Abstract
Whilst there is growing evidence highlighting the importance of paternal mental illness (PMI) on child development, this relationship still remains under-studied and often over-looked. Considering the increasingly active role of fathers in their children’s upbringing, a comprehensive overview of the impact of PMI on child development is overdue. This study aimed to combine and synthesise currently available evidence on the relationship between PMI and multiple domains of child development. Narrative synthesis of systematic reviews and meta-analyses on the relationship between PMI and child development (mental health and social, emotional, language, cognitive or adaptive behaviour), published between 1980 to December 2021, was conducted in line with PRISMA 2020 guidelines. Review quality was assessed based on AMSTAR-2 criteria and respective study confidence was interpreted in line with GRADE scoring. All relevant meta-analytic effect sizes were converted to odds ratios (OR) and grouped using a random effects model. Grouped meta-analyses saw PMI to have a significant, detrimental effect on all studied domains of child development [OR: 1.54; 95% CI (1.36–1.74)]. Subgroup analyses saw PMI affecting both internalising [OR: 1.62; 95% CI (1.27–2.08)] and externalising [OR: 1.63; 95% CI (1.28–2.08)] child behaviours to a similar extent. However, included reviews were of poor methodological quality, demonstrating either low or critically low confidence. These results show a consistent and influential effect of PMI on child development. The relationship between fathers’ mental illness and child development warrants further investigation, as current research is limited in scope, particularly regarding cognitive domains of child development and non-affective PMI diagnoses.
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References
Pérez CF, Brahm P, Riquelme S, Rivera C, Jaramillo K, Eickhorst A (2017) Paternal post-partum depression: how has it been assessed? A literature review. Ment Health Prev 7:28–36
Rao WW, Zhu XM, Zong QQ, Zhang Q, Hall BJ, Ungvari GS et al (2020) Prevalence of prenatal and postpartum depression in fathers: a comprehensive meta-analysis of observational surveys. J Affect Disord 263:491–499
Garfield CF, Duncan G, Rutsohn J, McDade TW, Adam EK, Coley RL et al (2014) A longitudinal study of paternal mental health during transition to fatherhood as young adults. Pediatrics 133(5):836–843
Leiferman JA, Farewell CV, Jewell J, Lacy R, Walls J, Harnke B et al (2021) Anxiety among fathers during the prenatal and postpartum period: a meta-analysis. J Psychosom Obstet Gynecol 42(2):152–161
Psouni E, Frisk C, Brocki K (2021) Anxiety among fathers in the postnatal period: links to depression, attachment insecurity and emotion regulation. J Affect Disord Rep 6:100276
Giallo R, D’Esposito F, Christensen D, Mensah F, Cooklin A, Wade C et al (2012) Father mental health during the early parenting period: results of an Australian population based longitudinal study. Soc Psychiatry Psychiatr Epidemiol 47(12):1907–1916
Matthey S, Barnett B, Howie P, Kavanagh DJ (2003) Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? J Affect Disord 74(2):139–147
Ramchandani PG, O’Connor TG, 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. J Child Psychol Psychiatry 49(10):1069–1078
van den Berg MP, van der Ende J, Crijnen AA, Jaddoe VW, Moll HA, Mackenbach JP et al (2009) Paternal depressive symptoms during pregnancy are related to excessive infant crying. Pediatrics 124(1):e96-103
Reeb BT, Conger KJ, Wu Y (2010) Paternal depressive symptoms and adolescent functioning: the moderating effect of gender and father hostility. Fathering 8(1):131
Shelton KH, Harold GT (2008) Interparental conflict, negative parenting, and children’s adjustment: bridging links between parents’ depression and children’s psychological distress. J Fam Psychol 22(5):712
Wickersham A, Leightley D, Archer M, Fear N (2020) The association between paternal psychopathology and adolescent depression and anxiety: a systematic review. J Adolesc 79:232–246
Brennan PA, Hammen C, Katz AR, Le Brocque RM (2002) Maternal depression, paternal psychopathology, and adolescent diagnostic outcomes. J Consult Clin Psychol 70(5):1075–1085
Phares V, Lopez E, Fields S, Kamboukos D, Duhig AM (2005) Are fathers involved in pediatric psychology research and treatment? J Pediatr Psychol 30(8):631–643
