Abstract
Extensive research shows maternal depression to be associated with poorer child outcomes, and characteristics of these mothers have been described. Recent research describes associations of paternal depressive symptoms and child behavioral and emotional outcomes, but characteristics of these fathers have not been investigated. This study describes characteristics of fathers with depressive symptoms in the USA. Utilizing data from 7,247 fathers and mothers living in households with children aged 5–17 years who participated in the Medical Expenditure Panel Survey 2004–2006, the Patient Health Questionnaire-2 was used to assess parental depressive symptoms, the Short Form-12 was used to examine paternal and maternal physical health, the Columbia Impairment Scale was used to measure child behavioral or emotional problems, and the Children with Special Health Care Needs Screener was used to identify children with special health care needs. In multivariate analyses, poverty (AOR 1.52; 95% CI 1.05–2.22), maternal depressive symptoms (AOR 5.77; 95% CI 4.18–7.95), living with a child with special health care needs (AOR 1.42, 95% CI 1.04–1.94), poor paternal physical health (AOR 3.31; 95% CI 2.50–4.38) and paternal unemployment (AOR 6.49; 95% CI 4.12–10.22) were independently associated with increased rates of paternal depressive symptoms. These are the first data that demonstrate that poverty, paternal physical health problems, having a child with special health care needs, maternal depressive symptoms, and paternal unemployment are independently associated with paternal depressive symptoms, with paternal unemployment associated with the highest rates of such problems.
Similar content being viewed by others
Abbreviations
- AOR:
-
Adjusted odds ratio
- MEPS:
-
Medical Expenditure Panel Survey
- CI:
-
Confidence interval
- CIDI:
-
Composite International Diagnostic Interview
- CIS:
-
Columbia Impairment Scale
- CSHCN:
-
Children with special health care needs
- DSM-IV:
-
Diagnostic and statistical manual of mental disorders IV
- HPA:
-
Hypothalamic pituitary adrenal
- MCS:
-
Mental component score
- NHIS:
-
National Health Interview Survey
- PCS:
-
Physical Component Scale
- PHQ-2:
-
Patient Health Questionnaire-2
- PRIME-MD:
-
Primary Care Evaluation of Mental Disorders
- SF-12:
-
Short-Form 12
References
APA. (2000). Diagnostic and statistical manual of mental disorders, (4th ed), Text Revision. Washington, DC.
Wainwright, N. W. J., & Surtees, P. G. (2002). Childhood adversity, gender and depression over the life-course. Journal of Affective Disorders, 72(1), 33–44.
Grigoriadis, S., & Robinson, G. (2007). Gender issues in depression. Annals of Clinical Psychiatry, 19(4), 247–255.
Centers for Disease Control and Prevention (CDC). (2010). Current depression among adults—United States, 2006 and 2008. Morbidity and mortality weekly report. 59(38), 1229–1235.
Kelly, Y., & Bartley, M. (2010). Parental and child health. In Children of the 21st century: the first five years (pp. 249–264). The Policy Press.
Mensah, F. K., & Kiernan, K. E. (2010). Maternal general health and children’s cognitive development and behaviour in the early years: Findings from the Millennium Cohort Study. Child: Care, Health and Development.
Nicol-Harper, R., Harvey, A., & Stein, A. (2007). Interactions between mothers and infants: Impact of maternal anxiety. Infant Behavior and Development, 30(1), 161–167.
Glasheen, C., Richardson, G., & Fabio, A. (2010). A systematic review of the effects of postnatal maternal anxiety on children. Archives of Women’s Mental Health, 13(1), 61–74.
Alder, J., Fink, N., Bitzer, J., Hsli, I., & Holzgreve, W. (2007). Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. Journal of Maternal—Fetal and Neonatal Medicine, 20(3):189–209.
Kavanaugh, M., Halterman, J. S., Montes, G., Epstein, M., Hightower, A. D., & Weitzman, M. (2006). Maternal depressive symptoms are adversely associated with prevention practices and parenting behaviors for preschool children. Ambulatory Pediatrics, 6(1), 32–37.
Martini, J., Knappe, S., Beesdo-Baum, K., Lieb, R., & Wittchen, H.-U. (2010). Anxiety disorders before birth and self-perceived distress during pregnancy: Associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Human Development, 86(5), 305–310.
Goodman, S. H., & Gotlib, I. H. (1999). Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission. Psychological Review, 106(3), 458–490.
Sohr-Preston, S., & Scaramella, L. (2006). Implications of timing of maternal depressive symptoms for early cognitive and language development. Clinical Child and Family Psychology Review, 9(1), 65–83.
