James F. Paulson, Ph.D., of the Eastern Virginia Medical School, Norfolk, Va., presented the findings of the study at a JAMA media briefing on mental health.
It is well established that maternal prenatal and postpartum depression is prevalent and has negative personal, family, and child developmental outcomes, but the prevalence, risk factors and effects of depression among new fathers is not well understood, and has received little attention from researchers and clinicians, according to background information in the article.
Dr. Paulson and co-author Sharnail D. Bazemore, M.S., of the Eastern Virginia Medical School, conducted a meta-analysis to determine estimates and variability in rates of paternal prenatal and postpartum depression and its association with maternal depression. The authors included studies that documented depression in fathers between the first trimester and the first postpartum year, and identified 43 studies involving 28,004 participants for inclusion in the analysis.
Among the findings of the researchers:
- The overall estimate of paternal depression was 10.4 percent (estimated 12-month prevalence of depression among men in the general population is 4.8 percent).
- There was considerable variability between different time periods, with the 3- to 6-month postpartum period showing the highest rate (25.6 percent) and the first 3 postpartum months showing the lowest rate (7.7 percent).
- Differences were observed across study locations, with higher rates of prenatal and postpartum depression reported in the United States (14.1 percent vs. 8.2 percent internationally).
- There is a moderate correlation between depression in fathers and mothers.
“There are many implications of these findings. The observation that expecting and new fathers disproportionately experience depression suggests that more efforts should be made to improve screening and referral, particularly in light of the mounting evidence that early paternal depression may have substantial emotional, behavioral, and developmental effects on children. The correlation between paternal and maternal depression also suggests a screening rubric—depression in one parent should prompt clinical attention to the other. Likewise, prevention and intervention efforts for depression in parents might be focused on the couple and family rather than the individual,” the authors write.
“Future research in this area should focus on parents together to examine the onset and joint course of depression in new parents. 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.”
(JAMA 2010;303:1961-1969. Available pre-embargo to the media at www.jamamedia.org)
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