Davison KK, Gicevic S, Aftosmes-Tobio A, Ganter C, Simon CL, Newlan S et al (2016) Fathers’ representation in observational studies on parenting and childhood obesity: a systematic review and content analysis. Am J Public Health 106(11):e14-21
Keys EM, Norris JM, Cameron EE, Bright KS, Tomfohr-Madsen LM, Benzies KM (2019) Recruitment and retention of fathers with young children in early childhood health intervention research: a systematic review and meta-analysis protocol. Syst Rev 8(1):300
Barker B, Iles JE, Ramchandani PG (2017) Fathers, fathering and child psychopathology. Curr Opin Psychol 15:87–92
Reich W, Earls F, Frankel O, Shayka JJ (1993) Psychopathology in children of alcoholics. J Am Acad Child Adolesc Psychiatry 32(5):995–1002
Lieb R, Isensee B, Höfler M, Pfister H, Wittchen HU (2002) Parental major depression and the risk of depression and other mental disorders in offspring: a prospective-longitudinal community study. Arch Gen Psychiatry 59(4):365–374
Connell AM, Goodman SH (2002) The association between psychopathology in fathers versus mothers and children’s internalizing and externalizing behavior problems: a meta-analysis. Psychol Bull 128(5):746
Shevlin M, McElroy E, Murphy J (2017) Homotypic and heterotypic psychopathological continuity: a child cohort study. Soc Psychiatry Psychiatr Epidemiol 52(9):1135–1145
Achenbach T, Ivanova M, Rescorla L, Turner L, Althoff R (2016) Internalizing/externalizing problems: review and recommendations for clinical and research applications. J Am Acad Child Adolesc Psychiatry 55:647
Sweeney S, MacBeth A (2016) The effects of paternal depression on child and adolescent outcomes: a systematic review. J Affect Disord 205:44–59
Liu J (2004) Childhood externalizing behavior: theory and implications. J Child Adolesc Psychiatr Nurs 17(3):93–103
MacKenzie LE, Howes Vallis E, Rempel S, Zwicker A, Drobinin V, Pavlova B et al (2020) Cognition in offspring of parents with psychotic and non-psychotic severe mental illness. J Psychiatr Res 130:306–312
Cheung K, Theule J (2019) Paternal depression and child externalizing behaviors: a meta-analysis. J Fam Psychol 33(1):98–108
Natsuaki MN, Shaw DS, Neiderhiser JM, Ganiban MJ, Gordon TH, Reiss D et al (2014) Raised by depressed parents: Is it an environmental risk? Clin Child Fam Psychol Rev 17(4):357–367
Gutierrez-Galve L, Stein A, Hanington L, Heron J, Ramchandani PG (2015) Paternal depression in the postnatal period and child development: mediators and moderators. Pediatrics 135(2):e339–e347
Ramchandani PG, Stein A, O’Connor TG, Heron J, Murray L, Evans J (2008) Depression in men in the postnatal period and later child psychopathology: a population cohort study. J Am Acad Child Adolesc Psychiatry 47(4):390–398
Papatheodorou S (2019) Umbrella reviews: what they are and why we need them. Eur J Epidemiol 34(6):543–546
Eaton WW, Neufeld K, Chen LS, Cai G (2000) A comparison of self-report and clinical diagnostic interviews for depression: diagnostic interview schedule and schedules for clinical assessment in neuropsychiatry in the Baltimore epidemiologic catchment area follow-up. Arch Gen Psychiatry 57(3):217–222
Hunt M, Auriemma J, Cashaw A (2003) Self-report bias and underreporting of depression on the BDI-II. J Pers Assess 80:26–30
Parolin M, Simonelli A, Mapelli D, Sacco M, Cristofalo P (2016) Parental substance abuse as an early traumatic event. preliminary findings on neuropsychological and personality functioning in young drug addicts exposed to drugs early. Front Psychol 7:887
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A (2016) Rayyan—a web and mobile app for systematic reviews. Syst Rev 5(1):210
Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J et al (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. Br Med J. https://doi.org/10.1136/bmj.j4008
Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J et al (2011) GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 64(4):383–394
Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M et al (2006) Guidance on the conduct of narrative synthesis in systematic reviews. A Prod ESRC Methods Program Vers 1:92
Aromataris E, Fernandez R, Godfrey CM, Holly C, Khalil H, Tungpunkom P (2015) Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. JBI Evid Implement 13(3):132–140
Pieper D, Antoine SL, Mathes T, Neugebauer EAM, Eikermann M (2014) Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol 67(4):368–375
Higgins JPT, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539–1558
Review Manager (RevMan) (2020) The cochrane collaboration
