Postpartum Depression Affects Dads Too

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Depression in new mothers is well recognized -- but new dads get depressed, too, and it can negatively affect parenting, according to a large observational study.

The study, of more than 1,700 fathers of 1-year-olds, found that depression occurred in 7 percent of those dads, and increased the odds of recent spankings nearly four-fold and more than halved the likelihood of the men reading with their child most days of the week, reported Dr. R. Neal Davis and colleagues at the University of Michigan in Ann Arbor.

Pediatricians could be in a good position to help, as 77 percent of the depressed dads reported having talked to their child's doctor in the prior year, Davis and co-authors wrote in the April issue of Pediatrics.

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"Pediatric providers should consider screening fathers for depression, discussing specific parenting behaviors (e.g., reading to children and appropriate discipline), and referring for treatment if appropriate," the group recommended in their paper.

American fathers are clearly taking a more active role in parenting -- a role which the American Academy of Pediatrics has encouraged clinicians to support, noted Dr. Craig F. Garfield of Northwestern University in Chicago, and Richard Fletcher, PhD, of the University of Newcastle, Australia, in an accompanying editorial.

As with new moms, fathers appear to be at the greatest risk for depression in the first year after their child's birth -- and can be screened with the same validated tools.

But getting clinicians to "embrace paternal perinatal depression screening with the same vigor" as for maternal screening could be less than straightforward, they predicted.

"The field of pediatrics is now faced with finding ways to support fathers in their parenting role much in the same way we support mothers," Garfield and Fletcher wrote in Pediatrics.

The study included 1,746 fathers of 1-year-olds interviewed through the Fragile Families and Child Wellbeing Study, a nationally-representative study following a cohort of U.S. children born between 1998 and 2000.

Depression Hits News Dads

Overall, 7 percent of the men reported a major depressive episode within the prior year.

Although these depressed dads were less likely to be employed and more likely to report substance abuse, they were not less likely than other fathers to have spoken with their child's doctor in the prior year.

The analysis focused on four aspects of parenting commonly considered at well-child visits: playing games, singing songs, and reading stories to children at least three days in a typical week, and spanking.

Both depressed and nondepressed dads were just as likely to engage in interactive play and singing songs or nursery rhymes with their children, at 94 percent to 95 percent and 75 percent in both groups, respectively.

But spanking during the prior month was reported by 41 percent of depressed dads compared with only 13 percent of other fathers, with a trend for less reading together.

After adjustment for paternal age, race and ethnicity, socioeconomic, employment, and other factors, the findings were both significant.

Depressed fathers were 62 percent less likely to report reading to their children at least three days a week and 3.92-fold more likely to have spanked them in the past month.

While spanking is controversial, it was particularly concerning that these children were only 1 year old, the researchers noted, "a developmental stage when children are unlikely to understand the connection between their behavior and subsequent punishment and when spanking is more likely to cause physical injury."

Irritability and anger as common symptoms of depression may be implicated, Davis' group suggested.

They recommended that pediatric care providers be clear with fathers about inappropriate corporal punishment and give alternatives for handling problem behaviors in their children, as well as dealing with the dads' feelings of frustration and irritability.

Depression may also take away motivation or interest in reading to children -- an activity that may take focused effort compared with singing and playing games, they added.

Depression Hits News Dads

The investigators cautioned that their cross-sectional, observational study could not determine causality or rule out residual confounding, and that paternal self-report of parenting behaviors may have been limited by recall bias or social desirability.

In addition, Davis and co-authors cautioned, while "depressed fathers may have been more likely to report adverse parenting behaviors because of low mood at the time of the survey," they did not see this pattern across all domains of parenting behaviors.