Fathers’ Depression May Affect Children’s Behavior

Kindergarten-age children who have fathers with depression are more likely than children not exposed to paternal depression to have behavioral problems and poor social skills several years later, a study in the American Journal of Preventive Medicine has found.

Kristine Schmitz, M.D., of Robert Wood Johnson Medical School, and colleagues examined data from 1,422 children enrolled in the Future of Families and Child Wellbeing study. This ongoing study is following a cohort of individuals born in one of 20 large U.S. cities between 1998 and 2000 as well as their families. More than 75% of mothers in the study were unmarried at the time of their children’s birth. Paternal depression was assessed using the World Health Organization’s Composite International Diagnostic Interview Short Form when the children were 5 years old, at which time 9% of fathers screened positive for depression.

When the children were 9 years old, their teachers reported the children’s behavior via the Conners’ Teacher Rating Scale—Revised Short form and the Social Skills Rating Scale. These assessments measure externalizing behaviors, internalizing behaviors, attention problems, and social problems.

After adjusting for numerous child and family variables, including maternal depression and whether the father lived with the child, the researchers found that paternal depression was associated with a 36% higher oppositional score, 37% higher hyperactive score, and 25% higher attention-deficit/hyperactivity disorder score at age 9. Paternal depression was also associated with an 11% lower positive social skills score and a 25% higher problematic behavior score. There were no associations between paternal depression and cognitive problems/inattention.

“Several potential mechanisms could underlie the findings,” the researchers wrote. “Depression can lead to suboptimal parenting and less emotional support for the child. Paternal depression has been associated with fewer positive and more negative parenting behaviors, including harsher parenting and physical punishment.”

The researchers added that the findings support the need to identify fathers at risk for depression beyond the perinatal period and link them to interventions to support their children’s well-being.

“[The findings] also suggest the need for interventions supporting school-aged children exposed to paternal depression,” the researchers wrote. “Pediatricians, with their frequent contact with families, are well-positioned to address these important needs.”

For related information, see the Psychiatric News article “One-Third of Teens Have Parent With Anxiety or Depression.”

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Daughters of Men With Postnatal Depression May Be at Higher Risk for Depression in Adolescence

Girls whose dads experienced depression shortly after their birth are more likely to develop depression by age 18, according to a study published Wednesday in JAMA Psychiatry.

This cohort study of 3,176 father-offspring pairs in Southwest England explored the association of depression symptoms in fathers eight weeks after the birth of their infant and depression symptoms in the offspring 18 years later. The researchers also examined potential environmental pathways for depression risk. After adjusting for the age and education level of the father, they found that maternal depression had the greatest influence on depression risk, which explained 21% of the association, followed by conduct problems in the offspring at age 3.5 years, which explained 8% of the association.

“Our findings suggest that paternal depression during the postnatal period appears to exert its influence on late emotional problems in girls at least in part through maternal depression,” wrote Leticia Gutierrez-Galve, Ph.D., of the Centre for Psychiatry at Imperial College in London. “Maternal depression has been previously associated with impaired parenting, particularly sensitive parenting. Mothers with depression may show less maternal responsiveness or sensitivity, less verbal and visual interaction, and more intrusiveness during interactions with their infants.”

Parent participants, who were part of an ongoing population-based cohort study called ALSPAC, took the Edinburgh Postnatal Depression Scale, a 10-item self-report questionnaire at eight weeks after the birth of their infants and again eight months later. Also at eight months, mothers were interviewed about their relationships with their partners using a nine-item scale, asking questions such as “Do you get angry with your partner?” and “Does your partner listen when you want to talk about your feelings?”.

When the offspring were about 3.5 years old, the mothers completed the Rutter Revised Preschool Scales, which assess problem behaviors (emotional problems, conduct problems, and hyperactivity) and prosocial behaviors. The offspring were evaluated for depression at age 18, using the computerized version of the Clinical Interview Schedule-Revised.

Ultimately, just over 7% of the 3,165 adolescents studied had a primary diagnosis of depression at age 18 years. Researchers found that the teens whose dads had depression eight weeks after their birth were 1.5 times more likely to go on to develop depression themselves. Couple conflict and paternal involvement did not appear play a role in the risk of offspring depression, the researchers wrote, noting they did not have enough data to explore the quality of parent-child interactions.

“Early conduct disorder in children appears to be a mechanism of risk transmission between depression in fathers and subsequent depression at age 18 years,” the researchers concluded. “Overall, these findings highlight the importance of recognizing and treating depression in fathers during the postnatal period and considering both parents when one parent presents with depression.”

For related information, see the Psychiatric News article “New Primary Care Guidelines Recommend Routine Screening for Depression in Adolescents.”

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Children Are Affected by Depressed Dads

Children who live with their depressed fathers are more likely than their peers to have emotional and behavioral problems. That’s the finding of Michael Weitzman, M.D., a professor of pediatrics and psychiatry at New York University School of Medicine, and colleagues published in the November 7 Pediatrics. The researchers said the negative effects of maternal mental health problems on child health are well documented, but this is the first study to show that living with depressed fathers is independently associated with increased rates of children's emotional and behavior problems. Their study population was a representative sample of 22,000 children and their parents.

 “[T]his finding raises questions of great importance about how to educate the health care workforce, how to develop and implement strategies to facilitate identifying fathers with mental health problems, and how to develop referral systems and ways to reimburse for this vital work,” wrote Weitzman and colleagues.

To read more about the association between maternal mental health and child behavior, see Psychiatric News.

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