36 (95%CI:1.13-1.65) and maternal postnatal depression OR=1.17 (95%CI:1.03-1.33); 3) family factors: low marital satisfaction OR=1.40 (95%CI:1.22-1.61). No statistically significant association with infant factors was found in the meta-analysis.

LIMITATIONS

There was publication bias since we only included English studies. Samples were under-represented in low-and middle-income countries. The meta-analysis results are subject to unobserved confounding factors and cannot explain causality.

CONCLUSION

This overview of the evidence suggests a relationship between paternal employment, psychological status, history of maternal mental illness, first pregnancy, marital relationship and paternal PPD. The low number of studies for some infant factors in meta-analysis leaves gaps in knowledge that need to be addressed. The mechanisms underlying the reported associations and their causal relationship still remain unclear. The awareness of the serious long-term consequences of paternal PPD should encourage better identification of those at risk and the development of effective interventions to protect fathers from PPD.

Postpartum and Paternal Postnatal Depression: Identification, Risks, and Resources

This article provides an overview of the prevalence and cause of postpartum depression in women and postnatal depression among their male partners, as well as a review of related symptoms, risk factors, and effects on children. Evidence-based screening tools, management options, and resources for patients and providers are also presented.

Reciprocal relationships between paternal psychological distress and child internalising and externalising difficulties from 3 to 14 years: a cross-lagged analysis

Research shows that paternal psychological distress is associated with child emotional and behavioural difficulties. However, little is known about the direction of this association including whether it is bidirectional. The aim of this study was to explore the reciprocal relationships between paternal psychological distress and child emotional and behavioural problems longitudinally (at ages 3, 5, 7, 11 and 14 years) in a sample of 13,105 children (49% girls) who participated in the UK's Millennium Cohort Study (MCS), a large-scale, nationally representative, longitudinal survey. Four domains of child problems (emotional symptoms, peer relations, conduct problems and hyperactivity/inattention) were measured with the Strengths and Difficulties Questionnaire and paternal psychological distress was measured with the Kessler K-6 scale. Data were analysed using cross-lagged path models. At all ages, paternal psychological distress predicted both subsequent child emotional symptoms as well as peer problems. Paternal psychological distress at child's age 3 was related to more hyperactivity at age 5 and, at age 5, paternal psychological distress was associated with more conduct problems at age 7. At age 11, paternal distress was also related to age 14 conduct problems and hyperactivity. Child effects were fewer and were found mainly for behavioural problems. Notably, we found bidirectional links between paternal psychological distress and child peer difficulties, from 11 to 14 years. Paternal psychological distress appears to influence child behaviour more consistently than the converse. However, in early adolescence, there appears to be a reciprocal relationship between fathers' mental health problems and children's peer problems.

Fatherhood Is Associated with Increased Infidelity and Moderates the Link between Relationship Satisfaction and Infidelity

Background: Relationship satisfaction has been identified as an important factor in terms of extradyadic sexual involvement. However, in men, fatherhood might be associated with infidelity by leading to changes in relationship satisfaction and the social life of parents. To date, no study has focused on the association of fatherhood and infidelity, nor the influence of fatherhood on the association between relationship satisfaction and infidelity. Methods: Using a cross-sectional design, 137 fathers and 116 non-fathers were assessed regarding relationship satisfaction, infidelity, and potential confounds. Results: Significantly more fathers reported having been unfaithful in the current relationship than non-fathers (30.7% vs. 17.2%). Fathers also reported longer relationship duration, higher relationship satisfaction, and lower neuroticism than non-fathers. Furthermore, fatherhood moderated the association between relationship satisfaction and infidelity insofar that only in non-fathers reduced relationship satisfaction was associated with infidelity. Conclusions: The results suggest that fatherhood increases the risk of engaging in extradyadic sexual activities and moderates the link between relationship satisfaction and infidelity. However, results need to be interpreted with caution due to the cross-sectional study design and the lack of information about the specific time point of the infidelity incident(s).

