Tuesday, May 18, 2010

JAMA - Significant Number of Fathers Experience Prenatal, Postpartum Depression


This is an early release from the May 19 issue of the Journal of the American Medical Association (JAMA) - a special issue on mental health. It seems that fathers suffer depression at more than twice the rate of the average man in the wider culture (10.4% vs 4.8%).

The depression rates seem to be higher in the US than in other locations (14.1 vs 8.2 internationally) and it also seems to be worse in 3-6 month postpartum period (my guess is that reality and sleep deficit began to show an impact at this point). The maternal-paternal correlation in depressive symptoms was significant, but moderate in magnitude.

The upshot is that men need to be aware of this as they head into the pregnancy cycle - it's not only women who suffer depression after the birth of a child.
Significant Number of Fathers Experience Prenatal, Postpartum Depression

NEW YORK—About 10 percent of fathers experience prenatal or postpartum depression, with rates being highest in the 3 to 6 month postpartum period, according to an analysis of previous research appearing in the May 19 issue of JAMA, a theme issue on mental health.

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[19]:1961-1969. Available pre-embargo to the media at www.jamamedia.org)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory: To contact James F. Paulson, Ph.D., call Annie Panno at 757-446-6041 or email pannoaf@evms.edu.

Article Reference:

Paulson, JF, & Bazemore, JD. (2010). Prenatal and Postpartum Depression in Fathers
and Its Association With Maternal Depression. JAMA;303[19]:1961-1969.

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