Prevalence of postnatal psychiatric morbidity in mothers and fathers.
TL;DR: The hypothesis that different aetiological factors would be important in brief and persistent disorders in mothers was upheld and mothers had a significantly higher prevalence of psychiatric ‘caseness’ at both six weeks and six months postpartum than fathers.
Abstract: In the first study to systematically examine postnatal depression in fathers, we examined depression in 200 postnatal couples, using a two-stage design. The prevalence of depression ascertained by the 13-item Edinburgh Postnatal Depression Scale (EPDS), using a cut-off score for 'caseness' of 13 or more in an unselected postnatal sample, was 27.5% in mothers at six weeks postpartum, 25.7% in mothers at six months postpartum, 9.0% in fathers at six weeks postpartum, and 5.4% in fathers at six months postpartum. The prevalence did not differ significantly in either mothers or fathers from a control group of parents with children between three and five years of age. As expected, mothers had a significantly higher prevalence of psychiatric 'caseness' at both six weeks and six months postpartum than fathers. Fathers were significantly more likely to be cases if their partners were also cases. The hypothesis that different aetiological factors would be important in brief and persistent disorders in mothers was upheld.
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TL;DR: The average prevalence rate of non-psychotic postpartum depression based on the results of a large number of studies is 13% as discussed by the authors, and the average prevalence estimates are affected by the nature of the assessment method.
Abstract: The average prevalence rate of non-psychotic postpartum depression based on the results of a large number of studies is 13%. Prevalence estimates are affected by the nature of the assessment method...
3,004 citations
TL;DR: Results confirmed findings of an earlier meta-analysis and in addition revealed four new predictors of postpartum depression: self-esteem, marital status, socioeconomic status, and unplanned/unwanted pregnancy.
Abstract: Background Approximately 13% of women experience postpartum depression. Early recognition is one of the most difficult challenges with this mood disorder because of how covertly it is suffered. Objectives The purpose of this meta-analysis was to update the findings of an earlier meta-analysis of postpartum depression predictors that had synthesized the results of studies conducted mostly in the 1980s. Method A meta-analysis of 84 studies published in the decade of the 1990s was conducted to determine the magnitude of the relationships between postpartum depression and various risk factors. Using the software system Advanced Basic Meta-Analysis, effect sizes were calculated three ways: unweighted, weighted by sample size, and weighted by quality index score. Results Thirteen significant predictors of postpartum depression were revealed. Ten of the 13 risk factors had moderate effect sizes while three predictors had small effect sizes. The mean effect size indicator ranges for each risk factor were as follows: prenatal depression (.44 to .46), self esteem (.45 to. 47), childcare stress (.45 to .46), prenatal anxiety (.41 to .45), life stress (.38 to .40), social support (.36 to .41), marital relationship (.38 to .39), history of previous depression (.38 to .39), infant temperament (.33 to .34), maternity blues (.25 to .31), marital status (.21 to .35), socioeconomic status (.19 to .22), and unplanned/unwanted pregnancy (.14 to .17). Conclusions Results confirmed findings of an earlier meta-analysis and in addition revealed four new predictors of postpartum depression: self-esteem, marital status, socioeconomic status, and unplanned/unwanted pregnancy.
1,822 citations
01 Feb 2005
TL;DR: Although many screening instruments have been developed or modified to detect major and minor depression in pregnant and newly delivered women, the evidence on their screening accuracy relative to a reference standard has yet to be systematically reviewed and assessed.
Abstract: Depression is the leading cause of diseaserelated disability among women. In particular, women of childbearing age are at high risk for major depression. Pregnancy and new motherhood may increase the risk of depressive episodes. Depression during the perinatal period can have devastating consequences, not only for the women experiencing it but also for the women’s children and family. Perinatal depression encompasses major and minor depressive episodes that occur either during pregnancy or within the first 12 months following delivery. When referring to depression in this population, researchers and clinicians frequently have not been clear about whether they are referring to major depression alone or to both major and minor depression. Major depression is a distinct clinical syndrome for which treatment is clearly indicated, whereas the definition and management of minor depression are less clear. In this report, we refer to major depression alone by identifying it discretely as major depression. Minor depression is an impairing, yet less severe, constellation of depressive symptoms for which controlled trials have not consistently indicated whether or not particular interventions are more effective than placebo. In this report, we refer to this grouping as major or minor depression or by the more general terms “depression” or “depressive illness.” Perinatal depression, whether one is referring to major depression alone or to either major or minor depression, often goes unrecognized because many of the discomforts of pregnancy and the puerperium are similar to symptoms of depression. Another mental disorder that can occur in the perinatal period is postpartum psychosis. Unlike postpartum depression, postpartum psychosis is a relatively rare event with a range of estimated incidence of 1.1 to 4.0 cases per 1,000 deliveries. The onset of postpartum psychosis is usually acute, within the first 2 weeks of delivery, and appears to be more common in women with a strong family history of bipolar or schizoaffective disorder. Postpartum psychosis is an important disorder in its own right, but it is not addressed specifically in this report. The precise level of the prevalence and incidence of perinatal depression is uncertain. Published estimates of the rate of major and minor depression in the postpartum period range widely—from 5 percent to more than 25 percent of new mothers, depending on the assessment method, the timing of the assessment, and population characteristics. In addition, although many screening instruments have been developed or modified to detect major and minor depression in pregnant and newly delivered women, the evidence on their screening accuracy relative to a reference standard has yet to be systematically reviewed and assessed. Evidence on the effectiveness of screening all pregnant women and providing a preventive intervention to those scoring at high risk has not been systematically investigated and evaluated either. To address these gaps, the Agency for Healthcare Research and Quality (AHRQ), in collaboration with the Safe Motherhood Group (SMG), commissioned this evidence report from the RTI International-University of North Carolina’s (RTI-UNC’s) Evidence-based Practice Center (EPC) for a systematic review of the evidence on three questions related to perinatal depression. These questions address the prevalence and incidence of perinatal depression, the accuracy of screening instruments for Evidence Report/Technology Assessment Number 119
1,418 citations
Cites methods from "Prevalence of postnatal psychiatric..."
