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Significant' Number of Dads Experience Postpartum
Dads Have Postpartum Depression, Too: Depression in Father Doubles Risk of Child's Later Behavior Problems
Significant' Number of Dads Experience
About 10 percent of fathers feel depressed either before their babies are born or after, with rates peaking in the three-to-six-month postpartum period, according to an analysis of previous research published in the mental-health-themed May 19 issue of JAMA.
Researchers call the findings significant.
"There are many implications of these findings," the authors write. "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 report's co-authors, James F. Paulson, Ph.D., and Sharnail D. Bazemore, M.S., of the Eastern Virginia Medical School in Norfolk, conducted a meta-analysis to measure rates of paternal prenatal and postpartum depression, as well as its link to mothers' postpartum sadness.
Researchers included studies documenting depression in dads between the first trimester of pregnancy and the first year after the baby's birth, identifying 28,400 participants from 43 different surveys to take into account for their own article.
They estimated that the overall rate of paternal depression was 10.4 percent, compared with a 4.8 percent rate of depression in the course of one year among the general population.
There was also marked variety in the timing of fathers' baby-related depression, with the highest rate, 25.6 percent, occurring three to six months after birth and the lowest rate, 7.7 percent, happening in the first three months after birth.
Higher rates of prenatal or postpartum depression in dads were observed in the United States (14.1 percent) than internationally (8.2 percent).
Risk factors and effects of depression among fathers of newborns had previously gotten little attention in the medical community, the authors write. On the other hand, maternal prenatal and postpartum sadness is well understood and prevalent, and can have a negative impact on women, their families and child development, they said.
"The correlation between paternal and maternal depression also
suggests a screening rubric -- depression in one parent should prompt
clinical attention to the other," the researchers write. "Likewise,
prevention and intervention efforts for depression in parents might
be focused on the couple and family rather than the individual."
Dads Have Postpartum Depression, Too:
Depression in Father Doubles Risk of Child's Later Behavior
Fathers, too, can be depressed in the weeks following the birth of a child. And that depression can mean trouble for the child, report Paul Ramchandani, MD, consultant in child and adolescent psychiatry at the University of Oxford, U.K., and colleagues.
"We found a doubling of risk of behavioral problems in children of fathers who had been depressed eight weeks after the birth," Ramchandani tells WebMD. "The thing that is striking is there is the same effect for fathers as has been established for mothers."
The researchers analyzed data collected as part of the Avon Longitudinal Study of Parents and Children. The study, based on questionnaires and psychological tests, included 8,431 fathers, 11,833 mothers, and 10,024 children. Data were collected eight weeks after the birth of a child, 21 months after the birth, and when the child was 3 years old.
The effect of a father's postpartum depressionpostpartum depression is not quite the same as that of a mother's depression.mother's depression.
"The mothers' depression effect is slightly higher than in fathers," Ramchandani says. "Depression in mothers seems linked to a range of later problems in both boys and girls. The father effect seems confined to boys and to behavior problems -- but this is not definitive."
Postpartum Depression: A Family Problem
The findings don't surprise Shari I. Lusskin, MD, director of reproductive psychiatry at NYU School of Medicine. Postpartum depression, Lusskin says, isn't a mother's problem; it's a family problem.
"For a change, this study turns the spotlight away from women onto the rest of the family constellation," Lusskin says. "That is very important. Women get saddled with all the blame, which further stigmatizes postpartum depression and leads to women not getting diagnosed or treated. So now we are spreading the blame."
Nobody is really to blame, Lusskin is quick to point out. Mothers and fathers don't get depressed because they are bad parents.
Treatment for Mom and Dad
"Depression is a medical condition, not a moral condition," Lusskin says. "If you feel that your mood is not what it should be after the birth of a child, or if you feel your partner's mood is abnormal, seek help and seek help early. The sooner you get treated, the better -- and the fewer consequences for the mother, the father, and the child."
Ramchandani, too, argues that the focus should be on the family.
"This study flags one thing: There is an effect of fathers' depression," he says. "At the time of childbirth we focus on mothers. But actually we should be paying attention to the wider family. The birth of a child is a fantastic thing, but it is also a time of intense change, and that impacts the whole family."
Treatment, Lusskin says, should involve both partners -- not just the one who seems to be depressed.
"If you seek help, advise your doctor to meet your partner whenever possible, to assess the partner's emotional well-being and involve the partner in your recovery," she says. "A woman may be depressed but if her partner is even more depressed and nonfunctional, she has to take care not only of herself but her partner -- and can't rely on the partner to help with her own depression."
Even if a person's partner is not depressed, involving your significant other in postpartum-depression treatment minimizes mixed messages and unintentional interference with treatment.
"For example, if you going to give a woman antidepressant medications during breastfeeding, it is good to explain to her partner why you are making this risk/benefit choice, so the partner does not misunderstand and sabotage treatment," Lusskin says.
Sources: Daniel DeNoon, Ramchandani, P. The Lancet, June 25, 2005; vol 365: pp 2201-2205. Paul Ramchandani, MD, consultant, child and adolescent psychiatry, University of Oxford, U.K. Shari I. Lusskin, MD, director of reproductive psychiatry; and clinical assistant professor of psychiatry and obstetrics/gynecology, NYU School of Medicine. my.webmd.com/content/Article/107/108672.htm