New parents' experiences of postpartum depression: a systematic review of qualitative evidence

OBJECTIVES

The objective of the review was to synthesize the evidence on new mothers' and fathers' experiences of postpartum depression (PPD).

INTRODUCTION

Postpartum depression is a form of clinical depression that affects women and, less frequently, men, typically during the first months after childbirth. It has been estimated that 10% to 20% of women and 10% of men suffer from PPD and it may have serious consequences for mothers, fathers and their children. Therefore, this review covers the experiences of both mothers and fathers.

INCLUSION CRITERIA

This qualitative review considered studies that included new mothers and fathers who had any number of children and who experienced PPD within a one-year postpartum period. The phenomenon of interest was the lived experience of new mothers and fathers with PPD. Qualitative studies including, but not limited to, phenomenology, grounded theory, ethnography, action research and feminist research were considered.

METHODS

The review systematically searched the following databases: MEDLINE, CINAHL, PsycINFO, Scopus and the Finnish database MEDIC. In addition, the search for unpublished articles included ProQuest Dissertations and Theses. The methodological quality of the included studies was assessed independently by two reviewers, and qualitative data were extracted from papers by two independent reviewers using a standardized data extraction tool. Qualitative research findings were pooled using the JBI methodology.

RESULTS

Thirteen papers that considered mothers' (n = 199) experiences of PPD were included in the review. A total of 98 findings were extracted and aggregated into 14 categories, and from them, four synthesized findings were developed: i) Depressed mothers feel unable to control their own lives due to low resilience; ii) The ambivalent feelings depressed mothers experience towards their babies, partners and in-laws cause distress and suffering; iii) Depressed mothers experience anger and despair if they perceive imbalances between their support needs and the support they get from healthcare providers and significant others; and iv) Depressed mothers experience hopelessness and helplessness resulting from their new-found motherhood and financial worries. Two papers that considered fathers' (n = 20) experiences of PPD were included in the review. A total of 19 findings were extracted and aggregated into six categories, and from them, two synthesized findings were developed: i) Depressed fathers experience disappointment arising from perceived imbalances between their support needs and the support they get from their partner and significant others; and ii) Depressed fathers are more imbalanced after childbirth than fathers who are not suffering from PPD, so they feel unable to control their own lives due to low resilience.

CONCLUSIONS

The qualitative studies concerning new parents' experiences of PPD have focused on the mother's perspective, and studies of the father's perspective, especially of the father's own experiences of PPD, are scarce. Both mothers and fathers do not receive enough support from their significant others. In addition, mothers want more support from health professionals. Because PPD has a great influence on the well-being of mothers and fathers, as well as children, it is important to understand what parents undergo after childbirth.

Psychosocial Factors Associated with Paternal Perinatal Depression in the United States: A Systematic Review

Paternal perinatal depression can occur in approximately one out of ten fathers. However, research within this population is limited. A previous systematic review suggested that United States had higher rates of paternal perinatal depression compared to other countries. Therefore, this systematic review identified psychosocial factors for depression during the perinatal period in fathers who live in the United States. A literature search was conducted from multiple databases using keywords and MeSH terms to retrieve articles up to the year 2019. Twenty five articles were included in this review. A social-ecological framework was applied to identify psychosocial factors associated with paternal depression. Individual factors include prior history of depression, having maladaptive cognitive coping styles, fathers who self-identified as African-American or Hispanic, parenting stress, substance use, and history of criminal conviction. Interpersonal factors include lack of social support, quality of relationship with the mother of the baby, coparenting conflict, quality of current and childhood relationships with their own parents, and maternal depression. Community factors include frequent daily experiences with racism, and limited access to transportation and housing. These findings underscore the importance of assessing depression and developing father-inclusive interventions that address the psychological needs of fathers.

Supporting women who develop poor postnatal mental health: what support do fathers receive to support their partner and their own mental health?