Kane P, Garber J (2004) The relations among depression in fathers, children’s psychopathology, and father–child conflict: a meta-analysis. Clin Psychol Rev 24(3):339–360
Ayano G, Maravilla JC, Alati R (2019) Risk of autistic spectrum disorder in offspring with parental mood disorders: a systematic review and meta-analysis. J Affect Disord 248:185–197
Goodday SM, Shuldiner J, Bondy S, Rhodes AE (2019) Exposure to parental psychopathology and offspring’s risk of suicide-related thoughts and behaviours: a systematic review. Epidemiol Psychiatric Sci 28(2):179–190
Spry EA, Aarsman SR, Youssef GJ, Patton GC, Macdonald JA, Sanson A et al (2020) Maternal and paternal depression and anxiety and offspring infant negative affectivity: a systematic review and meta-analysis. Dev Rev 58:100934
Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M et al (2014) Effects of perinatal mental disorders on the fetus and child. Lancet 384(9956):1800–1819
Cui C, Li M, Yang Y, Liu C, Cao P, Wang L (2020) The effects of paternal perinatal depression on socioemotional and behavioral development of children: a meta-analysis of prospective studies. Psychiatry Res 284:112775
Skari H, Skreden M, Malt UF, Dalholt M, Ostensen AB, Egeland T et al (2002) Comparative levels of psychological distress, stress symptoms, depression and anxiety after childbirth—a prospective population-based study of mothers and fathers. BJOG Int J Obstet and Gynaecol 109(10):1154–1163
Demontigny F, Girard ME, Lacharité C, Dubeau D, Devault A (2013) Psychosocial factors associated with paternal postnatal depression. J Affect Disord 150(1):44–49
Wilmshurst L (2004) Child and adolescent psychopathology: a casebook. SAGE, Newcastle upon Tyne, p 326
Lahey BB, Applegate B, Waldman ID, Loft JD, Hankin BL, Rick J (2004) The structure of child and adolescent psychopathology: generating new hypotheses. J Abnorm Psychol 113(3):358–385
Jami ES, Hammerschlag AR, Bartels M, Middeldorp CM (2021) Parental characteristics and offspring mental health and related outcomes: a systematic review of genetically informative literature. Transl Psychiatry 11(1):1–38
Kim JY, Son MJ, Son CY, Radua J, Eisenhut M, Gressier F et al (2019) Environmental risk factors and biomarkers for autism spectrum disorder: an umbrella review of the evidence. Lancet Psychiatry 6(7):590–600
Cogley C, O’Reilly H, Bramham J, Downes M (2021) A systematic review of the risk factors for autism spectrum disorder in children born preterm. Child Psychiatry Hum Dev 52(5):841–855
Choi CS, Gonzales EL, Kim KC, Yang SM, Kim JW, Mabunga DF et al (2016) The transgenerational inheritance of autism-like phenotypes in mice exposed to valproic acid during pregnancy. Sci Rep 6:36250
Balachandar V, Mahalaxmi I, Neethu R, Arul N, Abhilash VG (2022) New insights into epigenetics as an influencer: an associative study between maternal prenatal factors in autism spectrum disorder (ASD). Neurol Perspect 2(2):78–86
Rai D, Lee BK, Dalman C, Golding J, Lewis G, Magnusson C (2013) Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study. BMJ 346:f2059
Sohr-Preston SL, Scaramella LV (2006) Implications of timing of maternal depressive symptoms for early cognitive and language development. Clin Child Fam Psychol Rev 9(1):65–83
Buss C, Davis EP, Muftuler LT, Head K, Sandman CA (2010) High pregnancy anxiety during mid-gestation is associated with decreased gray matter density in 6–9-year-old children. Psychoneuroendocrinology 35(1):141–153
Lebel C, Walton M, Letourneau N, Giesbrecht GF, Kaplan BJ, Dewey D (2016) Prepartum and postpartum maternal depressive symptoms are related to children’s brain structure in preschool. Biol Psychiat 80(11):859–868
Conti-Ramsden G, Durkin K (2012) Postschool educational and employment experiences of young people with specific language impairment. Lang Speech Hear Serv Sch 43(4):507–520
Weitzman M, Rosenthal DG, Liu YH (2011) Paternal depressive symptoms and child behavioral or emotional problems in the United States. Pediatrics 128(6):1126–1134
Winstanley M, Webb RT, Conti-Ramsden G (2018) More or less likely to offend? Young adults with a history of identified developmental language disorders. Int J Lang Commun Disord 53(2):256–270
Sawyer SM, Azzopardi PS, Wickremarathne D, Patton GC (2018) The age of adolescence. Lancet Child Adolesc Health 2(3):223–228
Fisher SD (2016) Paternal mental health: Why is it relevant? Am J Lifestyle Med 11(3):200–211
Mezulis AH, Hyde JS, Clark R (2004) Father involvement moderates the effect of maternal depression during a child’s infancy on child behavior problems in kindergarten. J Fam Psychol 18(4):575–588
