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DEMİRCİ Ö, INAN E. Postpartum Paternal Depression: Its Impact on Family and Child Development. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1153712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
The postpartum period is when parents undergo great changes and gain new responsibilities. Factors such as the changes that come with having a baby, not meeting the expectations about parenthood, having a child with a difficult temperament or health problems, or relational problems can be quite challenging in this period. These problems can deeply affect the psychological well-being of the parents. Although studies on depressive symptoms of mothers during pregnancy and postpartum are at an important level, studies aiming to examine the psychological state of fathers for the same period are still limited. However, perceptions that postpartum depression develops due to hormonal changes during pregnancy have been reshaped by the findings that this situation may also develop due to psychosocial factors. Relatedly, the number of studies on postpartum depression experienced by fathers has increased over time. Results of those studies show that fathers' psychological state also influences their parenting and the development of children. Fathers may experience paternal depression due to a lack of social support, economic conditions, relationship dynamics, and changing living conditions in the postpartum period. This situation may cause fathers to avoid parenting duties, spend less time with their children, be unable to cooperate with the mother, and have anger problems or deterioration in the relationship with the mother. The effects of depression on individuals' parenting styles negatively affect child-parent attachment and may cause children to develop emotional and behavioral problems. Therefore, it is very important to examine fathers' psychological state for children's development and the healthy progress of family dynamics. This review aims to address the effect of paternal depression on parenting and child development.
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Lanssens D, Vandenberk T, Storms V, Thijs I, Grieten L, Bamelis L, Gyselaers W, Tang E, Luyten P. Changes in Intrapersonal Factors of Participants in the Pregnancy Remote Monitoring Study Who Are at Risk for Pregnancy-Induced Hypertension: Descriptive Quantitative Study. J Med Internet Res 2023; 25:e42686. [PMID: 37672324 PMCID: PMC10512113 DOI: 10.2196/42686] [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] [Received: 09/13/2022] [Revised: 05/25/2023] [Accepted: 06/23/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND The peripartum period, defined as the period from the beginning of the gestation until 1 year after the delivery, has long been shown to be potentially associated with increased levels of stress and anxiety with regard to one's transition to the status of parent and the accompanying parental tasks. Yet, no research to date has investigated changes in intrapersonal factors during the peripartum period in women at risk for pregnancy-induced hypertension (PIH). OBJECTIVE The aim of this study is to explore and describe changes in intrapersonal factors in participants at risk for PIH. METHODS We used an explorative design in which 3 questionnaires were sent by email to 110 participants the day following enrollment in the Pregnancy Remote Monitoring program for pregnant women at risk for PIH. Women were invited to complete the questionnaires at the beginning of their participation in the Pregnancy Remote Monitoring project (mostly at 14 weeks of gestation) and after approaching 32 weeks of gestational age (GA). The Generalized Anxiety Disorder-7 Scale (GAD-7) and the Patient Health Questionnaire-9 were used to assess anxiety and depression, and adaptation of the Pain Catastrophizing Scale was used to measure trait pain catastrophizing. RESULTS Scores were significantly higher at 32 weeks of GA than at the moment of enrollment (GAD-7 score=7, range 4-11 vs 5, range 3-8; P=.01; and Patient Health Questionnaire-9 score=6, range 4-10 vs 4, range 2-7; P<.001). The subscale scores of the Pain Catastrophizing Scale were all lower at 32 weeks of GA compared with 14 weeks of GA (rumination: 4, range 1-6 vs 5, range 2-9.5; P=.11; magnification: 3, range 1-5.5 vs 4, range 3-7; P=.04; and helplessness: 5, range 2-9 vs 6, range 3.5-12; P=.06). The proportion of women with a risk for depression (GAD-7 score >10) was 13.3% (10/75) at enrollment and had increased to 35.6% (26/75) at 32 weeks of GA. CONCLUSIONS This study shows that pregnant women at risk for PIH have higher levels of stress and anxiety at 32 weeks of GA than at the moment of enrollment. Further research is recommended to investigate potential strategies to help pregnant women at risk for PIH manage feelings of stress and anxiety. TRIAL REGISTRATION ClinicalTrials.gov NCT03246737; https://clinicaltrials.gov/study/NCT03246737.
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Affiliation(s)
- Dorien Lanssens
- Limburg Clinical Research Center/Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Obstetrics and Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Faculty Medicine and Life Sciences, Department of Physiology, Hasselt University, Diepenbeek, Belgium
| | - Thijs Vandenberk
- Limburg Clinical Research Center/Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Valerie Storms
- Limburg Clinical Research Center/Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Inge Thijs
- Limburg Clinical Research Center/Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Lars Grieten
- Limburg Clinical Research Center/Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Lotte Bamelis
- Centre for Translational Psychological Research TRACE, Ziekenhuis Oost Liburg, Genk, Belgium
| | - Wilfried Gyselaers
- Limburg Clinical Research Center/Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Obstetrics and Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Faculty Medicine and Life Sciences, Department of Physiology, Hasselt University, Diepenbeek, Belgium
| | - Eileen Tang
- Faculty of Psychology and Educational Sciences, KULeuven, Leuven, Belgium
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, KULeuven, Leuven, Belgium
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussel, Belgium
- Educational and Health Psychology, Research Department of Clinical, University College London, London, United Kingdom
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Chen J, Zhao J, Chen X, Zou Z, Ni Z. Paternal perinatal depression: A concept analysis. Nurs Open 2023. [PMID: 37147794 DOI: 10.1002/nop2.1797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/18/2023] [Accepted: 04/20/2023] [Indexed: 05/07/2023] Open
Abstract
AIM Our aim is to clarify the concept of paternal perinatal depression including its definition, attributes, antecedents and consequences. DESIGN A concept analysis. METHODS To obtain relevant evidence, several databases were searched systematically including PubMed, EMBASE, Web of Science, CINAHL, PsycINFO and the Cochrane Library. Qualitative or quantitative articles published in English that focused on paternal perinatal depression were included. After the literature quality assessment, Walker and Avant's concept analysis strategy was used. RESULTS Five defining attributes (i.e. symptoms occur during the partner's pregnancy or 1-year postpartum and last at least 2 weeks, emotional symptoms, somatic symptoms, negative parenting behaviours and 'masked' symptoms), four antecedents (i.e. personal issues, pregnancy-related issues, infant-related issues, social issues) and three consequences (i.e. offspring outcomes, marital relationship, maternal negative emotions) were identified.
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Affiliation(s)
- Jianfei Chen
- School of Nursing, Wuhan University, Wuhan, China
| | - Jing Zhao
- School of Nursing, Wuhan University, Wuhan, China
| | - Xiaoli Chen
- School of Nursing, Wuhan University, Wuhan, China
| | - Zhijie Zou
- School of Nursing, Wuhan University, Wuhan, China
| | - Zhao Ni
- School of Nursing, Yale University, New Haven, Connecticut, USA
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, USA
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Yazdanpanahi Z, Mirmolaei ST, Taghizadeh Z, Jaafarpour M, Hajifoghaha M. Paternal postnatal depression: prevalence and the associated demographic and maternal reproductive factors among Iranian fathers. J Reprod Infant Psychol 2023:1-13. [PMID: 37096429 DOI: 10.1080/02646838.2023.2201844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
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.
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Affiliation(s)
- Zahra Yazdanpanahi
- Department of Reproductive Health, School of Nursing and Midwifery affiliated to Tehran university of Medical Sciences, Tehran, Iran
| | - Seyedeh Tahereh Mirmolaei
- Department of Reproductive Health, School of Nursing and Midwifery affiliated to Tehran university of Medical Sciences, Tehran, Iran
| | - Ziba Taghizadeh
- Department of Reproductive Health, School of Nursing and Midwifery affiliated to Tehran university of Medical Sciences, Tehran, Iran
| | - Molouk Jaafarpour
- Department of Midwifery, School of Nursing and Midwifery, Ilam University of Medical sciences, Ilam, Iran
| | - Mahboubeh Hajifoghaha
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Kukafka R, Law E, Mathews J, Lim SH, Shi L, Chua JS, Du R, Chan YH, Tan TC, Chee C, Chong YS. Evaluating the Effectiveness of the Supportive Parenting App on Parental Outcomes: Randomized Controlled Trial. J Med Internet Res 2023; 25:e41859. [PMID: 36645699 PMCID: PMC9887516 DOI: 10.2196/41859] [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: 08/11/2022] [Revised: 11/21/2022] [Accepted: 11/30/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Adjusting to new or additional parenting responsibilities increases stress and affects parental well-being. Existing research has highlighted both parents' desire to receive more support. It has also been found that receiving sufficient social support enhances parenting outcomes. With the increasing popularity of mobile health apps, a Supportive Parenting App (SPA) intervention was developed to fulfill the support needs of parents during the perinatal period. OBJECTIVE This study aimed to examine the effectiveness of the SPA on parental outcomes during the perinatal period. METHODS A 2-group pretest and repeated posttest randomized controlled trial was conducted wherein 200 couples (N=400 mothers and fathers) were recruited from 2 public health care institutions in Singapore. Parents were randomly assigned to intervention (100/200, 50%) or control (100/200, 50%) groups. The SPA intervention consisted of a mobile app-based psychoeducation and peer support program to support parents from pregnancy to 6 months post partum. The outcome measures included postnatal depression, anxiety, parental bonding, parental self-efficacy, perceived social support, and parenting satisfaction. Data were collected at baseline (at >24 weeks of gestation-age of viability in Singapore) and at the first, second, fourth, sixth, ninth, and 12th month post partum. Linear mixed models were used to compare parental outcomes between the groups, and a linear mixed model for repeated measures was used to examine within-group changes. RESULTS Parents in the intervention group mostly showed better outcomes compared with those in the control group. Parents in the intervention group had higher perceived social support than those in the control group at the first (effect size=1.59, 95% CI 0.38-2.80; Cohen standardized effect size=1.31; P=.01), second (effect size=1.98, 95% CI 1.09-2.88; Cohen standardized effect size=2.21; P=.003), and fourth (effect size=2.57, 95% CI 1.62-3.51; Cohen standardized effect size=2.72; P=.048) months post partum. However, parents in the intervention group showed significantly poorer parental bonding (effect size=1.67, 95% CI 0.24-3.11; Cohen standardized effect size=1.16; P=.02). The other parental outcomes did not differ significantly between groups. The scores of mothers and fathers also differed significantly for all outcomes except parental self-efficacy. CONCLUSIONS Parents in the intervention group generally fared better, especially regarding perceived social support. However, the lack of statistical significance in most outcomes showed the limited effectiveness of the SPA intervention, which may be because of the COVID-19 pandemic. Parental differences in outcome scores suggest that mothers and fathers have different support needs; therefore, interventions should be tailored accordingly. Further improvements and evaluations are needed to examine the effectiveness of the SPA intervention in enhancing parental outcomes. Despite statistically insignificant results, limitations should be considered to further improve mobile health app-based interventions such as SPA, as they could serve as reliable and convenient sources of support for parents. TRIAL REGISTRATION Clinicaltrails.gov NCT4706442; https://clinicaltrials.gov/ct2/show/NCT04706442.