Bailey, D., Golden, R., Roberts, J., & Ford, A. (2007). Maternal depression and developmental disability: Research critique. Mental Retardation and Developmental Disabilities Research Reviews, 13(4), 321–329.
Grupp-Phelan, J., Whitaker, R., & Naish, A. (2003). Depression in mothers of children presenting for emergency and primary care: Impact on mothers’ perceptions of caring for their children. Ambulatory Pediatrics, 3(3), 142–146.
Wang, L. Wu, T., Anderson, J. L., & Florence, J. E. (2011). Prevalence and risk factors of maternal depression during the first three years of child rearing. Journal of Women’s Health (Epub ahead of print).
Waylen, A., & Stewart-Brown, S. (2010). Factors influencing parenting in early childhood: A prospective longitudinal study focusing on change. Child: Care, Health and Development, 36(2), 198–207.
Hanington, L., Ramchandani, P., & Stein, A. (2010). Parental depression and child temperament: Assessing child to parent effects in a longitudinal population study. Infant Behavior and Development, 33(1), 88–95.
Ramchandani, P., O’Connor, T., Evans, J., Heron, J., Murray, L., & Stein, A. (2008). The effects of pre- and postnatal depression in fathers: A natural experiment comparing the effects of exposure to depression on offspring. Journal of Child Psychology and Psychiatry and Allied Disciplines, 49(10), 1069–1078.
Ramchandani, P., Stein, A., Evans, J., & O’Connor, T. (2005). Paternal depression in the postnatal period and child development: A prospective population study. Lancet, 365(9478), 2201–2205.
Weitzman, M., Rosenthal, D. G., & Liu, Y.-H. (2011). Paternal mental health problems and depression and child emotional and behavioral problems in the USA. Pediatrics, 128(6), 1126–1134.
Cohen, S. (2003). Design strategies and innovations in the medical expenditure panel survey. Medical Care, 41(7 Suppl), III5–III12.
How the Government Measures Unemployment. (2009). U.S. bureau of labor statistics: labor force statistics from the current population study.
Jenkinson, C., Chandola, T., Coulter, A., & Bruster, S. (2001). An assessment of the construct validity of the SF-12 summary scores across ethnic groups. Journal of Public Health Medicine, 23(3), 187–194.
Jenkinson, C., Layte, R., Jenkinson, D., et al. (1997). A shorter form health survey: Can the SF-12 replicate results from the SF-36 in longitudinal studies? Journal of Public Health Medicine, 19(2), 179–186.
Lam, C. L. K., Tse, E. Y. Y., & Gandek, B. (2005). Is the standard SF-12 health survey valid and equivalent for a Chinese population? Quality of Life Research, 14(2), 539–547.
Ware, J., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.
Kroenke, K., Spitzer, R., Williams, J. B. W., & Lwe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry, 32(4), 345–359.
Arroll, B., Goodyear-Smith, F., Crengle, S., et al. (2010). Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Annals of Family Medicine, 8(4), 348–353.
Richardson, L., Rockhill, C., Russo, J., et al. (2010). Evaluation of the PHQ-2 as a brief screen for detecting major depression among adolescents. Pediatrics, 125(5), e1097–e1103.
Bird, H. R., Andrews, H., & Schwab-Stone, M. (1996). Global measures of impairment for epidemiologic and clinical use with children and adolescents. International Journal of Methods in Psychiatric Research, 6, 295–307.
Bird, H. R., Shaffer, D., Fisher, P., et al. (1993). The Columbia Impairment Scale (CIS) - Pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research, 3(3), 167–176.
Winters, N., Collett, B., & Myers, K. (2005). Ten-year review of rating scales, VII: scales assessing functional impairment. Journal of the American Academy of Child and Adolescent Psychiatry, 44(4), 309–338.
Bethel, C. D., Rosenthal, D. G., Stein, R. E. K., Blumberg, S. J., Wells, N., & Newacheck, P. W. (2002). Identifying children with special health care needs: Development and evaluation of a short screening instrument. Ambulatory Pediatrics, 2(1), 38–48.
Research Triangle Institute. SUDAAN release 9.0.1. NRTI: Research Triangle Park.
Bailey, D., Golden, R., Roberts, J., & Ford, A. (2007). Maternal depression and developmental disability: Research critique. Mental Retardation and Developmental Disabilities Research Reviews, 13(4), 321–329.