Background

Research regarding support provided for poor maternal postnatal mental health (such as depression, anxiety disorders, and postpartum psychosis) is relatively common. Fathers appear to play an important role supporting partners but many feel alienated within maternity services. Research focusing on fathers is less common.

Methods

The current qualitative study aimed to investigate fathers’ experience of support provided to fathers, to help support their partner should she experience poor postnatal mental health.

Results

Twenty-five fathers participated in an online questionnaire regarding their experience of their partner’s poor postnatal mental health and the support provided to fathers to help her. Thematic analysis revealed three main themes and seven sub-themes. The themes were: ‘Support received to help support their partner’, ‘Support fathers wanted that was not received’ and ‘Father’s mental health’. The results highlight an overall lack of support for many fathers, despite many wanting support on how to help their partner, information on their own mental health and the services available. Fathers specifically wanted healthcare professionals to sign-post them to someone they can talk to for emotional support, and to be taught coping strategies which would help them to support both their partner and baby.

Conclusions

The findings from this study suggest that health professionals and perinatal mental health services need a better understanding about what resources fathers need to support the mental health of themselves and their partner.

The Association Between Fathers' Depression and Children's Socioemotional Development: Evidence from a Longitudinal Household Survey in China

Depression is highly prevalent among parents around the world. Although there has been substantial research on maternal depression, few studies have additionally considered paternal depression and examined the independent and potentially interactive influence between paternal and maternal depression on children's development. The objectives of this study were to investigate the unique association between paternal depression and children's later socioemotional development, and explore whether this association was moderated by maternal depression. We used data from the 2012 and 2014 waves of the China Family Panel Studies. We used multivariable linear regression models to examine the association between paternal depression, as measured using the Center for Epidemiological Studies-Depression Scale, and children's socioemotional development, as measured using the Positive Behaviors Scale. We also explored whether there was effect modification by maternal depression. The sample comprised of 1615 children (M_age = 7.38 years; 48.5% female) and their parents. Twenty-four percent of fathers and 33% of mothers were depressed. We found that paternal depression was negatively associated with children's socioemotional development (β = - 0.18; 95% CI - 0.31, - 0.03), controlling for maternal depression and other sociodemographic covariates. Moreover, we found that the association was moderated by maternal depression, whereby the negative association was stronger when mothers were not depressed (β = - 0.30; 95% CI - 0.52, - 0.08) versus null when mothers were depressed (β = - 0.02; 95% CI - 0.24, 0.20). Parenting interventions should promote the mental health of fathers, in addition to mothers, as a more holistic and family-based approach for improving both the wellbeing of parents and behavioral development of children.

Paternal depressive symptoms during the early postpartum period and the associated factors following the implementation of the two-child policy in China

AIM

To evaluate the prevalence of paternal depressive symptoms during the first three days of childbirth, as well as the associated factors, following the implementation of the two-child policy in China in 2015, which allows couples to have two children in the Chinese mainland.

METHODS

A cross-sectional study was conducted among 318 fathers. Paternal depressive symptoms and self-efficacy of fathers were screened using the Edinburgh Postnatal Depression Scale and the General Self-Efficacy Scale, respectively. In addition, basic information of all parents and neonates was collected. Univariate analysis, binary logistic regression analysis, and principal component analysis (PCA) were used to identify the relationship between paternal depressive symptoms and its associated factors.

RESULTS

Twenty-two percentage of fathers had depressive symptoms during the first three days of childbirth. Binary logistic regression analysis revealed that older fathers, those who slept for more than 8 h per night, or were dissatisfied with their living conditions were more susceptible to developing the symptoms. On the contrary, protective factors such as the educational level of fathers, planned pregnancy, prenatal guidance, having the second-born child, and higher self-efficacy were found to reduce the development of paternal depressive symptoms. PCA showed that the main components that influenced the paternal depressive symptoms were parental age and parity.

