Maternal and Child Health Journal

, Volume 17, Issue 1, pp 119–128

Characteristics of Fathers with Depressive Symptoms

  • David G. Rosenthal
  • Nicole Learned
  • Ying-Hua Liu
  • Michael Weitzman
Article

Abstract

Extensive research shows maternal depression to be associated with poorer child outcomes, and characteristics of these mothers have been described. Recent research describes associations of paternal depressive symptoms and child behavioral and emotional outcomes, but characteristics of these fathers have not been investigated. This study describes characteristics of fathers with depressive symptoms in the USA. Utilizing data from 7,247 fathers and mothers living in households with children aged 5–17 years who participated in the Medical Expenditure Panel Survey 2004–2006, the Patient Health Questionnaire-2 was used to assess parental depressive symptoms, the Short Form-12 was used to examine paternal and maternal physical health, the Columbia Impairment Scale was used to measure child behavioral or emotional problems, and the Children with Special Health Care Needs Screener was used to identify children with special health care needs. In multivariate analyses, poverty (AOR 1.52; 95% CI 1.05–2.22), maternal depressive symptoms (AOR 5.77; 95% CI 4.18–7.95), living with a child with special health care needs (AOR 1.42, 95% CI 1.04–1.94), poor paternal physical health (AOR 3.31; 95% CI 2.50–4.38) and paternal unemployment (AOR 6.49; 95% CI 4.12–10.22) were independently associated with increased rates of paternal depressive symptoms. These are the first data that demonstrate that poverty, paternal physical health problems, having a child with special health care needs, maternal depressive symptoms, and paternal unemployment are independently associated with paternal depressive symptoms, with paternal unemployment associated with the highest rates of such problems.