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Affiliation(s)
| | - Evelyn Law
- National University Hospital, Singapore, Singapore
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- Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jancy Mathews
- National University Polyclinics, Corporate Office, Singapore, Singapore
| | | | - Luming Shi
- Singapore Clinical Research Institute, Singapore, Singapore
| | - Jing Shi Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ruochen Du
- Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore, Singapore
| | | | - Thiam Chye Tan
- Mount Elizabeth Novena Specialist Centre, Singapore, Singapore
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Kothari A, Bruxner G, Dulhunty JM, Ballard E, Callaway L. Dads in Distress: symptoms of depression and traumatic stress in fathers following poor fetal, neonatal, and maternal outcomes. BMC Pregnancy Childbirth 2022; 22:956. [PMID: 36550457 PMCID: PMC9773585 DOI: 10.1186/s12884-022-05288-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study aims to explore the prevalence of symptoms of depression and traumatic stress in fathers in the setting of poor fetal, neonatal, and maternal outcomes. METHODS A prospective mixed-methods study was conducted at an outer metropolitan public teaching hospital in Brisbane, Australia, with quantitative results presented here. Subjects included 28 fathers whose male partners had experienced pregnancy or childbirth complicated by a significant congenital abnormality or aneuploidy, termination of pregnancy, fetal death in-utero, stillbirth, admission to the neonatal intensive care unit or special care nursery or significant maternal morbidity, such as a postpartum haemorrhage or an emergency postpartum hysterectomy. These experiences were classified into two groups: anticipatory (time to prepare) and sudden (no warning). The fathers were screened using the Edinburgh Postnatal Depression Scale (EPDS) and the Impact of Events Scale-Revised (IES-R) to assess subjective distress at 2-3 weeks (timepoint 1) and 3-4 months (timepoint 2) after the event. RESULTS Data for both the EPDS and IES-R scales was available for 26 fathers (92.9%) at timepoint 1 and for 15 fathers (53.6%) at timepoint 2. High overall EPDS scores (≥10) were noted in 16/27 (59.3%) fathers at timepoint 1 and 6/15 fathers (40.0%) at timepoint 2. High overall IES-R scores ≥33 were noted in 12/26 (46.2%) fathers at timepoint 1 and 4/15 fathers (26.7%) at timepoint 2. A higher percentage of fathers who experienced anticipatory events had EPDS and IES-R score above these cut-offs at timepoint 1 (8/13 or 61.5%) compared to those experiencing sudden events (8/14 or 57.1%), however, percentages were similar between groups at time point 2 (2/7 or 28.6%% and 4/8 or 50.0%, respectively). More fathers who experienced anticipatory events had IES-R scores ≥33 at timepoint 1 (7/13 or 53.8%) compared to those experiencing sudden events (5/14 or 38.0%). CONCLUSION Our study indicates high rates of distress in fathers exposed to poor fetal, neonatal, and maternal outcomes, which can persist for months after the event. Increased support for fathers in this setting may be required to prevent poor mental health. Further research on the long-term effects of these adverse events is warranted.
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Affiliation(s)
- A. Kothari
- grid.490424.f0000000406258387Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia
| | - G. Bruxner
- grid.490424.f0000000406258387Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia
| | - J. M. Dulhunty
- grid.490424.f0000000406258387Redcliffe Hospital, Anzac Avenue, Redcliffe, Queensland 4020 Australia ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia
| | - E. Ballard
- grid.1049.c0000 0001 2294 1395QIMR Berghofer Medical Research Institute, Brisbane, Queensland Australia
| | - L. Callaway
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Queensland Australia ,grid.416100.20000 0001 0688 4634The Royal Brisbane and Women’s Hospital, Brisbane, Queensland Australia
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Postpartum Depression after Maternal Isolation during the COVID-19 Pandemic: The MUMI-19 Study (Mothers Undergoing Mental Impact of COVID-19 Pandemic). J Clin Med 2022; 11:jcm11195504. [PMID: 36233372 PMCID: PMC9573123 DOI: 10.3390/jcm11195504] [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: 07/11/2022] [Revised: 08/27/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The COVID-19 pandemic has shaken the world by imposing unprecedented health measures, including in the postpartum period. Objectives: We aim to assess the impact of maternal isolation in the immediate postpartum period on the rate of postpartum depression (PPD) in a tertiary center. Study Design: We conducted a prospective cohort study, between 22 April and 29 October 2020, using anonymous questionnaires on 265 participants (129 during lockdown and 135 outside). The Edinburgh Postnatal Depression Scale (EPDS) was used as screening for PPD. We used a univariate logistic regression model to analyze the association between risk factors and PPD. Results: There was no difference between the two groups for PPD assessed by an EPDS score >10.5 on day 30 and/or day 60 (23.1% vs. 29.3%, p = 0.661) but on day 3 it was higher (31% vs. 17.8%, p = 0.015) during the lockdown period and partners were more impacted psychologically (48.3% vs. 10.5%, p < 0.001). Parity ≥1 was a protective factor for PPD (OR = 0.2, 95% CI [0.1−0.6], p = 0.003). Risk factors of PPD were: history of psychological abuses (OR = 6.4, CI 95% [1.1−37.6], p = 0.04), stressful life event (OR = 4.5, CI 95% [1.6−12.6], p = 0.004), and bad birth experience (OR = 5.1, CI 95% [1.4−17.8], p = 0.012). Conclusion: Maternal isolation in the immediate postpartum period is associated with an increased rate of moderate to severe symptoms of postpartum blues. The well-known long-term consequences of PPD must be balanced against the expected benefits of partner’s restrictive access to maternity ward.
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Smythe KL, Petersen I, Schartau P. Prevalence of Perinatal Depression and Anxiety in Both Parents: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2218969. [PMID: 35749112 PMCID: PMC9233234 DOI: 10.1001/jamanetworkopen.2022.18969] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
IMPORTANCE New and expectant parents experience perinatal mood disorders, with consequences to parenting ability, bonding with the neonate, interpersonal relationships, and health and well-being of parents. Research shows that maternal and paternal perinatal mood disorders are associated, but no recent systematic review has addressed the prevalence of perinatal mood disorders in both mothers and fathers (parental dyad). OBJECTIVE To examine the prevalence of perinatal mood disorders in parental dyads and identify factors associated with perinatal mood disorders in parental dyads. DATA SOURCES Ovid (MEDLINE, Embase, and PsycINFO) and Web of Science were searched from January 1, 1990, to June 8, 2021, for observational studies reporting on the prevalence of perinatal depression or anxiety in a parental dyad. STUDY SELECTION Studies reporting the prevalence of anxiety or depression in both members of a parental dyad were included, with diagnosis according to established criteria (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition], International Classification of Diseases, 11th Revision) or use of validated screening tools. DATA EXTRACTION AND SYNTHESIS Prevalence data were extracted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were analyzed in subgroups: antenatal depression, early postnatal depression (0-12 weeks), late postnatal depression (3-12 months), and perinatal anxiety. Pooled prevalence was calculated using a random-effects meta-analysis model. Quality assessment was performed using Joanna Briggs Institute Appraisal Checklist for Studies Reporting Prevalence Data. Data were analyzed in June 2021. MAIN OUTCOMES AND MEASURES Prevalence of perinatal anxiety and perinatal depression in parental dyads. RESULTS Twenty-three studies were included, with data from 29 286 couples. The pooled prevalence of antenatal depression in both parents was 1.72% (95% CI, 0.96%-2.48%; P < .001). The prevalence of early postnatal depression (up to 12 weeks post partum) was 2.37% (95% CI, 1.66%-3.08%; P < .001) and the prevalence of late postnatal depression (3-12 months post partum) was 3.18% (95% CI, 2.3-4.05; P < .001). Only 3 studies reported on perinatal anxiety in both parents, precluding a quantitative analysis. CONCLUSIONS AND RELEVANCE In up to 3.18% of couples, both parents may concurrently experience perinatal depression. Perinatal health care must consider the mental health needs of parents, both as individuals and as a parental dyad. Further research is needed to examine outcomes in families where both parents experience perinatal mood disorders.
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Affiliation(s)
- Kara L Smythe
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Irene Petersen
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Patricia Schartau
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
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Dhungel B, Tsuguhiko K, Kachi Y, Ochi M, Gilmour S, Takehara K. Prevalence of and associated factors for psychological distress among single fathers in Japan. J Epidemiol 2021. [PMID: 34690244 PMCID: PMC10165216 DOI: 10.2188/jea.je20210273] [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] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In Japan, ten percent of single-parent households are led by fathers. Taking care of children as a single father is very stressful and could put a strain on their health. It is very important to prevent and identify psychological distress among fathers for both their own health and to avoid negative impacts on children. This study aims to determine the prevalence of, and factors associated with psychological distress among single fathers and understand how it is different from partnered fathers. METHODS We used data from the Comprehensive Survey of Living Conditions 2016. Psychological distress, assessed using the K6 scale, was analysed among 868 single and 43,880 partnered fathers. Logistic regression analysis was performed to assess the risk factors for psychological distress such as employment type, sleep hours, smoking and drinking habits. RESULTS Single fathers had a higher proportion (8.5%) of psychological distress compared to partnered fathers (5.0%). A large percentage of single fathers had a lower educational level and were non-regular workers, self-employed or unemployed, compared to partnered fathers. Among single fathers, the crude and adjusted odds ratio for employment type and sleep hours were significantly associated with psychological distress. CONCLUSION As single parents who are self-employed or directors are likely to have significantly reduced psychological distress than those with regular jobs, measures are needed to improve the work-family balance for non-self-employed fathers. There is a need to provide assistance to improve the quality and amount of sleep of single fathers to ensure their and their children's good health.