Fisher SD, Brock RL, O’Hara MW, Kopelman R, Stuart S (2015) Longitudinal contribution of maternal and paternal depression to toddler behaviors: Interparental conflict and later depression as mediators. Couple Fam Psychol Res Practice 4(2):61–73
Ramchandani PG, Stein A, Evans J, O’Connor TG, Team AS (2005) Paternal depression in the postnatal period and child development: a prospective population study. Lancet 365(9478):2201–2205
Ramchandani PG, Psychogiou L (2009) Paternal psychiatric disorders and children’s psychosocial development. Lancet 374(9690):646–653
England MJ, Sim LJ (2009) National Research council (US) and institute of medicine (US) committee on depression parenting practices. associations between depression in parents and parenting, child health, and child psychological functioning. depression in parents, parenting, and children: opportunities to improve identification, treatment, and prevention. National Academies Press: Washington
Baum N, Rahav G, Sharon M (2014) Heightened susceptibility to secondary traumatization: a meta-analysis of gender differences. Am J Orthopsychiatry 84(2):111–122
Benenson JF, Gauthier E, Markovits H (2021) Girls exhibit greater empathy than boys following a minor accident. Sci Rep 11(1):7965
De Santis KK, Lorenz RC, Lakeberg M, Matthias K (2021) The application of AMSTAR2 in 32 overviews of systematic reviews of interventions for mental and behavioural disorders: a cross-sectional study. Res Synth Methods 13:924747
Cooper C, Bebbington PE, Meltzer H, Bhugra D, Brugha T, Jenkins R et al (2008) Depression and common mental disorders in lone parents: results of the 2000 national psychiatric morbidity survey. Psychol Med 38(3):335–342
Chhabra J, McDermott B, Li W (2020) Risk factors for paternal perinatal depression and anxiety: a systematic review and meta-analysis. Psychol Men Masc 21(4):593–611
Meltzer H, Gatward R, Goodman R, Ford T (2003) Mental health of children and adolescents in Great Britain. Int Rev Psychiatry 15(1–2):185–187
Kinge JM, Øverland S, Flatø M, Dieleman J, Røgeberg O, Magnus MC et al (2021) Parental income and mental disorders in children and adolescents: prospective register-based study. Int J Epidemiol 50(5):1615–1627
ENOC (2018) Child and adolescent mental health in Europe. European Network of Ombudspersons for Children, Dubai
Allen L, Kelly BB (2015) committee on the science of children birth to age 8: deepening and broadening the foundation for success; board on children, youth, and families; institute of medicine national research council. child development and early learning. transforming the workforce for children birth through age 8: a unifying foundation. National Academies Press: Washington
Johansson M, Benderix Y, Svensson I (2020) Mothers’ and fathers’ lived experiences of postpartum depression and parental stress after childbirth: a qualitative study. Int J Qual Stud Health Well Being 15(1):1722564
Pedersen SC, Maindal HT, Ryom K (2021) “I Wanted to be there as a father, but i couldn’t”: a qualitative study of fathers’ experiences of postpartum depression and their help-seeking behavior. Am J Men’s Health 15(3):15579883211024376
OECD. Parental leave: where are the fathers? OECD Family Database; 2021. https://www.oecd.org/els/soc/PF2_1_Parental_leave_systems.pdf
Nielsen L (2014) Shared Physical Custody: Summary of 40 studies on outcomes for children. J Divorce Remarriage 55(8):613–635
Wade TJ, Veldhuizen S, Cairney J (2011) Prevalence of psychiatric disorder in lone fathers and mothers: examining the intersection of gender and family structure on mental health. Can J Psychiat 56(9):567–573
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HS and JvdW conceived and designed the study. HS, JvdW and SM contributed to the database preparation and interpretation of the data. HS and SM conducted data analyses and assessed review quality using AMSTAR-2 and GRADE. HS drafted the manuscript. All authors critically reviewed and revised the manuscript and approved the final manuscript for publication.
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Scarlett, H., Moirangthem, S. & van der Waerden, J. The impact of paternal mental illness on child development: an umbrella review of systematic reviews and meta-analyses. Eur Child Adolesc Psychiatry (2023). https://doi.org/10.1007/s00787-023-02261-1
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DOI: https://doi.org/10.1007/s00787-023-02261-1