Keywords

Paternal depressive symptoms Child behavior Child emotional problems 

Abbreviations

AOR

Adjusted odds ratio

MEPS

Medical Expenditure Panel Survey

CI

Confidence interval

CIDI

Composite International Diagnostic Interview

CIS

Columbia Impairment Scale

CSHCN

Children with special health care needs

DSM-IV

Diagnostic and statistical manual of mental disorders IV

HPA

Hypothalamic pituitary adrenal

MCS

Mental component score

NHIS

National Health Interview Survey

PCS

Physical Component Scale

PHQ-2

Patient Health Questionnaire-2

PRIME-MD

Primary Care Evaluation of Mental Disorders

SF-12

Short-Form 12

References

  1. 1.
    APA. (2000). Diagnostic and statistical manual of mental disorders, (4th ed), Text Revision. Washington, DC.Google Scholar
  2. 2.
    Wainwright, N. W. J., & Surtees, P. G. (2002). Childhood adversity, gender and depression over the life-course. Journal of Affective Disorders, 72(1), 33–44.PubMedCrossRefGoogle Scholar
  3. 3.
    Grigoriadis, S., & Robinson, G. (2007). Gender issues in depression. Annals of Clinical Psychiatry, 19(4), 247–255.PubMedCrossRefGoogle Scholar
  4. 4.
    Centers for Disease Control and Prevention (CDC). (2010). Current depression among adults—United States, 2006 and 2008. Morbidity and mortality weekly report. 59(38), 1229–1235.Google Scholar
  5. 5.
    Kelly, Y., & Bartley, M. (2010). Parental and child health. In Children of the 21st century: the first five years (pp. 249–264). The Policy Press.Google Scholar
  6. 6.
    Mensah, F. K., & Kiernan, K. E. (2010). Maternal general health and children’s cognitive development and behaviour in the early years: Findings from the Millennium Cohort Study. Child: Care, Health and Development.Google Scholar
  7. 7.
    Nicol-Harper, R., Harvey, A., & Stein, A. (2007). Interactions between mothers and infants: Impact of maternal anxiety. Infant Behavior and Development, 30(1), 161–167.PubMedCrossRefGoogle Scholar
  8. 8.
    Glasheen, C., Richardson, G., & Fabio, A. (2010). A systematic review of the effects of postnatal maternal anxiety on children. Archives of Women’s Mental Health, 13(1), 61–74.PubMedCrossRefGoogle Scholar
  9. 9.
    Alder, J., Fink, N., Bitzer, J., Hsli, I., & Holzgreve, W. (2007). Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. Journal of MaternalFetal and Neonatal Medicine, 20(3):189–209.Google Scholar
  10. 10.
    Kavanaugh, M., Halterman, J. S., Montes, G., Epstein, M., Hightower, A. D., & Weitzman, M. (2006). Maternal depressive symptoms are adversely associated with prevention practices and parenting behaviors for preschool children. Ambulatory Pediatrics, 6(1), 32–37.PubMedCrossRefGoogle Scholar
  11. 11.
    Martini, J., Knappe, S., Beesdo-Baum, K., Lieb, R., & Wittchen, H.-U. (2010). Anxiety disorders before birth and self-perceived distress during pregnancy: Associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Human Development, 86(5), 305–310.PubMedCrossRefGoogle Scholar
  12. 12.
    Goodman, S. H., & Gotlib, I. H. (1999). Risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission. Psychological Review, 106(3), 458–490.PubMedCrossRefGoogle Scholar
  13. 13.
    Sohr-Preston, S., & Scaramella, L. (2006). Implications of timing of maternal depressive symptoms for early cognitive and language development. Clinical Child and Family Psychology Review, 9(1), 65–83.PubMedCrossRefGoogle Scholar
  14. 14.
    Bailey, D., Golden, R., Roberts, J., & Ford, A. (2007). Maternal depression and developmental disability: Research critique. Mental Retardation and Developmental Disabilities Research Reviews, 13(4), 321–329.PubMedCrossRefGoogle Scholar
  15. 15.
    Grupp-Phelan, J., Whitaker, R., & Naish, A. (2003). Depression in mothers of children presenting for emergency and primary care: Impact on mothers’ perceptions of caring for their children. Ambulatory Pediatrics, 3(3), 142–146.PubMedCrossRefGoogle Scholar
  16. 16.
    Wang, L. Wu, T., Anderson, J. L., & Florence, J. E. (2011). Prevalence and risk factors of maternal depression during the first three years of child rearing. Journal of Women’s Health (Epub ahead of print).Google Scholar
  17. 17.
    Waylen, A., & Stewart-Brown, S. (2010). Factors influencing parenting in early childhood: A prospective longitudinal study focusing on change. Child: Care, Health and Development, 36(2), 198–207.CrossRefGoogle Scholar
  18. 18.
    Hanington, L., Ramchandani, P., & Stein, A. (2010). Parental depression and child temperament: Assessing child to parent effects in a longitudinal population study. Infant Behavior and Development, 33(1), 88–95.PubMedCrossRefGoogle Scholar
  19. 19.
