July 26, 2018
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Paternal depression almost as common as maternal postpartum depression

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Photo of Erika Cheng, PhD, MPA
Erika R. Cheng

The prevalence of depression among fathers with children aged younger than 15 months has been understudied, but a research letter published in JAMA Pediatrics suggests that rates of paternal depression are comparable to the proportion of mothers who experience postpartum depression.

“The fact that so many new dads are experiencing depression is significant because depression can have serious consequences if left untreated,” Erika R. Cheng, PhD, MPA, an epidemiologist and researcher for Children's Health Services Research and the associate director of the CHSR Fellowship Program at the Indiana University School of Medicine, told Infectious Disease in Children. “We know that dads who are depressed are less engaged with their kids, which can lead to cognitive and behavioral problems.”

To estimate the prevalence of paternal depression, researchers used The Child Health Improvement Through Computer Automation (CHICA) system to review data collected from parents of children aged 15 months and younger. CHICA — operating in five community health centers in Indianapolis — provides pediatric health surveillance and management through a computer-based decision support system that administers patient-tailored, 20-item prescreening forms (PSF) in English and Spanish.  

Depressed man
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Cheng and colleagues modified the PSF from Aug. 1, 2016, to Dec. 31, 2017, to include a three-item version of the Edinburgh Postnatal Depression Scale and questions to identify who answered the PSF and who attended the clinic visit. Respondents who endorsed any of the three items were classified as positive for depression, according to the research letter.

The CHICA data, collected from 9,572 clinic visits, comprised responses from parents with children aged 15 months or younger. Researchers observed that fathers attended 30.8% of the visits and responded to the PSF at 8.4% of the clinic visits. According to the study, when children were older, non-Hispanic black and Medicaid eligible fathers were less likely to be present at pediatric well-child care visits. Despite this, Cheng noted that it was surprising to see how many fathers were present at the well visit. 

“This presents a great opportunity for pediatricians to improve the health of the entire family by screening both parents for depression and connecting them with appropriate resources,” Cheng told Infectious Disease News.

Depression was positively screened in 4.4% (n = 36) of the fathers who responded to the PSF, which was comparable to the 5% (n = 273) of mothers who screened positive. Overall, fathers made up 11.7% of the overall proportion of parents who were considered depressed. 

Cheng and colleagues said that screening rates for mothers and fathers are low despite the growing evidence that the management of maternal postpartum depression can be adequately implemented in the pediatric primary care setting. These findings highlight the importance of educating physicians about depression in parents, and the researchers recommended developing strategies to “integrate screening tools into routine care.”

“Depression in new dads is not uncommon and should be taken seriously,” Cheng said. “Dads who experience symptoms of depression — including sadness, irritability, agitation, and anger — shouldn’t hide their feelings. We’d like to continue our efforts to de-stigmatize men’s mental health and increase awareness of depression in fathers in the postpartum period.”  – By Marley Ghizzone

Disclosures: Cheng reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.