CONCLUSIONS

The prevalence of paternal depressive symptoms during the postpartum period did not increase significantly after the implementation of the two-child policy in China. However, focusing on the associated factors is necessary in order to manage postpartum depression during the early postpartum period.

Relationship between paternal psychological distress and involvement in childcare among fathers of preschool-aged children: mediating effect of maternal psychological distress

Background

The role of the father as a co-caregiver is becoming increasingly important across cultures. Parental psychological distress is an influencing factor of maladaptive parenting behaviors and negative psychosocial outcomes in children. Considerable research has focused on psychological distress in parents, commonly experienced during the childrearing years; however, the relationship between paternal psychological distress and fathers’ involvement in childcare has been less studied. This study aimed to examine this relationship.

Methods

This study explored the relationship between parental psychological distress and fathers’ involvement in childcare by analyzing data from 1541 children and their parents from the 2011 Panel Study on Korean Children. Psychological distress was assessed using the Kessler 6-Item Psychological Distress Scale. Fathers’ involvement in childcare was measured in terms of the quality and quantity of involvement, using a Father’s Childcare Involvement Scale completed by mothers and the daily hours spent by fathers in childcare.

Results

The mean scores for paternal and maternal psychological distress were 5.26 ± 4.20 and 5.79 ± 4.42, respectively; for the quality of fathers’ involvement in childcare, 14.46 ± 2.63; and for the quantity of fathers’ involvement, 2.53 ± 1.62. Paternal psychological distress was significantly correlated with maternal psychological distress and fathers’ involvement in childcare. Maternal psychological distress demonstrated a partial mediating effect on the relationship between paternal psychological distress and the quality of fathers’ involvement in childcare for preschool-aged children (β = −.085, p < .001); this effect was significant (Sobel test; Z = 3.13, p = .002). Further, maternal psychological distress demonstrated a complete mediating effect on the relationship between paternal psychological distress and the quantity of fathers’ involvement in childcare (β = −.065, p = .018); this effect too was significant (Sobel test; Z = 2.38, p = .018).

Conclusions

Paternal psychological distress influenced the quality and quantity of fathers’ involvement in childcare and was mediated by maternal psychological distress. To promote fathers’ involvement in childcare, a family-centered approach for childcare should reflect the triadic interaction of father–mother–child. These findings have implications for primary health professionals, as well as policymakers who design community health programs for early childhood.

[Prevalence and associated factors of depression symptoms in fathers of children aged 6 months to 17 years in Québec]

OBJECTIVES

In fathers, depression symptoms experienced during pregnancy and after childbirth represent a depression risk factor during the child first months. Since depression can have a huge impact on their subsequent involvement with the child, this issue is worrisome and requires consideration. Until now, however, few studies have dealt with paternal depression and its determinants beyond the perinatal period.

METHOD

This study uses data from a representative provincial survey conducted with 1342 fathers of children aged 6 months to 17 years. It documents the prevalence of moderate and severe depression symptoms with the CES-D scale as well as associated factors.

RESULTS

Findings show prevalence rates ranging from 3% to 10% depending on depression symptom severity and children age. Associated factors include problematic use of alcohol, no employment, stress related to balancing work and family, domestic violence environment, and low revenue and social support.

CONCLUSION

These results are interpreted in light of the role and involvement fathers keep in their child's life. They also stress the importance of identifying depression symptoms in this population beyond the perinatal period while monitoring the symptom intensity.

Studying perceived needs for information on maternal and infant health care in the puerperium period among fathers of newborns in China

OBJECTIVE

The objective of this study is to understand the perceived needs for information on maternal and infant healthcare during the puerperium among the fathers of newborns in China, and to examine factors that are associated with the patterns of perceived needs.

DESIGN

A cross-sectional study was conducted.