    Ramchandani, P., O’Connor, T., Evans, J., Heron, J., Murray, L., & Stein, A. (2008). The effects of pre- and postnatal depression in fathers: A natural experiment comparing the effects of exposure to depression on offspring. Journal of Child Psychology and Psychiatry and Allied Disciplines, 49(10), 1069–1078.CrossRefGoogle Scholar
  20. 20.
    Ramchandani, P., Stein, A., Evans, J., & O’Connor, T. (2005). Paternal depression in the postnatal period and child development: A prospective population study. Lancet, 365(9478), 2201–2205.PubMedCrossRefGoogle Scholar
  21. 21.
    Weitzman, M., Rosenthal, D. G., & Liu, Y.-H. (2011). Paternal mental health problems and depression and child emotional and behavioral problems in the USA. Pediatrics, 128(6), 1126–1134.PubMedCrossRefGoogle Scholar
  22. 22.
    Cohen, S. (2003). Design strategies and innovations in the medical expenditure panel survey. Medical Care, 41(7 Suppl), III5–III12.PubMedGoogle Scholar
  23. 23.
    How the Government Measures Unemployment. (2009). U.S. bureau of labor statistics: labor force statistics from the current population study. Google Scholar
  24. 24.
    Jenkinson, C., Chandola, T., Coulter, A., & Bruster, S. (2001). An assessment of the construct validity of the SF-12 summary scores across ethnic groups. Journal of Public Health Medicine, 23(3), 187–194.PubMedCrossRefGoogle Scholar
  25. 25.
    Jenkinson, C., Layte, R., Jenkinson, D., et al. (1997). A shorter form health survey: Can the SF-12 replicate results from the SF-36 in longitudinal studies? Journal of Public Health Medicine, 19(2), 179–186.PubMedCrossRefGoogle Scholar
  26. 26.
    Lam, C. L. K., Tse, E. Y. Y., & Gandek, B. (2005). Is the standard SF-12 health survey valid and equivalent for a Chinese population? Quality of Life Research, 14(2), 539–547.PubMedCrossRefGoogle Scholar
  27. 27.
    Ware, J., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.PubMedCrossRefGoogle Scholar
  28. 28.
    Kroenke, K., Spitzer, R., Williams, J. B. W., & Lwe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry, 32(4), 345–359.PubMedCrossRefGoogle Scholar
  29. 29.
    Arroll, B., Goodyear-Smith, F., Crengle, S., et al. (2010). Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Annals of Family Medicine, 8(4), 348–353.PubMedCrossRefGoogle Scholar
  30. 30.
    Richardson, L., Rockhill, C., Russo, J., et al. (2010). Evaluation of the PHQ-2 as a brief screen for detecting major depression among adolescents. Pediatrics, 125(5), e1097–e1103.PubMedCrossRefGoogle Scholar
  31. 31.
    Bird, H. R., Andrews, H., & Schwab-Stone, M. (1996). Global measures of impairment for epidemiologic and clinical use with children and adolescents. International Journal of Methods in Psychiatric Research, 6, 295–307.CrossRefGoogle Scholar
  32. 32.
    Bird, H. R., Shaffer, D., Fisher, P., et al. (1993). The Columbia Impairment Scale (CIS) - Pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research, 3(3), 167–176.Google Scholar
  33. 33.
    Winters, N., Collett, B., & Myers, K. (2005). Ten-year review of rating scales, VII: scales assessing functional impairment. Journal of the American Academy of Child and Adolescent Psychiatry, 44(4), 309–338.PubMedCrossRefGoogle Scholar
  34. 34.
    Bethel, C. D., Rosenthal, D. G., Stein, R. E. K., Blumberg, S. J., Wells, N., & Newacheck, P. W. (2002). Identifying children with special health care needs: Development and evaluation of a short screening instrument. Ambulatory Pediatrics, 2(1), 38–48.CrossRefGoogle Scholar
  35. 35.
    Research Triangle Institute. SUDAAN release 9.0.1. NRTI: Research Triangle Park.Google Scholar
  36. 36.
    Bailey, D., Golden, R., Roberts, J., & Ford, A. (2007). Maternal depression and developmental disability: Research critique. Mental Retardation and Developmental Disabilities Research Reviews, 13(4), 321–329.PubMedCrossRefGoogle Scholar
  37. 37.
    Mensah, F. K., & Kiernan, K. E. (2011). Maternal general health and children’s cognitive development and behaviour in the early years: findings from the Millennium Cohort Study. Child: Care, Health and Development, 37(1), 44–54.CrossRefGoogle Scholar
  38. 38.
    Wang, L., Wu, T., Anderson, J., & Florence, J. (2011). Prevalence and risk factors of maternal depression during the first three years of child rearing. Journal of Women’s Health, 20(5), 711–718.PubMedCrossRefGoogle Scholar
  39. 39.
    Waylen, A., & Stewart Brown, S. (2010). Factors influencing parenting in early childhood: a prospective longitudinal study focusing on change. Child: Care, Health and Development, 36(2), 198–207.CrossRefGoogle Scholar
  40. 40.
    Prince, M., Patel, V., Saxena, S., et al. (2007). No health without mental health. Lancet, 370(9590), 859–877.PubMedCrossRefGoogle Scholar
  41. 41.