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Affiliation(s)
- Bibha Dhungel
- Department of Health Policy, National Centre for Child Health and Development.,Graduate School of Public Health, St. Luke's International University
| | - Kato Tsuguhiko
- Graduate School of Public Health, St. Luke's International University.,Department of Social Medicine, National Centre for Child Health and Development
| | - Yuko Kachi
- Department of Public Health, Kitasato University School of Medicine.,School of Humanities and Social Sciences, Tokyo Metropolitan University
| | - Manami Ochi
- Department of Social Medicine, National Centre for Child Health and Development.,Department of Health and Welfare Services, National Institute of Public Health
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University
| | - Kenji Takehara
- Department of Health Policy, National Centre for Child Health and Development
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Garfield CF, Lee YS, Warner-Shifflett L, Christie R, Jackson KL, Miller E. Maternal and Paternal Depression Symptoms During NICU Stay and Transition Home. Pediatrics 2021; 148:peds.2020-042747. [PMID: 34341101 DOI: 10.1542/peds.2020-042747] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the trajectory and risk factors of depression symptoms among parents from NICU admission to 30 days postdischarge. We hypothesized depression symptom scores would decrease from admission and then increase from discharge to 30 days. METHODS Prospective longitudinal cohort study of premature infants in NICU. Parents completed the validated Edinburgh Postnatal Depression Scale (EPDS) at 4 time points: NICU admission, discharge, and 14 days and 30 days postdischarge. EPDS score change across time and probability of a positive screen (EPDS ≥10) were by assessed using mixed effect regression models. RESULTS Of 431 parents enrolled (mothers, n = 230 [53%]), 33% of mothers (n = 57) and 17% of fathers (n = 21) had a positive EPDS screening. Score change was 1.9 points different between mothers and fathers (confidence interval [CI]: 1.3-2.6; P < .0001), with mothers decreasing 2.9 points (CI: 2.1-3.7; P < .0001) and fathers decreasing 1.0 points (CI: 0.1-2.0; P = .04). Over time, mothers decreased 10.96 times (CI: 2.99-38.20; P = .0003); fathers decreased at a nonsignificant rate. Admission or discharge screening improved 30-day depressive symptom prediction (AUC 0.66 baseline demographics only versus 0.84+initial [P < .0001], and versus 0.80+discharge screening [P < .001]). CONCLUSIONS Mothers and fathers experience different depressive symptom trajectories from NICU to home. Screening parents for postpartum depression during the NICU stay is likely to result in improved identification of parents at risk for postpartum depression after discharge. Focused attention on fathers appears warranted.
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Affiliation(s)
- Craig F Garfield
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois .,Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Young S Lee
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Rebecca Christie
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kathryn L Jackson
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Emily Miller
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Seymour M, Dunning M, Cooklin A, Giallo R. Socioecological factors associated with fathers' well‐being difficulties in the early parenting period. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12016] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Amanda Cooklin
- Parenting Research Centre, Melbourne, Victoria, Australia,
| | - Rebecca Giallo
- Parenting Research Centre, Melbourne, Victoria, Australia,
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Giallo R, Cooklin A, Zerman N, Vittorino R. Psychological distress of fathers attending an Australian early parenting service for early parenting difficulties. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/j.1742-9552.2012.00044.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | | | - Nikki Zerman
- Tweddle Child and Family Health Service, Melbourne, Victoria, Australia
| | - Renzo Vittorino
- Tweddle Child and Family Health Service, Melbourne, Victoria, Australia
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13
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Recto P, Champion JD. Psychosocial Factors Associated with Paternal Perinatal Depression in the United States: A Systematic Review. Issues Ment Health Nurs 2020; 41:608-623. [PMID: 32286093 DOI: 10.1080/01612840.2019.1704320] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
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.
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Affiliation(s)
- Pamela Recto
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Jane Dimmitt Champion
- Lee and Joseph D. Jamail Endowed Professorship in Nursing, School of Nursing, University of Texas at Austin, Austin, Texas, USA
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Rao WW, Zhu XM, Zong QQ, Zhang Q, Hall BJ, Ungvari GS, Xiang YT. Prevalence of prenatal and postpartum depression in fathers: A comprehensive meta-analysis of observational surveys. J Affect Disord 2020; 263:491-499. [PMID: 31757623 DOI: 10.1016/j.jad.2019.10.030] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/03/2019] [Accepted: 10/25/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Increasing attention has been paid to maternal prenatal and postpartum depressive symptoms (depression thereafter), but little is known about the prevalence of paternal prenatal and postpartum depression. To fill this gap, the current study meta-analyzed the worldwide prevalence of prenatal and postpartum depression in fathers. METHODS Studies that reported paternal depression occurring between the first trimester and the first postpartum year were identified by searching both international (PubMed, PsycINFO, Web of Science and EMBASE) and Chinese (WanFang and CNKI) databases between their inception date and July 1, 2018. A random-effects model was used to calculate pooled estimates and 95% confidence intervals. RESULTS Forty-seven studies with 20,728 subjects were included in the meta-analysis. The prevalence of prenatal depression in fathers was 9.76% in all three trimesters, 13.59% in the first, 11.31% in the second and 10.12% in the third trimester. The prevalence of postpartum depression was 8.75% within a whole year, 8.98% within one-month, 7.82% between one- and three months, 9.23% between three months and six months and 8.40% between six months to twelve months after child-birth. The prevalence of paternal postpartum depression was moderated by year of publication, study area, age of fathers of ≥18 years, quality assessment score and mean age (all P<0.05). CONCLUSIONS This meta-analysis found that the prevalence of prenatal and postpartum depression in fathers was relatively common. Regular screening, effective prevention and appropriate treatment need to be implemented in this population.
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Affiliation(s)
- Wen-Wang Rao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
| | - Xiao-Min Zhu
- Department of Psychiatry, Suzhou Guangji Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Qian-Qian Zong
- School of Nursing, Capital Medical University, Beijing, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China
| | - Brian J Hall
- Department of Psychology, Global and Community Mental Health Research Group, University of Macau, Macao SAR, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia; The University of Notre Dame Australia, Fremantle, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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15
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Darwin Z, Domoney J, Iles J, Bristow F, Siew J, Sethna V. Assessing the Mental Health of Fathers, Other Co-parents, and Partners in the Perinatal Period: Mixed Methods Evidence Synthesis. Front Psychiatry 2020; 11:585479. [PMID: 33510656 PMCID: PMC7835428 DOI: 10.3389/fpsyt.2020.585479] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/21/2020] [Indexed: 01/17/2023] Open
Abstract
Introduction: Five to 10 percentage of fathers experience perinatal depression and 5-15% experience perinatal anxiety, with rates increasing when mothers are also experiencing perinatal mental health disorders. Perinatal mental illness in either parent contributes to adverse child and family outcomes. While there are increasing calls to assess the mental health of both parents, universal services (e.g., maternity) and specialist perinatal mental health services usually focus on the mother (i.e., the gestational parent). The aim of this review was to identify and synthesize evidence on the performance of mental health screening tools and the acceptability of mental health assessment, specifically in relation to fathers, other co-parents and partners in the perinatal period. Methods: A systematic search was conducted using electronic databases (MEDLINE, PsycINFO, Maternity, and Infant Care Database and CINAHL). Articles were eligible if they included expectant or new partners, regardless of the partner's gender or relationship status. Accuracy was determined by comparison of screening tool with diagnostic interview. Acceptability was predominantly assessed through parents' and health professionals' perspectives. Narrative synthesis was applied to all elements of the review, with thematic analysis applied to the acceptability studies. Results: Seven accuracy studies and 20 acceptability studies were included. The review identified that existing evidence focuses on resident fathers and assessing depression in universal settings. All accuracy studies assessed the Edinburgh Postnatal Depression Scale but with highly varied results. Evidence on acceptability in practice is limited to postnatal settings. Amongst both fathers and health professionals, views on assessment are mixed. Identified challenges were categorized at the individual-, practitioner- and service-level. These include: gendered perspectives on mental health; the potential to compromise support offered to mothers; practitioners' knowledge, skills, and confidence; service culture and remit; time pressures; opportunity for contact; and the need for tools, training, supervision and onward referral routes. Conclusion: There is a paucity of published evidence on assessing the mental health of fathers, co-mothers, step-parents and other partners in the perinatal period. Whilst practitioners need to be responsive to mental health needs, further research is needed with stakeholders in a range of practice settings, with attention to ethical and practical considerations, to inform the implementation of evidence-based assessment.