Mensah, F. K., & Kiernan, K. E. (2011). Maternal general health and children’s cognitive development and behaviour in the early years: findings from the Millennium Cohort Study. Child: Care, Health and Development, 37(1), 44–54.
Wang, L., Wu, T., Anderson, J., & Florence, J. (2011). Prevalence and risk factors of maternal depression during the first three years of child rearing. Journal of Women’s Health, 20(5), 711–718.
Waylen, A., & Stewart Brown, S. (2010). Factors influencing parenting in early childhood: a prospective longitudinal study focusing on change. Child: Care, Health and Development, 36(2), 198–207.
Prince, M., Patel, V., Saxena, S., et al. (2007). No health without mental health. Lancet, 370(9590), 859–877.
Scully, D., Kremer, J., Meade, M. M., Graham, R., & Dudgeon, K. (1998). Physical exercise and psychological well being: A critical review. British Journal of Sports Medicine, 32(2), 111–120.
Paulson, J., & Bazemore, S. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. JAMA (Chicago, Ill.), 303(19):1961–1969.
Whitaker, R., Orzol, S., & Kahn, R. (2006). Maternal mental health, substance use, and domestic violence in the year after delivery and subsequent behavior problems in children at age 3 years. Archives of General Psychiatry, 63(5), 551–560.
Hoppmann, C., Gerstorf, D., & Hibbert, A. (2011). Spousal associations between functional limitation and depressive symptom trajectories: Longitudinal findings from the study of asset and health dynamics among the oldest old (AHEAD). Health Psychology, 30(2), 153–162.
Ohayon, M., & Schatzberg, A. (2010). Chronic pain and major depressive disorder in the general population. Journal of Psychiatric Research, 44(7), 454–461.
Wilson, S. H., & Walker, G. M. (1993). Unemployment and health: A review. Public Health, 107(3), 153–162.
Bronte-Tinkew, J., Moore, K. A., Matthews, G., & Carrano, J. (2007). Symptoms of major depression in a sample of fathers of infants. Journal of Family Issues, 28(1), 61–99.
Dav, S., Sherr, L., Senior, R., & Nazareth, I. (2009). Major paternal depression and child consultation for developmental and behavioural problems. British Journal of General Practice, 59(560), 180–185.
Melrose, S. (2010). Paternal postpartum depression: How can nurses begin to help? Contemporary Nurse : A Journal for the Australian Nursing Profession, 34(2), 199–210.
Reeb, B., Conger, K., & Wu, E. (2010). Paternal depressive symptoms and adolescent functioning: The moderating effect of gender and father hostility. Fathering, 8(1), 131–142.
Dav, S., Petersen, I., Sherr, L., & Nazareth, I. (2010). Incidence of maternal and paternal depression in primary care: A cohort study using a primary care database. Archives of Pediatrics and Adolescent Medicine, 164(11), 1038–1044.
Dav, S., Sherr, L., Senior, R., & Nazareth, I. (2008). Associations between paternal depression and behaviour problems in children of 4–6 years. European Child and Adolescent Psychiatry, 17(5), 306–315.
Merikangas, K. R. (1982). Assortative mating for psychiatric disorders and psychological traits. Archives of General Psychiatry, 39(10), 1173–1180.
Wee, K. Y., & Skouteris, H. et al. (2010). Correlates of ante- and postnatal depression in fathers: A systematic review. Journal of Affective Disorders.
Churchill, S., Villareale, N., Monaghan, T., Sharp, V., & Kieckhefer, G. (2010). Parents of children with special health care needs who have better coping skills have fewer depressive symptoms. Maternal and Child Health Journal, 14(1), 47–57.
Ratliffe, C., Harrigan, R., Haley, J., Tse, A., & Olson, T. (2002). Stress in families with medically fragile children. Issues in Comprehensive Pediatric Nursing, 25(3), 167–188.
Barman, S., Pulkkinen, L., Kaprio, J., & Rose, R. (2004). Inattentiveness, parental smoking and adolescent smoking initiation. Addiction, 99(8), 1049–1061.
Cummings, S., Neff, J., & Husaini, B. (2003). Functional impairment as a predictor of depressive symptomatology: The role of race, religiosity, and social support. Health and Social Work, 28(1), 23–32.
Everson, S., Maty, S., Lynch, J., & Kaplan, G. (2002). Epidemiologic evidence for the relation between socioeconomic status and depression, obesity, and diabetes. Journal of Psychosomatic Research, 53(4), 891–895.
Cooper, C., Bebbington, P. E., Meltzer, H., et al. (2008). Depression and common mental disorders in lone parents: results of the 2000 National Psychiatric Morbidity Survey. Psychological Medicine, 38(3), 335–342.