    Scully, D., Kremer, J., Meade, M. M., Graham, R., & Dudgeon, K. (1998). Physical exercise and psychological well being: A critical review. British Journal of Sports Medicine, 32(2), 111–120.PubMedCrossRefGoogle Scholar
  42. 42.
    Paulson, J., & Bazemore, S. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. JAMA (Chicago, Ill.), 303(19):1961–1969.Google Scholar
  43. 43.
    Whitaker, R., Orzol, S., & Kahn, R. (2006). Maternal mental health, substance use, and domestic violence in the year after delivery and subsequent behavior problems in children at age 3 years. Archives of General Psychiatry, 63(5), 551–560.PubMedCrossRefGoogle Scholar
  44. 44.
    Hoppmann, C., Gerstorf, D., & Hibbert, A. (2011). Spousal associations between functional limitation and depressive symptom trajectories: Longitudinal findings from the study of asset and health dynamics among the oldest old (AHEAD). Health Psychology, 30(2), 153–162.PubMedCrossRefGoogle Scholar
  45. 45.
    Ohayon, M., & Schatzberg, A. (2010). Chronic pain and major depressive disorder in the general population. Journal of Psychiatric Research, 44(7), 454–461.PubMedCrossRefGoogle Scholar
  46. 46.
    Wilson, S. H., & Walker, G. M. (1993). Unemployment and health: A review. Public Health, 107(3), 153–162.PubMedCrossRefGoogle Scholar
  47. 47.
    Bronte-Tinkew, J., Moore, K. A., Matthews, G., & Carrano, J. (2007). Symptoms of major depression in a sample of fathers of infants. Journal of Family Issues, 28(1), 61–99.CrossRefGoogle Scholar
  48. 48.
    Dav, S., Sherr, L., Senior, R., & Nazareth, I. (2009). Major paternal depression and child consultation for developmental and behavioural problems. British Journal of General Practice, 59(560), 180–185.CrossRefGoogle Scholar
  49. 49.
    Melrose, S. (2010). Paternal postpartum depression: How can nurses begin to help? Contemporary Nurse : A Journal for the Australian Nursing Profession, 34(2), 199–210.CrossRefGoogle Scholar
  50. 50.
    Reeb, B., Conger, K., & Wu, E. (2010). Paternal depressive symptoms and adolescent functioning: The moderating effect of gender and father hostility. Fathering, 8(1), 131–142.PubMedCrossRefGoogle Scholar
  51. 51.
    Dav, S., Petersen, I., Sherr, L., & Nazareth, I. (2010). Incidence of maternal and paternal depression in primary care: A cohort study using a primary care database. Archives of Pediatrics and Adolescent Medicine, 164(11), 1038–1044.CrossRefGoogle Scholar
  52. 52.
    Dav, S., Sherr, L., Senior, R., & Nazareth, I. (2008). Associations between paternal depression and behaviour problems in children of 4–6 years. European Child and Adolescent Psychiatry, 17(5), 306–315.CrossRefGoogle Scholar
  53. 53.
    Merikangas, K. R. (1982). Assortative mating for psychiatric disorders and psychological traits. Archives of General Psychiatry, 39(10), 1173–1180.PubMedCrossRefGoogle Scholar
  54. 54.
    Wee, K. Y., & Skouteris, H. et al. (2010). Correlates of ante- and postnatal depression in fathers: A systematic review. Journal of Affective Disorders.Google Scholar
  55. 55.
    Churchill, S., Villareale, N., Monaghan, T., Sharp, V., & Kieckhefer, G. (2010). Parents of children with special health care needs who have better coping skills have fewer depressive symptoms. Maternal and Child Health Journal, 14(1), 47–57.PubMedCrossRefGoogle Scholar
  56. 56.
    Ratliffe, C., Harrigan, R., Haley, J., Tse, A., & Olson, T. (2002). Stress in families with medically fragile children. Issues in Comprehensive Pediatric Nursing, 25(3), 167–188.PubMedCrossRefGoogle Scholar
  57. 57.
    Barman, S., Pulkkinen, L., Kaprio, J., & Rose, R. (2004). Inattentiveness, parental smoking and adolescent smoking initiation. Addiction, 99(8), 1049–1061.PubMedCrossRefGoogle Scholar
  58. 58.
    Cummings, S., Neff, J., & Husaini, B. (2003). Functional impairment as a predictor of depressive symptomatology: The role of race, religiosity, and social support. Health and Social Work, 28(1), 23–32.PubMedCrossRefGoogle Scholar
  59. 59.
    Everson, S., Maty, S., Lynch, J., & Kaplan, G. (2002). Epidemiologic evidence for the relation between socioeconomic status and depression, obesity, and diabetes. Journal of Psychosomatic Research, 53(4), 891–895.PubMedCrossRefGoogle Scholar
  60. 60.
    Cooper, C., Bebbington, P. E., Meltzer, H., et al. (2008). Depression and common mental disorders in lone parents: results of the 2000 National Psychiatric Morbidity Survey. Psychological Medicine, 38(3), 335–342.PubMedCrossRefGoogle Scholar
  61. 61.
    Cross-national comparisons of the prevalences and correlates of mental disorders. (2000). WHO International Consortium in Psychiatric Epidemiology. Bulletin of the World Health Organization, 78(4), 413–426.Google Scholar
  62. 62.
