US researchers who reviewed published studies on pre- and post-natal depression concluded that about 10 per cent of fathers experience depression before or after the birth of a child, with the highest rates occuring in the 3 to 6 months after birth.
You can read how Dr James F Paulson and colleagues, from the Department of Pediatrics at Eastern Virginia Medical School, Norfolk, arrived at their findings online in the May 19 issue of JAMA.
While evidence of pre- and post-natal depression in mothers is well established, where fathers are concerned it is patchy and inconsistent, wrote the authors in their background information. So they decided to do a systematic review and meta-analysis of the available literature on pre- and post-natal depression in fathers and how it might relate to that experienced by mothers.
A meta-analysis is a way of pooling the results from several studies examining similar variables and analyzing them as if they came from one large study. To do this you have to be careful about which studies you include, for instance you should take into account heterogeneity, that is the extent to which the studies differ in terms of methods and data sampling, and other features.
For this review, Paulson and colleagues searched a wide range of article databases, including MEDLINE, PsycINFO, EMBASE, and Google Scholar, as well as dissertation abstracts and reference lists in articles. The period they were interested in was January 1980 to October 2009, and they included only studies that documented depression in fathers between the first trimester of pregnancy and the first year after birth.
After applying their inclusion criteria and eliminating duplicate records, they were left with 43 studies covering over 28,000 participants, from which they extracted data on rates of paternal and maternal depression, as well as reported trends that linked the two. Two raters did this independently so as to minimize extraction bias.
They did however, find some significant heterogeneity among the studies, and had to apply some statistical methods to enable them to handle the data in a pooled fashion (eg they applied “random-effects models of event rates”). They also took into account other variables so they could assess the impact of publication bias, different sampling frames, timing, study location and measurement methods.
From the analysis the authors established:
- An overall meta-estimate of paternal depression of 10.4 per cent (95% confidence interval CI ranged from 8.5 to 12.7%, with substantial heterogeneity in the data).
- This compares with an estimated 12-month prevalence of depression among men in the general population of 4.8 per cent.
- There was a wide variability in the rates among different time periods relative to birth, with the 3 to 6 month post-natal period showing the highest rate of paternal depression (25.6 per cent) and the first three post-natal months showing the lowest (7.7 per cent).
- Participants living in the US had the highest rate of pre- and post-natal paternal depression (14.1 per cent versus 8.2 per cent internationally).
- There was a moderate correlation between depression in fathers and mothers.
They concluded that pre- and post-natal depression was evident in about 10 per cent of fathers in the studies they reviewed, with the 3 to 6 month post-natal period showing the highest levels, and there was also a modest link between depression in fathers and depression in mothers (ie their trends tended to follow each other either up or down).
In their discussion of the findings the authors wrote there were several implications, such as there is probably a need to improve screening for paternal depression, particularly since we know that depression in fathers can affect children’s development.
They also noted that the link between paternal and maternal depression suggests we should perhaps encourage screening of the other parent when one parent presents with depression, and similarly, prevention and treatment should probably focus on the family or the couple rather than the individual.
“Future research in this area should focus on parents together to examine the onset and joint course of depression in new parents,” wrote the authors, suggesting that:
“This may increase our capacity for early identification of parental depression, add leverage for prevention and treatment, and increase the understanding of how parental depression conveys risk to infants and young children.”
“Prenatal and Postpartum Depression in Fathers and Its Association With Maternal Depression: A Meta- analysis.”
James F. Paulson; Sharnail D. Bazemore
Source: JAMA Archives.
Written by: Catharine Paddock, PhD