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Affiliation(s)
- Zoe Darwin
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Jill Domoney
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Jane Iles
- Department of Psychology, University of Surrey, Surrey, United Kingdom
| | - Florence Bristow
- Community Perinatal Mental Health Service for Croydon, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jasmine Siew
- Department of Experimental Clinical and Health Psychology, Research in Developmental Disorders Lab, Ghent University, Ghent, Belgium.,Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Vaheshta Sethna
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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16
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Wroe J, Campbell L, Fletcher R, McLoughland C. “What am I thinking? Is this normal?” A cross-sectional study investigating the nature of negative thoughts, parental self-efficacy and psychological distress in new fathers. Midwifery 2019; 79:102527. [DOI: 10.1016/j.midw.2019.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 08/06/2019] [Accepted: 08/11/2019] [Indexed: 10/26/2022]
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Vandenberk T, Lanssens D, Storms V, Thijs IM, Bamelis L, Grieten L, Gyselaers W, Tang E, Luyten P. Relationship Between Adherence to Remote Monitoring and Patient Characteristics: Observational Study in Women With Pregnancy-Induced Hypertension. JMIR Mhealth Uhealth 2019; 7:e12574. [PMID: 31464190 PMCID: PMC6737887 DOI: 10.2196/12574] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/19/2019] [Accepted: 04/09/2019] [Indexed: 12/05/2022] Open
Abstract
Background Pregnancy-induced hypertension (PIH) is associated with high levels of morbidity and mortality in mothers, fetuses, and newborns. New technologies, such as remote monitoring (RM), were introduced in 2015 into the care of patients at risk of PIH in Ziekenhuis Oost-Limburg (Genk, Belgium) to improve both maternal and neonatal outcomes. In developing new strategies for obstetric care in pregnant women, including RM, it is important to understand the psychosocial characteristics associated with adherence to RM to optimize care. Objective The aim of this study was to explore the role of patients’ psychosocial characteristics (severity of depression or anxiety, cognitive factors, attachment styles, and personality traits) in their adherence to RM. Methods Questionnaires were sent by email to 108 mothers the day after they entered an RM program for pregnant women at risk of PIH. The Generalized Anxiety Disorder Assessment-7 and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and the severity of depression, respectively; an adaptation of the Pain Catastrophizing Scale was used to assess cognitive factors; and attachment and personality were measured with the Experiences in Close Relationships-Revised Scale (ECR-R), the Depressive Experiences Questionnaire, and the Multidimensional Perfectionism Scale, respectively. Results The moderate adherence group showed significantly higher levels of anxiety and depression, negative cognitions, and insecure attachment styles, especially compared with the over adherence group. The low adherence group scored significantly higher than the other groups on other-oriented perfectionism. There were no significant differences between the good and over adherence groups. Single linear regression showed that the answers on the PHQ-9 and ECR-R questionnaires were significantly related to the adherence rate. Conclusions This study demonstrates the relationships between adherence to RM and patient characteristics in women at risk of PIH. Alertness toward the group of women who show less than optimal adherence is essential. These findings call for further research on the management of PIH and the importance of individual tailoring of RM in this patient group. Trial Registration ClinicalTrials.gov NCT03509272; https://clinicaltrials.gov/ct2/show/NCT03509272
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Affiliation(s)
- Thijs Vandenberk
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.,Mobile Health Unit, Hasselt University, Diepenbeek, Belgium
| | - Dorien Lanssens
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.,Mobile Health Unit, Hasselt University, Diepenbeek, Belgium
| | - Valerie Storms
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium
| | - Inge M Thijs
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.,Mobile Health Unit, Hasselt University, Diepenbeek, Belgium
| | - Lotte Bamelis
- Centre for Translational Psychological Research TRACE, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Lars Grieten
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.,Mobile Health Unit, Hasselt University, Diepenbeek, Belgium
| | - Wilfried Gyselaers
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Obstetrics & Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium.,Limburg Clinical Research Center, Hasselt University, Diepenbeek, Belgium.,Mobile Health Unit, Hasselt University, Diepenbeek, Belgium
| | - Eileen Tang
- Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.,Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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18
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Clément MÈ, Menand V, Piché G, Dubeau D. [Prevalence and associated factors of depression symptoms in fathers of children aged 6 months to 17 years in Québec]. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:550-560. [PMID: 30545249 PMCID: PMC6681513 DOI: 10.1177/0706743718815882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Marie-Ève Clément
- 1 Chaire de recherche du Canada sur la violence faite aux enfants, Université du Québec en Outaouais, Quebec, Canada.,2 Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Quebec, Canada
| | - Véronique Menand
- 1 Chaire de recherche du Canada sur la violence faite aux enfants, Université du Québec en Outaouais, Quebec, Canada
| | - Geneviève Piché
- 2 Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Quebec, Canada
| | - Diane Dubeau
- 2 Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Quebec, Canada
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19
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Da Costa D, Danieli C, Abrahamowicz M, Dasgupta K, Sewitch M, Lowensteyn I, Zelkowitz P. A prospective study of postnatal depressive symptoms and associated risk factors in first-time fathers. J Affect Disord 2019; 249:371-377. [PMID: 30818245 DOI: 10.1016/j.jad.2019.02.033] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/11/2019] [Accepted: 02/11/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recent studies show that paternal depression negatively impacts children's behavioral and emotional development. This study determined the prevalence of depressed mood in first-time fathers at 2 and 6 months postpartum and identified associated risk factors. METHODS A prospective cohort study with 622 men who completed sociodemographic and psychosocial questionnaires during their partner's third trimester of pregnancy. Fathers completed measures again at 2 and 6 months postpartum and partners completed the depressed mood measure at all three timepoints. A cutoff of ≥10 for the Edinburgh Postnatal Depression Scale identified depressed mood status. RESULTS The prevalence of depressive symptoms in fathers was 13.76% at 2 months and 13.60% at 6 months postpartum. Men who were depressed during their partner's pregnancy were 7 times more likely to be depressed at 2 months postpartum. Depressed mood status at both the antenatal and 2 month postpartum assessment was associated with increased risk of depressed mood at 6 months postpartum. Older age, poor sleep quality at study entry, worse couple adjustment, having a partner experiencing antenatal depressive symptoms and elevated parental stress were associated with depressive symptoms at 2 months postpartum. Poor sleep quality, financial stress and a decline in couple adjustment were independently associated to depressive symptoms at 6 months postpartum. LIMITATIONS This sample was fairly well-educated and predominately middle-class. Depressive symptoms were assessed using a self-report questionnaire. CONCLUSIONS The psychosocial risk factors identified provide opportunities for early screening and targeted prevention strategies for fathers at risk for depression during the transition to parenthood.
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Affiliation(s)
- Deborah Da Costa
- Department of Medicine, McGill University, Canada; Division of Clinical Epidemiology, McGill University Health Centre - Research Institute, Canada.
| | - Coraline Danieli
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Canada
| | - Michal Abrahamowicz
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Canada
| | - Kaberi Dasgupta
- Department of Medicine, McGill University, Canada; Division of Clinical Epidemiology, McGill University Health Centre - Research Institute, Canada
| | - Maida Sewitch
- Department of Medicine, McGill University, Canada; Division of Clinical Epidemiology, McGill University Health Centre - Research Institute, Canada
| | - Ilka Lowensteyn
- Division of Clinical Epidemiology, McGill University Health Centre - Research Institute, Canada
| | - Phyllis Zelkowitz
- Lady Davis Institute, Department of Psychiatry, Jewish General Hospital and McGill University, Canada
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20
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Mundorf C, Shankar A, Moran T, Heller S, Hassan A, Harville E, Lichtveld M. Reducing the Risk of Postpartum Depression in a Low-Income Community Through a Community Health Worker Intervention. Matern Child Health J 2019; 22:520-528. [PMID: 29288405 DOI: 10.1007/s10995-017-2419-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectives To clarify the effectiveness of perinatal social support interventions in reducing postpartum depression among minority, low-income women. Methods The Transdisciplinary Research Consortium for Gulf Resilience on Women's Health supported a community-based participatory research project to improve perinatal health among low-income, first-time pregnant women living in a vulnerable Gulf Coast region. Community health workers (CHWs) were partnered with recruited women, and used a mix of mobile technology and home visits to develop a supportive relationship during the perinatal period. Results Women enrolled in the CHW-led intervention had lower (F: 2.38, p = 0.04) average postpartum depression scores (EPDS) 6 months postpartum than a comparison population. The difference, however, was not seen among women in the intervention group who reported relatively poor relationships with their CHWs. Conclusions for Practice Results reinforce the evidence that perinatal social support can affect postpartum depression outcomes. CHWs are increasingly utilized by public programs to reach at-risk populations. We discuss the potential efficacy of CHW programs, but also, the need to pair outreach with effective monitoring and evaluation of the relationship development between CHW and clients.
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Affiliation(s)
| | - Arti Shankar
- Department of Biostatistics & Bioinformatics, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Tracy Moran
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Sherry Heller
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Anna Hassan
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Emily Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Maureen Lichtveld
- Department of Global Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
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21
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Koch S, De Pascalis L, Vivian F, Meurer Renner A, Murray L, Arteche A. Effects of male postpartum depression on father-infant interaction: The mediating role of face processing. Infant Ment Health J 2019; 40:263-276. [PMID: 30720878 DOI: 10.1002/imhj.21769] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
It is estimated that postpartum depression affects up to 25% of men. Despite such high prevalence, the majority of studies on postpartum depression are focused on mothers, and the role of paternal depression and its effects on infant development have been overlooked by researchers and clinicians. The present study aimed to fill this gap by investigating the effect of paternal postpartum depression on father-infant interactions. In addition, we examined whether differences in face recognition mediated the effects of paternal postpartum depression on father-infant interactions. A total of 61 father-infant dyads (17 postpartum depression, 44 controls) took part in the study. Results revealed that compared to controls, fathers with postpartum depression had a worse pattern of interaction with their infants on measures of responsiveness, mood, and sensitivity; they also had greater difficulty in recognizing happy adult faces, but greater facility in recognizing sad adult faces. Depressed fathers attributed greater intensities to sad adult and infant faces. The tendency to attribute greater intensity to sad adult faces was confirmed as a partial mediator of the effect of paternal postpartum depression on measures of father responsiveness and as a full mediator of the effects of paternal depression on father sensitivity. Clinical implications and suggestions for further studies are discussed.
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Affiliation(s)
- Sabrina Koch
- School of Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Leonardo De Pascalis
- Department of Psychological Science, University of Liverpool, Liverpool, United Kingdom
| | - Fabielle Vivian
- School of Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Anelise Meurer Renner
- School of Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Lynne Murray
- Department of Psychology, University of Reading, Reading, United Kingdom
| | - Adriane Arteche
- School of Health, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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Lin WC, Chang SY, Chen YT, Lee HC, Chen YH. Postnatal paternal involvement and maternal emotional disturbances: The effect of maternal employment status. J Affect Disord 2017; 219:9-16. [PMID: 28501681 DOI: 10.1016/j.jad.2017.05.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/04/2017] [Accepted: 05/06/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Recently, studies have begun emphasizing paternal involvement during the perinatal period and its impact on maternal health. However, most studies have assessed maternal perception and focused on adolescents or minority groups in Western countries. Therefore, the current study investigated the association between paternal involvement and maternal postnatal depression and anxiety, along with the effects of maternal job status in the Asian society of Taiwan. METHODS This study recruited pregnant women in the first trimester of pregnancy as well as their partners on prenatal visits from July 2011 to September 2013 at four selected hospitals in metropolitan areas of Taipei, Taiwan. In total, 593 parental pairs completed the first interview and responded to the follow-up questionnaires until 6 months postpartum. Self-reported data were collected, and multiple logistic regression models were used for analyses. RESULTS Lower paternal childcare and nursing frequency was independently associated with an increased risk of maternal postpartum depression (adjusted odds ratio (OR) =4.33, 95% confidence interval (CI)=1.34-13.98), particularly among unemployed mothers. Furthermore, among unemployed mothers, the risk of postnatal anxiety was 3.14 times higher in couples with fathers spending less time with the child, compared with couples with fathers spending more time (95% CI=1.10-8.98). However, no significant findings were obtained for employed mothers. CONCLUSIONS The high prevalence of maternal postnatal emotional disturbances warrants continual consideration. Higher paternal involvement in childcare arrangements should be emphasized to aid in ameliorating these maternal emotional disturbances, particularly among unemployed mothers.