METHODS

A survey was conducted in the obstetrics department of the First Affiliated Hospital of Soochow University in Suzhou, China. A total of 206 fathers of newborns were interviewed with a response rate of 98.1%. Latent class analysis (LCA) was used to identify a priori unknown patterns of perceived needs for information (knowledge/skills) on maternal and infant healthcare during the puerperium period. Chi-square tests were applied to examine factors associated with such patterns of needs.

RESULTS

The majority of the participants perceived strong needs for information on maternal and infant healthcare during the puerperium. LCA identified three latent classes on perceived needs for information on maternal healthcare among Chinese fathers of newborns: Class 1 - Low: Some Infant Health Related Needs; Class 2 - Moderate: Lower Physical Recovery Needs; and Class 3 - High: Enthusiastic Needs. Similarly, three latent classes were identified for perceived needs for information on infant health care: Class 1 - Low: Some Medical Needs; Class 2 - Moderate: Lower Breastfeeding Needs; and Class 3 - High: Enthusiastic Needs. Fathers aged 30 to 35, urban residents, and those with higher education were more likely to be in the Enthusiastic Needs groups for information needs for both maternal and infant healthcare.

CONCLUSIONS

Perceived needs for information on maternal and infant healthcare are widespread among fathers of newborns in China. Three distinct latent classes for perceived needs for information (knowledge/skills) on maternal and infant health were identified in this population. Socio-demographics, such as age, residence, and education, were significantly associated with such patterns of needs. The findings have implications for the development of interventions to improve maternal and infant healthcare in China.

Factors associated with paternal perinatal depression in fathers of newborns in Nigeria

INTRODUCTION

There is a lack of information on paternal postnatal depression in developing countries such as Nigeria.

METHODS

This study aims to assess the prevalence of depression in fathers at the birth of their infants and the incidence of paternal postnatal depression at 6 weeks postpartum. We also examined the correlation between paternal postpartum depression (PPD) at 6 weeks and maternal PPD as well as the sociodemographic and other correlates of paternal PPD at 6 weeks.

RESULTS

All the 331 fathers recruited at baseline completed the study. Prevalence of depression in fathers at birth of their babies was 10 (3%). After excluding the 3%, the incidence of PPD in fathers (N = 321) at 6 weeks was 19 (5.9%). In all, 29 (8.8%) fathers had PPD. The prevalence of depression in mothers at 6 weeks postpartum was 57 (17.8%). The prevalence of depression in mothers at 6 weeks was significantly higher than the incidence of depression in fathers at 6 weeks (X² = 26.2, p < .001). There was no significant correlation between maternal PPD and paternal PPD. At baseline, prevalence of PPD among the unemployed fathers was higher than in the employed, 3 (21.4%) versus 7 (2.2%), this was significant (FE p < .01). There was no significant correlate of paternal PPD at 6 weeks.

DISCUSSION

Postpartum mental health services should be extended to fathers of newborns especially those who are unemployed. Our findings have implications for family health.

The Economic Case for the Prevention of Mental Illness

Poor mental health has profound economic consequences. Given the burden of poor mental health, the economic case for preventing mental illness and promoting better mental health may be very strong, but too often prevention attracts little attention and few resources. This article describes the potential role that can be played by economic evidence alongside experimental trials and observational studies, or through modeling, to substantiate the need for increased investment in prevention. It illustrates areas of action across the life course where there is already a good economic case. It also suggests some further areas of substantive public health concern, with promising effectiveness evidence, that may benefit from economic analysis. Financial and economic barriers to implementation are then presented, and strategies to address the barriers and increase investment in the prevention of mental illness are suggested.

Association between gestational diabetes mellitus and depression in parents: a retrospective cohort study

Purpose

The aim of this study was to examine the association between gestational diabetes mellitus (GDM) and depression incidence in mothers and fathers during prenatal and postnatal periods.

