Depression in Men in the Postnatal Period and Later Child Psychopathology: A Population Cohort Study

doi:10.1097/CHI.0b013e31816429c2

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 47, Issue 4, April 2008, Pages 390-398

https://doi.org/10.1097/CHI.0b013e31816429c2 Get rights and content

ABSTRACT

Objective

Postnatal depression in women is associated with adverse effects on both maternal health and children's development. It is unclear whether depression in men at this time poses comparable risks. The present study set out to assess the association between depression in men in the postnatal period and later psychiatric disorders in their children and to investigate predisposing factors for depression in men following childbirth.

Method

A population-based cohort of 10,975 fathers and their children from the Avon Longitudinal Study of Parents and Children (ALSPAC) was recruited in the prenatal period and followed for 7 years. Paternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale and later child psychiatric disorder (DSM-IV) with the Development and Well-Being Assessment.

Results

Depression in fathers in the postnatal period was significantly associated with psychiatric disorder in their children 7 years later (adjusted OR 1.72, 95% CI 1.07-2.77), most notably oppositional defiant/conduct disorders (adjusted OR 1.94, 95% CI 1.04-3.61), after adjusting for maternal depression and paternal educational level. A history of severe depression and high prenatal symptom scores for depression and anxiety were the strongest predictors of paternal depression in the postnatal period.

Conclusions

Depression in fathers in the postnatal period is associated with later psychiatric disorders in their children, independently of maternal postnatal depression. Further research into the risks associated with paternal psychopathology is required because this could represent an important opportunity for public health intervention.

Section snippets

Subjects

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a longitudinal cohort study set up to collect comprehensive data on a large population sample of children and their parents from early pregnancy through childhood.¹⁶ Pregnant mothers were recruited from the Bristol area of the United Kingdom. This is a mixed urban and rural population of approximately 1 million, with both deprived and affluent communities represented. All pregnant women due to deliver their baby between April 1,

RESULTS

Questionnaires were completed about children's behavior at age 6 years for 8,401 children; 6,075 (72.3%) of these had fathers who provided data on depression at 8 weeks postnatally. Psychiatric diagnoses were available for 8,195 children, and 5,924 (72.3%) of these had fathers who participated at 8 weeks. Compared to participating families, those families in which fathers did not participate at 8 weeks were more likely to come from lower socioeconomic groups (χ² = 205.3, df = 6; p < .01). The

DISCUSSION

To our knowledge this is the first population cohort study to demonstrate a clear association between depression in fathers in the postnatal period and later psychiatric disorders in their children. This association is independent of maternal postnatal depression, psychosocial risk, and depression in fathers after the postnatal period at 21 months.

The findings highlight three important factors regarding depression in men in the postnatal period. First, depression in men is relatively common.

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Unintended pregnancies are linked to adverse parental mental health, yet little attention has been given to this relationship in fathers specifically. We aimed to meta-analyse associations between unintended pregnancies and mental health problems in fathers with children aged ≤36 months.
We conducted keyword searches of Medline, CINAHL, Academic Search Complete, PsycInfo and Embase to February 2, 2022, and hand searched included reference lists.
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Analyses were limited by the use of retrospective assessment of pregnancy intention, and heterogeneity of measures used. Further, assessment of fathers' mental health was restricted to the first year postpartum. This review was limited to English language studies.
Unintended pregnancies present an identifiable risk for postpartum mental health problems in fathers.
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In our mother and baby unit located in Paris, fathers were also hospitalized as patients. Therefore difficulties in the familial dynamic, between each member of the triad and mental health difficulties of fathers were able to be treated.
Following the hospitalization of a few triads with a positive evolution, a reflection process is now in progress.
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This research was specifically funded by the Wellcome Trust through an Intermediate Clinical Fellowship held by Dr. Ramchandani (grant number 078434). Dr. Stein is also supported by the Wellcome Trust (066008) and Dr. Murray is supported by the MRC (UK). We are extremely grateful to all of the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, nurses, and receptionists. The UK Medical Research Council, the Wellcome Trust, and the University of Bristol provide core support for ALSPAC.

Article Plus (online only) materials for this article appear on the Journal's Web site:www.jaacap.com.

Disclosure: Drs. Ramchandani, Stein, O'Connor, Heron, and Murray report no conflicts of interest. Dr. Evans has been a paid speaker for Lilly Pharmaceuticals.

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NEW RESEARCHDepression in Men in the Postnatal Period and Later Child Psychopathology: A Population Cohort Study

ABSTRACT

Objective

Method

Results

Conclusions

Section snippets

Subjects

RESULTS

DISCUSSION

J Affect Disord

Clin Psychol Rev

J Affect Disord

J Affect Disord

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Social and emotional competence in children of depressed mothers

Child Dev

Impact of maternal depression on infant nutritional status and illness: a cohort study

Arch Gen Psychiatry

Intergenerational transmission of affective and cognitive processes associated with depression: infancy and the preschool years

The First-Time Fathers Study: a prospective study of the mental health and wellbeing of men during the transition to parenthood

Aust N Z J Psychiatry

Family structure and depressive symptoms in men preceding and following the birth of a child. The Avon Longitudinal Study of Pregnancy and Childhood Study Team

Am J Psychiatry

Promoting healthy beginnings: a randomized controlled trial of a preventive intervention to preserve marital quality during the transition to parenthood

J Consult Clin Psychol

When Partners Become Parents: The Big Life Change for Couples

Children of affectively ill parents: a review of the past 10 years

J Am Acad Child Adolesc Psychiatry

Paternal depression in the postnatal period and child development: a prospective population study

Lancet

Postpartum depression and child development: an investigation of mothers and fathers as sources of risk and resilience

Dev Psychopathol

Intellectual problems shown by 11-year-old children whose mothers had postnatal depression

J Child Psychol Psychiatry

Critical periods of brain growth and cognitive function in children

Brain

ALSPAC-the Avon Longitudinal Study of Parents and Children. I. Study methodology

Paediatr Perinat Epidemiol

Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale

Br J Psychiatry

NEW RESEARCH
Depression in Men in the Postnatal Period and Later Child Psychopathology: A Population Cohort Study