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Affiliation(s)
- Wan-Chien Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Shin-Yow Chang
- Department of Living Science, National Open University, Taipei, Taiwan
| | - Yi-Ting Chen
- Department of Educational Psychology and Counseling, National Taiwan Normal University (Doctoral Student), Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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23
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Gentile S, Fusco ML. Untreated perinatal paternal depression: Effects on offspring. Psychiatry Res 2017; 252:325-332. [PMID: 28314228 DOI: 10.1016/j.psychres.2017.02.064] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 02/18/2017] [Accepted: 02/24/2017] [Indexed: 11/17/2022]
Abstract
Transition to parenthood represents an important life event which increases vulnerability to psychological disorders. Aim of this article is to analyze all studies which investigated the effects of untreated perinatal paternal depression in offspring. We searched pertinent, peer-reviewed articles published in English (January 1980 to April 2016) on MEDLINE, PsycINFO, and Science.gov. Twenty-three studies met the inclusion criteria. Most of the reviewed studies suffer from methodological limitations, including the small sample, the lack of a structured psychiatric diagnosis, and inclusion bias. Despite such limitations, paternal depression seems to be associated with an increased risk of developmental and behavioural problems and even psychiatric disorders in offspring. In particular, in infants and toddlers such problems vary from increased crying to hyperactivity and conduct problems to psychological and developmental impairment, and poor social outcomes. School-age children of depressed fathers have a doubled risk for suffering from specific psychiatric disorders. Hence, facilitating access to vigorous and evidence based treatments is a public health opportunity for improving the quality of life of depressed parents and their children. Evidences emerging from this review actually suggest that the traditional gender-focused approach to perinatal mood disorders should be completed by a family-centred approach, in order to improve the effectiveness of perinatal mental health programs.
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Affiliation(s)
- Salvatore Gentile
- Department of Mental Health ASL Salerno, Piazza Galdi, 841013 Cava de' Tirreni, Salerno, Italy; University of Naples, Medical School "Federico II", Department of Neurosciences, Perinatal Psychiatry, Via S. Pansini, 5, 80131 Naples, Italy.
| | - Maria Luigia Fusco
- Mental Health Institute, Via Dante Alighieri 1, 80058 Torre Annunziata, Naples, Italy; Post-graduate School of Psychology (SIPGI Campania), Via Dante Alighieri 1, 80058 Torre Annunziata, Naples, Italy.
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Antenatal depressive symptoms and subjective birth experience in association with postpartum depressive symptoms and acute stress reaction in mothers and fathers: A longitudinal path analysis. Eur J Obstet Gynecol Reprod Biol 2017; 215:68-74. [PMID: 28601730 DOI: 10.1016/j.ejogrb.2017.05.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/12/2017] [Accepted: 05/23/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Postpartum depressive symptoms (PDS) and acute stress reactions (ASR) after childbirth are frequently documented in mothers, but research is scarce in fathers. In a longitudinal path analysis, the interplay of depressive symptoms in pregnancy and the subjective childbirth experience of mothers and fathers are examined with regard to the development of PDS and ASR postpartum. STUDY DESIGN One hundred eighty nine expectant couples were recruited between August 2006 and September 2009. They completed the Edinburgh Postnatal Depression Scale (EPDS) in the last trimester of pregnancy. In the first week postpartum, they answered the Salmon's Item List (subjective birth experience), and four weeks after birth the EPDS and the Impact of Event Scale - revised (IES-r). The data were evaluated in a longitudinal path analysis. RESULTS Compared with fathers, mothers reported more depressive symptoms (pregnancy: p<0.001; postpartum: p<0.001), higher ASR (p<0.001), and lower 'positive birth experience' (p<0.001). The association between depressive symptoms in mothers and fathers was not significant during pregnancy (r=0.107, p>0.10), but moderately correlated four weeks after birth (r=0.387, p<0.001). Depressive symptoms during pregnancy and a negative subjective birth experience were independently predictive of PDS and ASR after childbirth in mothers and fathers controlling for age, mode of delivery, parity, epidural anaesthesia, infant gender and birth weight. Antenatal depressive symptoms were related to subjective childbirth experience only in fathers. CONCLUSION Parental prenatal depressive symptoms and subjective birth experience are important predictors of postnatal psychological adjustment in mothers and fathers.
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Fisher SD. Paternal Mental Health: Why Is It Relevant? Am J Lifestyle Med 2017; 11:200-211. [PMID: 30202331 PMCID: PMC6125083 DOI: 10.1177/1559827616629895] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/02/2015] [Accepted: 01/11/2016] [Indexed: 01/23/2023] Open
Abstract
Father's mental health is an emerging area of interest that is beginning to be recognized in research, and to a lesser extent in clinical practice and society. Fathers are part of a parenting dyad with 2 partners who are responsible for their children's emotional development. Similar to mothers, the risk for mental health problems increases once a male becomes a father, but there is limited research examining this issue. The purpose of this review is to present the available literature on father's mental health and its effect on child emotional health through various mechanisms. In general, father's mental health was found to be related to increased child internalizing and externalizing behaviors, but each disorder had different risk factors, and a unique effect on parenting behaviors and the child's emotional health. The most developed paternal mental health literature is focused on depression. However, key conceptual and methodological problems exist that may limit our understanding of paternal depression. Additionally, the focus on paternal depression may not accurately represent the largest risk for paternal psychopathology and the resultant child mental health outcomes because men have an increased likelihood of displaying externalizing behaviors. Implications for research, clinical practice, and policy are discussed.
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Affiliation(s)
- Sheehan D. Fisher
- Department of Psychiatry and Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Leung BMY, Letourneau NL, Giesbrecht GF, Ntanda H, Hart M. Predictors of Postpartum Depression in Partnered Mothers and Fathers from a Longitudinal Cohort. Community Ment Health J 2017; 53:420-431. [PMID: 27826783 DOI: 10.1007/s10597-016-0060-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 10/25/2016] [Indexed: 11/26/2022]
Abstract
Postpartum depression (PPD) is a growing mental health concern in new mothers and fathers. The purpose of this study was to determine the predictors of depression at 3 months postpartum, comparing depressed couples to couples with only one depressed partner or no depressed partner, using data from the Alberta Pregnancy Outcomes and Nutrition study. Data from mothers and fathers were collected at second trimester and 3 months postpartum. Results showed predictors of PPD in mothers to be low household income, high prenatal depressive symptoms, and postnatally, low social support and higher number of stressful life events. Fathers had similar predictors, including low household income, high prenatal depressive symptoms, and postnatally low social support and smoking. Compared with non-depressed couples, factors that predicted PPD in both mothers and fathers in couples included low income, high prenatal depressive symptoms in mothers and low prenatal social support reported by fathers.
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Affiliation(s)
- Brenda M Y Leung
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, T1K 3M4, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 4N1, Canada.
| | - Nicole L Letourneau
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Gerald F Giesbrecht
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Henry Ntanda
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Martha Hart
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB, T2N 1N4, Canada
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Johansson M, Svensson I, Stenström U, Massoudi P. Depressive symptoms and parental stress in mothers and fathers 25 months after birth. J Child Health Care 2017; 21:65-73. [PMID: 29156983 DOI: 10.1177/1367493516679015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to determine the prevalence of depressive symptoms, feelings of incompetence and spouse relationship problems and their mutual relations. Data from a Swedish parent-infant population-based cohort 25 months after childbirth was used. A questionnaire containing Edinburgh Postnatal Depression Scale (EPDS) and a modified Swedish Parental Stress Questionnaire (SPSQ) regarding depression and parental stress was answered by 646 fathers and 700 mothers. Parents with depressive symptoms experienced more feelings of incompetence and spouse relationship problems than parents without depressive symptoms. The prevalence of depressive symptoms (EPDS ≥ 12) was more than11% for mothers and nearly 5% for fathers in the sample, 25 months after childbirth. The result indicated that feelings of incompetence and spouse relationship problems could be important constructs for understanding parental stress and depressive symptoms in the parents of young children. In conclusion, it is important that Child Health Care is attentive to both mothers' and fathers' depressive symptoms and parental stress after the first year.
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Affiliation(s)
- Maude Johansson
- 1 Linneaus University, Department of Psychology Vaxjo, Sweden
| | - Idor Svensson
- 2 Linneaus University, Department of Psychology Vaxjo Sweden
| | - Ulf Stenström
- 3 Linneaus University, Department of Psychology Vaxjo Sweden
| | - Pamela Massoudi
- 4 Department of Research and Development, Region Kronoberg and Department of Psychology, University of Gothenburg, Sweden
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Wong O, Nguyen T, Thomas N, Thomson-Salo F, Handrinos D, Judd F. Perinatal mental health: Fathers - the (mostly) forgotten parent. Asia Pac Psychiatry 2016; 8:247-255. [PMID: 26293755 DOI: 10.1111/appy.12204] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 07/07/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The importance of parental mental health as a determinant of infant and child outcomes is increasingly acknowledged. Yet, there is limited information regarding paternal mental health during the perinatal period. The aim of this review is to summarize existing clinical research regarding paternal mental health in the perinatal period in various contexts, and its possible impact on infant development. METHOD An electronic literature search was conducted using MEDLINE and PubMed databases. Key texts were used to cross-check for any further articles of interest. RESULTS Men are at increased risk of mental health problems during the transition to fatherhood, as well as during the perinatal period. Paternal mental health during the perinatal period has been shown to impact on their child's emotional and behavioral development. However, research addressing the needs of fathers with mental illness and the impact of their illness on their infant and family has been limited. CONCLUSIONS A paradigm shift is required, from a focus on women following childbirth and women with pre-existing psychiatric disorders, to a broader family perspective with the focus firmly on parent-infant relationships. This paradigm shift needs to involve greater research into the fathering role and paternal mental illness during the perinatal period, including further studies into risk factors, impact on the family system, and the most appropriate form of intervention and service provision.
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Affiliation(s)
- Olivia Wong
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia.
| | - Tram Nguyen
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Naomi Thomas
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia
| | - Frances Thomson-Salo
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Dennis Handrinos
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia
| | - Fiona Judd
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia
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Cameron EE, Sedov ID, Tomfohr-Madsen LM. Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. J Affect Disord 2016; 206:189-203. [PMID: 27475890 DOI: 10.1016/j.jad.2016.07.044] [Citation(s) in RCA: 282] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/30/2016] [Accepted: 07/09/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Research in paternal prenatal and postpartum depression has nearly doubled since prevalence rates were last meta-estimated in October 2009. An updated meta-analysis allows additional questions to be answered about moderators that influence risk. METHODS Studies reporting paternal depression between the first trimester and one-year postpartum were obtained for the period from January 1980 to November 2015. In total 74 studies with 41,480 participants were included, and data was extracted independently by two authors. Moderator analyses included measurement method, timing of assessment, study location, publication year, age, education, parity, history of depression, and maternal depression. RESULTS The meta-estimate for paternal depression was 8.4% (95% confidence interval [CI], 7.2-9.6%) with significant heterogeneity observed among prevalence rates. Prevalence significantly varied based on publication year, study location, measurement method, and maternal depression. Prevalence was not conditional on paternal age, education, parity, history of paternal depression, and timing of assessment. LIMITATIONS Analyses were limited by variability in assessment measures, countries from which studies were available, extant data for the first trimester and 6- to 9-month postpartum, and method of reporting sociodemographic information. CONCLUSIONS Paternal depression was present in 8% of men in the included studies. Future screening policies and interventions should consider moderating risk factors for depression throughout the transition to parenthood.