Patients and methods

Matched pairs (GDM vs no GDM) of randomly selected mothers with singleton live births (matched by age group, delivery year, and health region) and their partners (Quebec, Canada; cohort inception 1990-2007) were assessed for a composite outcome of depression/self-harm/suicide using a health administrative database. We examined the association of GDM and the composite outcome in the following three nonoverlapping periods: 1) 24 weeks gestation up to delivery; 2) delivery up to 1 year postpartum; and 3) 1 year postpartum to study end (March 31, 2012). We used stratified Cox proportional regression hazards models, with three models in mothers and three models in fathers, corresponding to each of the time periods of interest.

Results

In the 58,400 mothers, women with GDM had a nearly twofold greater risk (adjusted HR: 1.82, 95% CI 1.28, 2.59) of being diagnosed with depression compared to those without GDM during the prenatal period. In the first year postpartum, there was no conclusive difference observed between the two groups of mothers (adjusted HR: 1.05, 95% CI 0.84, 1.30). Beyond the first year postpartum, there was an 8% increased risk (adjusted HR: 1.08, 95% CI 1.03, 1.14) of depression in women with a history GDM compared to those without. A total of 63,384 fathers were included in our analyses, and no association between GDM in one's partner and depression was found during any of the three time periods evaluated.

Conclusion

GDM is associated with an increased risk of depression in women particularly during pregnancy highlighting the need to screen for depression and provide supportive interventions during this period.

The relationship between paternal prenatal depressive symptoms with postnatal depression: The PATH model

The purpose of the study was to determine the relationship between men's prenatal and postnatal depressive symptom (PDS). In a descriptive study, 403 fathers meeting the inclusion criteria were enrolled using Poisson random sampling method from public health clinics in Zanjan, Iran. All participants were selected in the third trimester of pregnancy and were followed up eight weeks after childbirth. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen the participants for depressive symptoms. Data was analyzed using descriptive test, Path analysis at a confidence level of 95%. Results showed that the effect of the prenatal depressive symptoms on PDS had perfect good fitness indices. A high level of prenatal depressive symptoms predicted a high level of PDS. We found significant total mediating effects of state, trait, and total anxiety on PDS. The total moderating effect of income on PDS was not statistically significant. These results suggest that a high level of prenatal depressive symptoms is a risk factor for a high level of PDS. Therefore, health providers should pay more attention to the psychological health of fathers during the pre and postpartum period. The predictor factors should be considered in both intervention and clinical assessment of paternal PDS.

Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia

BACKGROUND

Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers.

METHODS

We used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS).

RESULTS

Prevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband's depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife's depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers.

CONCLUSION

Both ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.

The association between paternal and adolescent depressive symptoms: evidence from two population-based cohorts

BACKGROUND

Incidence of depression increases markedly around age 13 years, and nearly three-quarters of adults report that their mental health problems started in adolescence. Although maternal depression is a risk factor for adolescent depression, evidence about the association between paternal and adolescent depression is inconclusive, and many studies have methodological limitations. We aimed to assess the association between paternal and adolescent depressive symptoms in two large population-based cohort studies.

METHODS

We used data for two-parent families from two representative prospective cohorts in Ireland (Growing up in Ireland [GUI]) and the UK (Millennium Cohort Study [MCS]). Parental depressive symptoms were measured with the Centre for Epidemiological Studies Depression Scale in the GUI cohort when children were 9 years old, and the Kessler six-item psychological distress scale in the MCS cohort when children were 7 years old. Adolescent depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ) at age 13 years in the GUI cohort and age 14 years in the MCS cohort. We analysed data using linear regression models, before and after adjustment for confounders, in both multiply imputed and complete case samples.

FINDINGS

There were 6070 families in GUI and 7768 in MCS. After all adjustments, a 1 SD (three-point) increase in paternal depressive symptoms was associated with an increase of 0·24 SMFQ points (95% CI 0·03-0·45; p=0·023) in the GUI cohort and 0·18 SMFQ points (0·01-0·36; p=0·041) in the MCS cohort. This association was independent of, and not different in magnitude to, the association between maternal and adolescent depressive symptoms (Wald test p=0·435 in the GUI cohort and 0·470 in the MCS cohort).