    Bielawska-Batorowicz, E., & Kossakowska-Petrycka, K. (2006). Depressive mood in men after the birth of their offspring in relation to a partner’s depression, social support, fathers’ personality and prenatal expectations. Journal of Reproductive and Infant Psychology, 24(1), 21–29.CrossRefGoogle Scholar
  63. 63.
    Hoard, L. R., & Anderson, E. A. (2004). Factors related to depression in rural and urban noncustodial, low-income fathers. Journal of Community Psychology, 32(1), 103–119.CrossRefGoogle Scholar
  64. 64.
    Oquendo, M. A., Ellis, S. P., Greenwald, S., Malone, K. M., Weissman, M. M., & Mann, J. J. (2001). Ethnic and sex differences in suicide rates relative to major depression in the United States. American Journal of Psychiatry, 158(10), 1652–1658.PubMedCrossRefGoogle Scholar
  65. 65.
    Rich-Edwards, J. W., Kleinman, K., Abrams, A., et al. (2006). Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology and Community Health, 60(3), 221–227.PubMedCrossRefGoogle Scholar
  66. 66.
    Saez-Santiago, E., & Bernal, G. (2002). Depression in ethnic minorities: Latinos and Latinas, African-Americans, Asian-Americans, and Native-Americans. In G. Bernal, J. Trimble, F. Leung, & K. Burlew (Eds.), Handbook of ethnic and racial minorities (pp. 401–428). Thousand Oaks, CA: Sage.Google Scholar
  67. 67.
    Strksen, I., Rysamb, E., Moum, T., & Tambs, K. (2005). Adolescents with a childhood experience of parental divorce: A longitudinal study of mental health and adjustment. Journal of Adolescence, 28(6), 725–739.CrossRefGoogle Scholar
  68. 68.
    Flouri, E. (2010). Fathers’ behaviors and children’s psychopathology. Clinical Psychology Review, 30(3), 363–369.PubMedCrossRefGoogle Scholar
  69. 69.
    Rae-Grant, Q., & Robson, B. E. (1988). Moderating the morbidity of divorce. Canadian Journal of Psychiatry, 33(6), 443–452.Google Scholar
  70. 70.
    Kessler, R. C., Walters, E. E., & Forthofer, M. S. (1998). The social consequences of psychiatric disorders, III: Probability of marital stability. The American Journal of Psychiatry, 155(8), 1092–1096.PubMedGoogle Scholar
  71. 71.
    Whisman, M., Tolejko, N., & Chatav, Y. (2007). Social consequences of personality disorders: Probability and timing of marriage and probability of marital disruption. Journal of Personality Disorders, 21(6), 690–695.PubMedCrossRefGoogle Scholar
  72. 72.
    Gilchrist, G., & Gunn, J. (2007). Observational studies of depression in primary care: What do we know? BMC Family Practice, 11(8), 28.CrossRefGoogle Scholar
  73. 73.
    Kessler, R. C., Foster, C. L., Saunders, W. B., & Stang, P. E. (1995). Social consequences of psychiatric disorders, I: Educational attainment. The American Journal of Psychiatry, 152(7), 1026–1032.PubMedGoogle Scholar
  74. 74.
    Maughan, B., & Carroll, J. (2006). Literacy and mental disorders. Current Opinion in Psychiatry, 19(4), 350–354.PubMedCrossRefGoogle Scholar
  75. 75.
    Blazer, D. G., Kessler, R. C., McGonagle, K. A., & Swartz, M. S. (1994). The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. American Journal of Psychiatry, 151(7), 979–986.PubMedGoogle Scholar
  76. 76.
    Keita, G. P. (2007). Psychosocial and cultural contributions to depression in women: Considerations for women midlife and beyond. Journal of Managed Care Pharmacy, 13(9 Suppl A), S12–S15.PubMedGoogle Scholar
  77. 77.
    Cooper, P., Fearn, V., Willetts, L., Seabrook, H., & Parkinson, M. (2006). Affective disorder in the parents of a clinic sample of children with anxiety disorders. Journal of Affective Disorders, 93(1–3), 205–212.PubMedCrossRefGoogle Scholar
  78. 78.
    Bergemann, E., & Boles, R. (2010). Maternal inheritance in recurrent early-onset depression. Psychiatric Genetics, 20(1), 31–34.PubMedCrossRefGoogle Scholar
  79. 79.
    Shastry, B. (2005). Bipolar disorder: An update. Neurochemistry International, 46(4), 273–279.PubMedCrossRefGoogle Scholar
  80. 80.
    Kessler, R. C., Berglund, P. A., Foster, C. L., Saunders, W. B., Stang, P. E., & Walters, E. E. (1997). Social consequences of psychiatric disorders, II: Teenage parenthood. The American Journal of Psychiatry, 154(10), 1405–1411.PubMedGoogle Scholar
  81. 81.
    Mirowsky, J., & Ross, C. (2002). Depression, parenthood, and age at first birth. Social Science and Medicine, 54(8), 1281–1298.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • David G. Rosenthal
    • 3
  • Nicole Learned
    • 3
  • Ying-Hua Liu
    • 1
  • Michael Weitzman
    • 1
    • 2
  1. 1.Department of PediatricsNew York University School of MedicineNew YorkUSA
  2. 2.Department of PsychiatryNew York University School of MedicineNew YorkUSA
  3. 3.New York University School of MedicineNew YorkUSA

Personalised recommendations