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Affiliation(s)
- Emily E Cameron
- Department of Psychology, University of Calgary, Calgary, AB, Canada.
| | - Ivan D Sedov
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Lianne M Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute for Child and Maternal Health (ACHRI), Calgary, AB, Canada; Department of Pediatrics, Alberta Children's Hospital, Calgary, AB, Canada
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Affiliation(s)
- Sue Moos
- Cheltenham & Tewkesbury Primary Care Trust, Cheltenham, UK
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31
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Abstract
Postnatal depression is the most frequent psychiatric disorder seen after childbirth, with a prevalence rate of 10% to 15%. The women at risk need to be identified by a valid and reliable method, either using a screening instrument or an interview schedule.The preventive strategies need to have enough power to detect a clinically worthwhile effect to be considered useful in clinical practice. Many of the risk factors for developing postnatal depression are present during the pregnancy and immediate post-partum period. The risk factors for postnatal depression include depression or anxiety during pregnancy, experiencing stressful life events during pregnancy or the early puerperium, maternity blues, low levels of social support, past history of depression and poor marital adjustment. The antenatal and postnatal period provides an ideal opportunity to screen women for these risk factors. The women identified to be at risk can be identified, and preventive interventions can be implemented.Routine clinical practice can be improved to identify some of the women at risk by better communication between health professionals. There are no antenatal screening tools that have been shown to be of benefit in predicting postnatal depression. Edinburgh Postnatal Depression Scale is widely used in the postnatal period to screen for depression. The psychosocial interventions to prevent postnatal depression have not been shown to be beneficial and there is a dearth of psychopharmacological trials to make firm conclusions about their efficacy in preventing postnatal depression. Individualised psychosocial interventions aimed at the at-risk populations and initiated in the postnatal period appear to have some benefit in preventing postnatal depression. The focus of this article will be the risk factors associated with postnatal depression, screening methods and tools to identify those at risk of developing the disorder and the psychosocial, psychological and psychopharmacological interventions to prevent postnatal depression.
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Affiliation(s)
- Pavan Kumar Mallikarjun
- Queen Elizabeth Psychiatric Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2QZ, England.
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Abstract
Swedish fathers are largely involved in their infant’s care, and Sweden has a generous parental leave, with 2 months especially assigned for fathers. The prevalence of depressive symptoms postpartum for fathers appears to be similar as for mothers in Sweden. This study aimed to describe fathers’ experiences of the first year postpartum, when they showed depressive symptoms 3 to 6 months postpartum. Semistructured interviews with 19 fathers were conducted and analyzed with content analysis. The fathers experienced loss of control and powerlessness due to discrepancies between their expectations and the reality they met after birth. They found the everyday-life turbulent, with much stress and worries for the infant, conflicts between family and work, and lack of support in everyday life. In addition, the fathers struggled with impaired partner-relationship, losses, and contradictory messages from both the society and their partners. These findings indicate that the fathers had difficulties to balance the competing demands of family, work, and their own needs. Thus, it is important to identify fathers with depressive symptoms at the Child Health Care Centers and attend to fathers’ needs of support and acknowledge them as parents equal to mothers.
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Affiliation(s)
| | | | - Fia Simon
- Karolinska Institutet, Stockholm, Sweden
| | - Lene Lindberg
- Karolinska Institutet, Stockholm, Sweden
- Stockholm County Council, Stockholm, Sweden
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Vänskä M, Punamäki RL, Tolvanen A, Lindblom J, Flykt M, Unkila-Kallio L, Tulppala M, Tiitinen A. Paternal mental health trajectory classes and early fathering experiences. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2016. [DOI: 10.1177/0165025416654301] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A father’s mental health is important for family well-being, but research is scarce on paternal symptoms during the transition to fatherhood. This study identified fathers’ latent mental health trajectory classes from the pre- to postnatal period and examined their associations with early fathering experiences. It further analysed, whether a family’s infertility history was associated with mental health trajectory classes and moderated their effects on fathering experiences. Finnish fathers ( N = 773) reported psychological distress (General Health Questionnaire; GHQ-36) and depressive symptoms (Beck Depression Inventory; BDI-13) in pregnancy (T1), and at 2 months (T2) and 12 months (T3) postpartum. They further reported their fathering experience (Parenting Stress Index; PSI-36) at T2 and T3. Results revealed five paternal mental health trajectory classes, differing in timing and course of symptoms across the pre- and postpartum: stable low (79%) and moderate increasing (9%) levels of symptoms, and prenatal (5%), early fatherhood (3%) and heterogeneous high levels of (4%) problems. The trajectory classes were associated with fathering experiences within parental, interactive and child domains, across the child’s first year. The stable low levels of symptoms-class showed the most positive experiences and the heterogeneous high levels of problems-class the most negative ones; mental health problems in the early fatherhood-class reported negative fathering experience, but only when the child was 2 months old. A family’s infertility history neither showed any significant association with trajectory classes nor moderated their impact on early fathering, supporting the growing evidence that infertility treatments do not place an additional burden on early fatherhood.
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Affiliation(s)
- Mervi Vänskä
- School of Social Sciences and Humanities, University of Tampere, Tampere, Finland
| | - Raija-Leena Punamäki
- School of Social Sciences and Humanities, University of Tampere, Tampere, Finland
| | - Asko Tolvanen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Jallu Lindblom
- School of Social Sciences and Humanities, University of Tampere, Tampere, Finland
| | - Marjo Flykt
- School of Social Sciences and Humanities, University of Tampere, Tampere, Finland
| | - Leila Unkila-Kallio
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Maija Tulppala
- Department of Obstetrics and Gynaecology, University of Helsinki, Helsinki, Finland
| | - Aila Tiitinen
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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35
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Lehti J. Theory of psychological adaptive modes. Med Hypotheses 2016; 90:66-73. [DOI: 10.1016/j.mehy.2016.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/18/2016] [Accepted: 03/07/2016] [Indexed: 02/06/2023]
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Alibekova R, Huang JP, Lee TSH, Au HK, Chen YH. Effects of smoking on perinatal depression and anxiety in mothers and fathers: A prospective cohort study. J Affect Disord 2016; 193:18-26. [PMID: 26766030 DOI: 10.1016/j.jad.2015.12.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 12/14/2015] [Accepted: 12/19/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Considerable concern persists on tobacco use during perinatal periods. No study has simultaneously investigated the longitudinal association of paternal smoking with maternal and paternal depressive and anxiety symptoms during perinatal periods. METHODS In this prospective study, 533 couples (pregnant women and their husbands) completed 5 self-report instruments from early pregnancy until 6 months postpartum. Generalized estimating equations were used for the analyses. RESULTS We found that fathers who smoked in the mother's presence had higher depressive (regression coefficient=1.0, 95% confidence interval (CI) 0.3-1.8) and anxiety symptoms (3.0, 95% CI=1.2-4.7) during perinatal periods compared with nonsmoking fathers. Paternal smoking in the mother's presence also increased maternal disturbances, especially for depression during pregnancy (1.2, 95% CI=0.1-2.3) and anxiety during the postpartum period (3.4, 95% CI=0.6-6.3). No significant association was found between paternal smoking but not in the mother's presence and maternal emotional disturbances. Paternal smoking but not in the mother's presence affected only paternal anxiety, especially in the postpartum period (regression coefficient 2.7, 95% CI 0.7-4.7) compared with nonsmokers. LIMITATIONS Self-report measures were used. The effects of maternal smoking could not be estimated because of the small sample of pregnant women who disclosed their smoking status. CONCLUSIONS These findings imply a necessity to combine strategies for smoking cessation with interventions for affective disturbances in fathers. We also stress the importance of at least restricting the father's smoking in the presence of the pregnant wife during perinatal periods if smoking cessation is tentatively unattainable.
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Affiliation(s)
- Raushan Alibekova
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Education, National Taiwan Normal University, Taipei, Taiwan
| | - Heng-Kien Au
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
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Anding JE, Röhrle B, Grieshop M, Schücking B, Christiansen H. Couple comorbidity and correlates of postnatal depressive symptoms in mothers and fathers in the first two weeks following delivery. J Affect Disord 2016; 190:300-309. [PMID: 26546770 DOI: 10.1016/j.jad.2015.10.033] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/10/2015] [Accepted: 10/16/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Postnatal depression affects a significant number of parents; however, its co-occurrence in mothers and fathers has not been studied extensively. Identifying predictors and correlates of postnatal depressive symptoms can help develop effective interventions. METHODS Questionnaires on several socio-demographic and psychosocial factors were administered to 276 couples within two weeks after birth. Depressive symptoms in mothers and fathers were assessed using the Edinburgh Postnatal Depression Scale (EPDS). After calculating the correlation coefficient between mothers and fathers' EPDS scores, univariate and multivariate linear regression analyses were performed to identify significant correlates of postnatal depressive symptoms in mothers and fathers. RESULTS Prevalence of maternal and paternal postnatal depressive symptoms was 15.9% (EPDS>12) and 5.4% (EPDS>10), respectively. There was a moderate positive correlation between mothers and fathers' EPDS scores (r=.30, p<.001). Multivariate analyses indicated that parental stress was the strongest predictor for maternal and paternal postnatal depressive symptoms. Pregnancy- and birth-related distress and partners' EPDS scores were also associated with depressive symptoms in both parents. Relationship satisfaction was only inversely related with fathers' EPDS scores, while mothers' EPDS scores were additionally associated with critical life events, history of childhood violence, and birth-related physiological complaints. LIMITATIONS Since information about participation rates (those who declined) is unavailable, we cannot rule out sampling bias. Further, some psychosocial factors were assessed using single items. CONCLUSION Since co-occurrence of depressive symptoms in mothers and fathers is high, developing and evaluating postnatal depression interventions for couples may be beneficial. Interventions to reduce parenting stress may help prevent parental postnatal depression.