Cross-national comparisons of the prevalences and correlates of mental disorders. (2000). WHO International Consortium in Psychiatric Epidemiology. Bulletin of the World Health Organization, 78(4), 413–426.
Bielawska-Batorowicz, E., & Kossakowska-Petrycka, K. (2006). Depressive mood in men after the birth of their offspring in relation to a partner’s depression, social support, fathers’ personality and prenatal expectations. Journal of Reproductive and Infant Psychology, 24(1), 21–29.
Hoard, L. R., & Anderson, E. A. (2004). Factors related to depression in rural and urban noncustodial, low-income fathers. Journal of Community Psychology, 32(1), 103–119.
Oquendo, M. A., Ellis, S. P., Greenwald, S., Malone, K. M., Weissman, M. M., & Mann, J. J. (2001). Ethnic and sex differences in suicide rates relative to major depression in the United States. American Journal of Psychiatry, 158(10), 1652–1658.
Rich-Edwards, J. W., Kleinman, K., Abrams, A., et al. (2006). Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology and Community Health, 60(3), 221–227.
Saez-Santiago, E., & Bernal, G. (2002). Depression in ethnic minorities: Latinos and Latinas, African-Americans, Asian-Americans, and Native-Americans. In G. Bernal, J. Trimble, F. Leung, & K. Burlew (Eds.), Handbook of ethnic and racial minorities (pp. 401–428). Thousand Oaks, CA: Sage.
Strksen, I., Rysamb, E., Moum, T., & Tambs, K. (2005). Adolescents with a childhood experience of parental divorce: A longitudinal study of mental health and adjustment. Journal of Adolescence, 28(6), 725–739.
Flouri, E. (2010). Fathers’ behaviors and children’s psychopathology. Clinical Psychology Review, 30(3), 363–369.
Rae-Grant, Q., & Robson, B. E. (1988). Moderating the morbidity of divorce. Canadian Journal of Psychiatry, 33(6), 443–452.
Kessler, R. C., Walters, E. E., & Forthofer, M. S. (1998). The social consequences of psychiatric disorders, III: Probability of marital stability. The American Journal of Psychiatry, 155(8), 1092–1096.
Whisman, M., Tolejko, N., & Chatav, Y. (2007). Social consequences of personality disorders: Probability and timing of marriage and probability of marital disruption. Journal of Personality Disorders, 21(6), 690–695.
Gilchrist, G., & Gunn, J. (2007). Observational studies of depression in primary care: What do we know? BMC Family Practice, 11(8), 28.
Kessler, R. C., Foster, C. L., Saunders, W. B., & Stang, P. E. (1995). Social consequences of psychiatric disorders, I: Educational attainment. The American Journal of Psychiatry, 152(7), 1026–1032.
Maughan, B., & Carroll, J. (2006). Literacy and mental disorders. Current Opinion in Psychiatry, 19(4), 350–354.
Blazer, D. G., Kessler, R. C., McGonagle, K. A., & Swartz, M. S. (1994). The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. American Journal of Psychiatry, 151(7), 979–986.
Keita, G. P. (2007). Psychosocial and cultural contributions to depression in women: Considerations for women midlife and beyond. Journal of Managed Care Pharmacy, 13(9 Suppl A), S12–S15.
Cooper, P., Fearn, V., Willetts, L., Seabrook, H., & Parkinson, M. (2006). Affective disorder in the parents of a clinic sample of children with anxiety disorders. Journal of Affective Disorders, 93(1–3), 205–212.
Bergemann, E., & Boles, R. (2010). Maternal inheritance in recurrent early-onset depression. Psychiatric Genetics, 20(1), 31–34.
Shastry, B. (2005). Bipolar disorder: An update. Neurochemistry International, 46(4), 273–279.
Kessler, R. C., Berglund, P. A., Foster, C. L., Saunders, W. B., Stang, P. E., & Walters, E. E. (1997). Social consequences of psychiatric disorders, II: Teenage parenthood. The American Journal of Psychiatry, 154(10), 1405–1411.
Mirowsky, J., & Ross, C. (2002). Depression, parenthood, and age at first birth. Social Science and Medicine, 54(8), 1281–1298.
Conflict of interest
None of the authors have any financial conflicts to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rosenthal, D.G., Learned, N., Liu, YH. et al. Characteristics of Fathers with Depressive Symptoms. Matern Child Health J 17, 119–128 (2013). https://doi.org/10.1007/s10995-012-0955-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-012-0955-5