INTERPRETATION

Our results show an association between depressive symptoms in fathers and depressive symptoms in their adolescent offspring. These findings support the involvement of fathers as well as mothers in early interventions to reduce the prevalence of adolescent depression, and highlight the importance of treating depression in both parents.

FUNDING

Department of Children and Youth Affairs and Economic and Social Research Council.

Bio-ecological factors associated with the psychological distress of fathers of children with autism spectrum disorder: A population-based study of Australian families

Using a bio-ecological framework, the aim of this study was to examine factors associated with psychological distress experienced by fathers of children with autism spectrum disorder from a nationally representative sample of Australian children and their families. Individual (e.g. age and self-efficacy), interpersonal (e.g. partner distress, couple relationship, child behaviour and social support) and social environmental factors (e.g. job quality and financial hardship) were explored as potential predictors of fathers’ distress. Data were drawn from the Longitudinal Study of Australian Children, where 159 fathers of children with autism spectrum disorder were identified. As comparison, 6578 fathers of children without developmental disabilities were identified. Multiple regression analyses showed that experiencing depression within the past year, job quality (e.g. autonomy and access to parental leave) and social support were significant predictors for fathers of children with autism spectrum disorder. The importance of supporting the well-being of fathers of children with autism spectrum disorder is discussed.

Paternal Depression Symptoms During Pregnancy and After Childbirth Among Participants in the Growing Up in New Zealand Study

IMPORTANCE

Antenatal and postnatal depression are known to be common and associated with poor outcomes for women and their children. There is little evidence on depression symptoms among men during the perinatal period.

OBJECTIVE

To identify characteristics associated with depression symptoms among men whose partners were pregnant and subsequently gave birth.

DESIGN, SETTING, AND PARTICIPANTS

A longitudinal cohort study provided data from a demographically diverse sample of 3523 New Zealand men who completed interviews during their partner's pregnancy and 9 months after the birth of their child. Participants were drawn from a cohort whose partners were pregnant women with a due date between April 25, 2009, and March 25, 2010, who were enrolled in the Growing Up in New Zealand study. Data analysis was conducted from September 1, 2015, to January 8, 2016.

MAIN OUTCOMES AND MEASURES

Depression symptoms were measured using the Edinburgh Postnatal Depression Scale and the 9-item Patient Health Questionnaire; elevated depression symptoms were defined as scores higher than 12 and 9, respectively.

RESULTS

The mean (SD) age of the participants at the antenatal interview was 33.20 (6.25) years (range, 16-63 years). Elevated antenatal paternal depression symptoms affected 82 fathers (2.3%) and were associated with perceived stress (odds ratio [OR], 1.38; 95% CI, 1.30-1.47) and fair to poor health during their partner's pregnancy (OR, 2.06; 95% CI, 1.18-3.61). Elevated postnatal paternal depression symptoms affected 153 (4.3%) of fathers and were associated with perceived stress in pregnancy (OR, 1.12; 95% CI, 1.08-1.17), no longer being in a relationship with the mother 9 months after childbirth (OR, 6.36; 95% CI, 2.28-17.78), having fair to poor health at 9 months (OR, 3.29; 95% CI, 2.10-5.16), being unemployed at 9 months (OR, 1.86; 95% CI, 1.11-3.10), and a history of depression (OR, 2.84; 95% CI, 1.69-4.78).

CONCLUSIONS AND RELEVANCE

Expectant fathers were at risk of depression symptoms if they felt stressed or were in poor health. Rates of elevated depression symptoms were higher during the postpartum period and were associated with adverse social and relationship factors. Identifying fathers most at risk of depressive symptoms and when best to target interventions (antenatal or postnatal) may be beneficial to men and their families.