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Affiliation(s)
- Jana Eos Anding
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Germany.
| | - Bernd Röhrle
- Department of Clinical Psychology, Philipps University Marburg, Germany
| | | | | | - Hanna Christiansen
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Germany
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Koh YW, Lee AM, Chan CY, Fong DYT, Lee CP, Leung KY, Tang CSK. Survey on examining prevalence of paternal anxiety and its risk factors in perinatal period in Hong Kong: a longitudinal study. BMC Public Health 2015; 15:1131. [PMID: 26572228 PMCID: PMC4647473 DOI: 10.1186/s12889-015-2436-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 10/20/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is emerging evidence of the significance of paternal mental health problems among the expectant fathers during the antenatal and postnatal period. The present study aims at determining the prevalence of paternal perinatal anxiety and identifying its risk factors among the fathers. METHODS A total of 622 expectant fathers were recruited in Hong Kong. The expectant fathers were assessed using standardized and validated psychological instruments on three time points including early pregnancy, late pregnancy and 6 week postnatal. Independent samples t-test, one way ANOVA, Pearson's correlation and multiple linear regression were used to examine the effect of hypothesized risk factors. Hierarchical multiple regression and mixed effect model were also conducted with potential confounding factors controlled for. RESULTS Results showed that a significant proportion of expectant fathers experienced anxiety during the perinatal period. Low self-esteem and poor social support were found to be risk factors of paternal anxiety across pregnancy to postnatal period. Work-family conflict could significantly predict paternal anxiety in the pregnancy period. CONCLUSIONS The present study points to the need for greater research and clinical attention to paternal anxiety, given that it is a highly prevalent problem and could be detrimental to their partner's well-being and children development. The present findings contributes to the theoretical understanding of the prevalence and risk factors of paternal perinatal anxiety and have implications for the design of effective identification, prevention, and interventions of these clinical problems.
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Affiliation(s)
- Y W Koh
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
| | - A M Lee
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
| | - C Y Chan
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
| | - D Y T Fong
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong.
| | - C P Lee
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong.
| | - K Y Leung
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Pokfulam, Hong Kong.
| | - C S K Tang
- National University of Singapore, Singapore, Singapore.
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Leach LS, Mackinnon A, Poyser C, Fairweather-Schmidt AK. Depression and anxiety in expectant and new fathers: longitudinal findings in Australian men. Br J Psychiatry 2015; 206:471-8. [PMID: 25858179 DOI: 10.1192/bjp.bp.114.148775] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 09/29/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND Despite growing interest in men's perinatal mental health, we still know little about whether becoming a new father is associated with increases in psychological distress. AIMS To use prospective longitudinal data to investigate whether becoming a first-time expectant (partner pregnant) and/or new father (child <1 year) is associated with increases in depression and anxiety. METHOD Men were aged 20-24 years at baseline (n = 1162). Levels of depression and anxiety were measured at four time points over 12 years. Over this time, 88 men were expectant fathers, 108 men were new fathers and 626 men remained non-fathers. RESULTS Longitudinal mixed models showed no significant increase in depression or anxiety as a function of expectant or new fatherhood, as compared with pre-fatherhood levels. CONCLUSIONS Our findings suggest that, generally, expectant and new fathers are not at greater risk of depression or anxiety. Future epidemiological research should continue to identify men who are most (and least) at risk to focus resources and assistance most effectively.
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Affiliation(s)
- Liana S Leach
- Liana S. Leach, PhD, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra; Andrew Mackinnon, PhD, Orygen Youth Health Research Centre, The University of Melbourne, Parkville; Carmel Poyser, BSc, MSc, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra; A. Kate Fairweather-Schmidt, PhD, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra and School of Psychology, Flinders University, Adelaide, Australia
| | - Andrew Mackinnon
- Liana S. Leach, PhD, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra; Andrew Mackinnon, PhD, Orygen Youth Health Research Centre, The University of Melbourne, Parkville; Carmel Poyser, BSc, MSc, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra; A. Kate Fairweather-Schmidt, PhD, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra and School of Psychology, Flinders University, Adelaide, Australia
| | - Carmel Poyser
- Liana S. Leach, PhD, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra; Andrew Mackinnon, PhD, Orygen Youth Health Research Centre, The University of Melbourne, Parkville; Carmel Poyser, BSc, MSc, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra; A. Kate Fairweather-Schmidt, PhD, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra and School of Psychology, Flinders University, Adelaide, Australia
| | - A Kate Fairweather-Schmidt
- Liana S. Leach, PhD, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra; Andrew Mackinnon, PhD, Orygen Youth Health Research Centre, The University of Melbourne, Parkville; Carmel Poyser, BSc, MSc, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra; A. Kate Fairweather-Schmidt, PhD, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra and School of Psychology, Flinders University, Adelaide, Australia
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Loscalzo Y, Giannini M, Contena B, Gori A, Benvenuti P. The Edinburgh Postnatal Depression Scale for Fathers: A contribution to the validation for an Italian sample. Gen Hosp Psychiatry 2015; 37:251-6. [PMID: 25724271 DOI: 10.1016/j.genhosppsych.2015.02.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 02/05/2015] [Accepted: 02/06/2015] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The aims of the study are to contribute to the validation of the Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987) on a sample of Italian fathers (both men in the perinatal period than those with grown-up children) and to analyze its factorial structure. METHODS Four hundred thirty-six fathers participated; specifically, we used two samples. The first was composed of 334 fathers, 39 of which were depressed new fathers. We conducted explorative factor analysis and receiver operator characteristic analysis. The second sample was composed of 102 fathers, 22 of which were depressed new fathers. We conducted confirmative factor analysis on this second sample. We administered the Italian version of the EPDS (Carpiniello et al., 1997; Benvenuti et al., 1999), the Beck Depression Inventory-II (Ghisi et al., 2006) and the Center for Epidemiological Studies Depression Scale (Fava, 1983). RESULTS The test seems to detect not depression but a state of distress including depressive symptoms, anxiety and unhappiness. Results showed a two-factor structure, different from that of mothers. The optimal cutoff for Italian fathers is 12/13. CONCLUSIONS The EPDS is a valid and reliable instrument, useful in the perinatal period for screening fathers at risk for perinatal distress and in need of psychological support.
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Affiliation(s)
- Yura Loscalzo
- University of Florence, School of Psychology, Department of Health Sciences, Via di San Salvi 12-Padiglione 26, 50135 Florence, Italy.
| | - Marco Giannini
- University of Florence, School of Psychology, Department of Health Sciences, Via di San Salvi 12-Padiglione 26, 50135 Florence, Italy
| | - Bastianina Contena
- University of Florence, School of Psychology, Department of Health Sciences, Via di San Salvi 12-Padiglione 26, 50135 Florence, Italy
| | - Alessio Gori
- University of Florence, School of Psychology, Department of Health Sciences, Via di San Salvi 12-Padiglione 26, 50135 Florence, Italy
| | - Paola Benvenuti
- University of Florence, School of Psychology, Department of Health Sciences, Via di San Salvi 12-Padiglione 26, 50135 Florence, Italy
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Giallo R, D'Esposito F, Cooklin A, Christensen D, Nicholson JM. Factors associated with trajectories of psychological distress for Australian fathers across the early parenting period. Soc Psychiatry Psychiatr Epidemiol 2014; 49:1961-71. [PMID: 24556811 DOI: 10.1007/s00127-014-0834-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 02/03/2014] [Indexed: 01/10/2023]
Abstract
PURPOSE Little is known about the course of fathers' psychological distress and associated risk factors beyond the postnatal period. Therefore, the current study aimed to: (a) assess the course of distress over 7 years postnatally; (b) identify classes of fathers defined by their symptom trajectories; and (c) identify early postnatal factors associated with persistent symptoms. METHOD Data from 2,470 fathers in the Longitudinal Study of Australian Children were analysed using latent growth modelling. Fathers' psychological distress was assessed using the Kessler-6 (Kessler et al. in Arch Psychiatry 60:184-189, 2003) when their children were aged 0-1, 2-3, 4-5 and 6-7 years. RESULTS Overall, distress was highest in the first postnatal year and then decreased over time. Two distinct trajectories were identified. The majority of fathers (92%) were identified as having minimal distress in the first postnatal year which decreased over time, whilst 8% had moderate distress which increased over time. Low parental self-efficacy, poor relationship and job quality were associated with 'persistent and increasing distress'. CONCLUSIONS Early postnatal factors associated with fathers' persistent distress were identified, providing opportunities for early identification and targeted early intervention.
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Affiliation(s)
- Rebecca Giallo
- Parenting Research Centre, 5/232 Victoria Parade, East Melbourne, Melbourne, VIC, 3002, Australia,
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Predictors of postpartum depression among rural women in Minia, Egypt: an epidemiological study. Public Health 2014; 128:817-24. [PMID: 25213100 DOI: 10.1016/j.puhe.2014.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 05/21/2014] [Accepted: 06/09/2014] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To study the prevalence of postpartum depression (PPD) in a certain rural area in Upper Egypt, identifying the factors that might be involved in its genesis. STUDY DESIGN The current study is a cross-sectional community-based study. METHODS The study was conducted in El-Burgaia village, 5 km north to El-Minia city over a period of three months. Systematic random sampling was used to interview 200 female subjects, who gave birth within the last 14 months preceding interview. The Edinburgh Postnatal Depression Scale (EPDS) was applied to these females to identify the presence of PPD. RESULTS The sample size analysed was 200 females, 99 (49.5%) of them had PPD (29.5% had minor PPD and 20% had major PPD). The age of the study subjects ranged between 19 and 45 years old (mean age 29 ± 5.2 years). PPD occurred more significantly among wives of less educated husbands (P = 0.03). PPD was more common among those previously diagnosed of having depression or prescribed antidepressants (P = 0.02), in addition to those females experiencing financial problems after delivery (P = 0.0001). PPD was even more common among females having complications after delivery (P = 0.01). Using logistic regression analysis, total household income, child sleeping hours, complications after delivery and support of husband after delivery were found to be statistically associated with PPD. CONCLUSIONS PPD is relatively common among rural females of El-Minia Governorate. Certain factors in these females, in the mere gestation and delivery after which they become depressed, and in the environment in which they live in, may all come to play a part in the emergence of their psychiatric illness.
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Simpson W, Glazer M, Michalski N, Steiner M, Frey BN. Comparative efficacy of the generalized anxiety disorder 7-item scale and the Edinburgh Postnatal Depression Scale as screening tools for generalized anxiety disorder in pregnancy and the postpartum period. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2014; 59:434-40. [PMID: 25161068 PMCID: PMC4143300 DOI: 10.1177/070674371405900806] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 03/01/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE About 24.1% of pregnant women suffer from at least 1 anxiety disorder, 8.5% of whom suffer specifically from generalized anxiety disorder (GAD). GAD is often associated with major depressive disorder (MDD). During the perinatal period, the presence of physical and somatic symptoms often makes differentiation between depression and anxiety more challenging. To date, no screening tools have been developed to detect GAD in the perinatal population. We investigated the psychometric properties of the GAD 7-item Scale (GAD-7) as a screening tool for GAD in pregnant and postpartum women. METHODS Two hundred and forty perinatal women (n = 155 pregnant and n = 85 postpartum) referred for psychiatric consultation were enrolled. On the day of initial assessment, all women completed the GAD-7 and the Edinburgh Postnatal Depression Scale (EPDS). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-based diagnoses were made by experienced psychiatrists. Scores from the GAD-7 and EPDS were compared with the clinical diagnoses to evaluate the psychometric properties of the GAD-7 and EPDS when used as a screening tool for GAD. RESULTS The GAD-7 yielded a sensitivity of 61.3% and specificity of 72.7% at an optimal cut-off score of 13. Compared with the EPDS and the EPDS-3A subscale, the GAD-7 displayed greater accuracy and specificity over a greater range of cut-off scores and more accurately identified GAD in patients with comorbid MDD. CONCLUSION Our findings suggest that the GAD-7 represents a clinically useful scale for the detection of GAD in perinatal women.
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Affiliation(s)
- William Simpson
- Student, MiNDS Neuroscience Program, McMaster University, Hamilton, Ontario
| | - Melanie Glazer
- Student, Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario
| | - Natalie Michalski
- Student, Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario
| | - Meir Steiner
- Professor Emeritus, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario; Psychiatrist, Women's Health Concerns Clinic, St Joseph's Healthcare, Hamilton, Ontario
| | - Benicio N Frey
- Associate Professor, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario; Director, Women's Health Concerns Clinic, St Joseph's Healthcare, Hamilton, Ontario; Academic Head, Mood Disorders Program, St Joseph's Healthcare, Hamilton, Ontario
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Poçan AG, Aki OE, Parlakgümüs AH, Gereklioglu C, Dolgun AB. The incidence of and risk factors for postpartum depression at an urban maternity clinic in Turkey. Int J Psychiatry Med 2014; 46:179-94. [PMID: 24552041 DOI: 10.2190/pm.46.2.e] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Postpartum depression (PPD) is an important health issue that affects not only mothers, but also entire families. Postpartum follow-up should address emotional and psychological issues, as well as physical issues, especially in those at risk. This study aimed to determine the incidence of PPD and the associated risk factors in a group of new mothers undergoing routine follow-up at an urban maternity clinic. METHODS This is a cross-sectional study investigating the relationship between PPD and various factors. A total of 187 women that presented to a university hospital for routine postpartum follow-up 4-6 weeks post delivery were recruited consecutively. The mothers were administered a sociodemographic form that included questions about the known risk factors (sociodemographic and sociocultural factors, and mother-related, pregnancy-related, and child-related factors) and the Edinburgh Postnatal Depression Scale (EPDS). RESULTS The incidence of PPD based on EPDS scores was 28.9% (scores > 12 were defined as PPD). Unplanned/unintended pregnancy, bottle-feeding only, mother's lack of satisfaction with the baby's sleep pattern, lack of family support for baby care, lack of satisfaction with the marital relationship, and family violence were significantly correlated with PPD (P < 0.05). Multiple logistic regression showed that bottle-feeding, lack of family support, lack of satisfaction with the marital relationship, and family violence were the primary factors that significantly increased the risk of PPD. CONCLUSIONS The findings show that the PPD occurs in almost one-third of women and that, among the risk factors, sociocultural factors were the most strongly associated with PPD.
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Beestin L, Hugh-Jones S, Gough B. The impact of maternal postnatal depression on men and their ways of fathering: an interpretative phenomenological analysis. Psychol Health 2014; 29:717-35. [DOI: 10.1080/08870446.2014.885523] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Koh YW, Chui CY, Tang CSK, Lee AM. The Prevalence and Risk Factors of Paternal Depression from the Antenatal to the Postpartum Period and the Relationships between Antenatal and Postpartum Depression among Fathers in Hong Kong. DEPRESSION RESEARCH AND TREATMENT 2014; 2014:127632. [PMID: 24600517 PMCID: PMC3926273 DOI: 10.1155/2014/127632] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 11/09/2013] [Accepted: 11/10/2013] [Indexed: 11/26/2022]
Abstract
Introduction. Despite the fact that maternal perinatal mental health problems have been extensively studied and addressed to be a significant health problem, the literature on paternal perinatal mental health problems is relatively scarce. The present study aims at determining the prevalence of paternal perinatal depression and identifying the risk factors and the relationship between antenatal and postpartum depression. Methodology. 622 expectant fathers were recruited from regional maternal clinics. The expectant fathers were assessed using standardized and validated psychological instruments on 3 time points including early pregnancy, late pregnancy, and six weeks postpartum. Results. Results showed that a significant proportion of expectant fathers manifested depressive symptoms during the perinatal period. Paternal antenatal depression could significantly predict higher level of paternal postpartum depression. Psychosocial risk factors were consistently associated with paternal depression in different time points. Conclusions. The present study points to the need for greater research and clinical attention to paternal depression given that it is a highly prevalent problem and could be detrimental to their spouse and children development. The present findings contribute to theoretical basis of the prevalence and risk factors of paternal perinatal depression and have implications of the design of effective identification, prevention, and interventions of these clinical problems.
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Affiliation(s)
- Y. W. Koh
- The University of Hong Kong, Hong Kong
| | | | | | - A. M. Lee
- The University of Hong Kong, Hong Kong
- Department of Psychiatry, The University of Hong Kong, Pokfulam, Hong Kong
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Luoma I, Puura K, Mäntymaa M, Latva R, Salmelin R, Tamminen T. Fathers' postnatal depressive and anxiety symptoms: an exploration of links with paternal, maternal, infant and family factors. Nord J Psychiatry 2013; 67:407-13. [PMID: 23286693 DOI: 10.3109/08039488.2012.752034] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Postnatal psychological symptoms have been studied less often in fathers than in mothers. However, recent research shows that fathers' psychopathology may have long-term effects on their children's emotional and behavioural development independently of maternal psychopathology. More research is needed on factors associated with paternal symptoms at the early stage of child development. AIMS The aim of the study was to examine the paternal, maternal, infant and family factors associated with the occurrence of depressive and anxiety symptoms in fathers of infants. METHODS As part of a study conducted in Tampere, Finland, on infants' social withdrawal symptoms, both parents of 4-, 8- and 18-month-old infants (n = 194) completed the Edinburgh Postnatal Depression Scale (EPDS) and general information questionnaires during routine check-ups of the infants in well-baby clinics. Parental depressive and anxiety symptoms were screened using the recommended cut-off points for this purpose (5/6 for fathers and 7/8 for mothers on the EPDS). The associations between the fathers' symptoms and paternal, maternal, infant and family factors were explored. RESULTS Twenty-one per cent of the fathers and 24% of the mothers scored above the cut-off points for depressive and anxiety symptoms on the EPDS. Both paternal and maternal factors predicted high paternal symptom level in regression models. Infant factors were not statistically significantly associated with paternal symptoms. CONCLUSIONS Father's psychological symptoms were associated with many facets of both parents' impaired well-being. The whole family system should be considered whenever there are concerns about either parent's psychological well-being.
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Affiliation(s)
- Ilona Luoma
- Tampere University Hospital, Department of Child Psychiatry and University of Tampere, School of Medicine , Tampere , Finland
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Sexual victimization and anxiety and mood disorders: a case-control study based on the Danish registry system. Ir J Psychol Med 2013; 30:119-124. [PMID: 30199969 DOI: 10.1017/ipm.2013.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Aims This study aimed to examine the relationship between rape and the subsequent psychiatric diagnosis of any anxiety or mood disorder. METHOD Data from the Danish Civil Registration System and the Danish Psychiatric Central Register were used to identify a sample of female victims who had visited a centre for rape victims during an index year and their subsequent psychiatric records were compared with a matched control group. RESULTS While controlling for demographic variables and previous psychiatric disorders, the effect of sexual victimization increased the likelihood of a subsequent diagnosis of an anxiety disorder but not a mood disorder. CONCLUSION Sexual victimization significantly increases the likelihood of experiencing an anxiety disorder, and therefore victims require post-assault information and support.
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Giallo R, D'Esposito F, Cooklin A, Mensah F, Lucas N, Wade C, Nicholson JM. Psychosocial risk factors associated with fathers' mental health in the postnatal period: results from a population-based study. Soc Psychiatry Psychiatr Epidemiol 2013; 48:563-73. [PMID: 22898826 DOI: 10.1007/s00127-012-0568-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 08/03/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE Fathers' psychological distress in the postnatal period can have adverse effects on their children's wellbeing and development, yet little is known about the factors associated with fathers' distress. This paper examines a broad range of socio-demographic, individual, infant and contextual factors to identify those associated with fathers' psychological distress in the first year postpartum. METHODS Secondary analysis of data from 3,219 fathers participating in the infant cohort of the Longitudinal Study of Australian Children at wave 1 when children were 0-12 months of age. RESULTS Approximately 10 % of fathers reported elevated symptoms of psychological distress. Logistic regression analyses revealed that the risk factors were poor job quality, poor relationship quality, maternal psychological distress, having a partner in a more prestigious occupation and low parental self-efficacy. CONCLUSION These findings provide new information to guide the assessment of fathers' risk for psychological distress in postnatal period. There are also important social policy implications related to workplace entitlements and the provision of services for fathers.
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Affiliation(s)
- Rebecca Giallo
- Parenting Research Centre, Level 5, 232 Victoria Parade, East Melbourne, VIC 3002, Australia.
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Rosenquist SE. When the bough breaks: rethinking treatment strategies for perinatal depression. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2013; 55:291-323. [PMID: 23488254 DOI: 10.1080/00029157.2012.723284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Awareness of depression among OB-GYN physicians has increased with the result that more than 13% of pregnant women in the United States receive prescriptions for antidepressant medications. But the safety and effectiveness of these compounds has been exaggerated while the effectiveness of psychotherapy has been overlooked and distorted and various medical guidelines for treatment of perinatal depression have been downplayed or ignored. This article addresses the common fears and misconceptions surrounding treatment of depression during pregnancy and after childbirth. The effectiveness of strategic cognitive-behavioral therapy enhanced with hypnosis offers excellent results without the risks associated with these medications. Targets for focused intervention are identified and discussed.
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