...For our analysis of the accuracy of screening tools (KQ 2), we identified 10 studies reporting test characteristics for English-language screeners.(27,40,42,50-56) In general, studies were of fair to good quality, although external validity was only poor to fair....
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TL;DR: Prenatal and postpartum depression was evident in about 10% of men in the reviewed studies and was relatively higher in the 3- to 6-month post partum period, and paternal depression showed a moderate positive correlation with maternal depression.
Abstract: Context It is well established that maternal prenatal and postpartum depression is prevalent and has negative personal, family, and child developmental outcomes. Paternal depression during this period may have similar characteristics, but data are based on an emerging and currently inconsistent literature. Objective To describe point estimates and variability in rates of paternal prenatal and postpartum depression over time and its association with maternal depression. Data Sources Studies that documented depression in fathers between the first trimester and the first postpartum year were identified through MEDLINE, PsycINFO, EMBASE, Google Scholar, dissertation abstracts, and reference lists for the period between January 1980 and October 2009. Study Selection Studies that reported identified cases within the selected time frame were included, yielding a total of 43 studies involving 28 004 participants after duplicate reports and data were excluded. Data Extraction Information on rates of paternal and maternal depression, as well as reported paternal-maternal depressive correlations, was extracted independently by 2 raters. Effect sizes were calculated using logits, which were back-transformed and reported as proportions. Random-effects models of event rates were used because of significant heterogeneity. Moderator analyses included timing, measurement method, and study location. Study quality ratings were calculated and used for sensitivity analysis. Publication bias was evaluated with funnel plots and the Egger method. Data Synthesis Substantial heterogeneity was observed among rates of paternal depression, with a meta-estimate of 10.4% (95% confidence interval [CI], 8.5%-12.7%). Higher rates of depression were reported during the 3- to 6-month postpartum period (25.6%; 95% CI, 17.3%-36.1%). The correlation between paternal and maternal depression was positive and moderate in size (r = 0.308; 95% CI, 0.228-0.384). No evidence of significant publication bias was detected. Conclusions Prenatal and postpartum depression was evident in about 10% of men in the reviewed studies and was relatively higher in the 3- to 6-month postpartum period. Paternal depression also showed a moderate positive correlation with maternal depression.
1,122 citations
TL;DR: Consideration of postpartum depression in fathers as well as mothers, and consideration of co-occurrence of depression in couples, is an important next step in research and practice involving childbearing families.
Abstract: Background. Much attention has been paid to the problem of postpartum depression in women. However, there is some indication that men also experience depression after the birth of a child, and that paternal depression is linked to maternal depression.
Aims. The purpose of this integrative review was to examine current knowledge about postpartum depression in fathers. Specific aims were (1) to examine the incidence of paternal depression in the first year after the birth of a child, (2) to identify the characteristics and predictors of paternal postpartum depression, (3) to describe the relationship between maternal and paternal postpartum depression, and (4) to discuss the influence of paternal depression on the family and infant.
Methods. A literature search from 1980 to 2002 was carried out using the CINAHL, PsychInfo, and Medline electronic databases. Twenty research studies were identified that included incidence rates of paternal depression during the first year postpartum. These were further examined and synthesized regarding onset, severity, duration, and predictors of paternal depressive symptoms, and for information about the relationship between maternal and paternal depression.
Findings. During the first postpartum year, the incidence of paternal depression ranged from 1·2% to 25·5% in community samples, and from 24% to 50% among men whose partners were experiencing postpartum depression. Maternal depression was identified as the strongest predictor of paternal depression during the postpartum period. The implications of parental depression for family health were discussed.
Conclusions. Postpartum depression in men is a significant problem. The strong correlation of paternal postpartum depression with maternal postpartum depression has important implications for family health and well-being. Consideration of postpartum depression in fathers as well as mothers, and consideration of co-occurrence of depression in couples, is an important next step in research and practice involving childbearing families.
612 citations
References
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TL;DR: The development and initial reliability studies of a set of specific diagnostic criteria for a selected group of functional psychiatric disorders, the Research Diagnostic Criteria (RDC), indicate high reliability for diagnostic judgments made using these criteria.
Abstract: • A crucial problem in psychiatry, affecting clinical work as well as research, is the generally low reliability of current psychiatric diagnostic procedures. This article describes the development and initial reliability studies of a set of specific diagnostic criteria for a selected group of functional psychiatric disorders, the Research Diagnostic Criteria (RDC). The RDC are being widely used to study a variety of research issues, particularly those related to genetics, psychobiology of selected mental disorders, and treatment outcome. The data presented here indicate high reliability for diagnostic judgments made using these criteria.
6,238 citations
TL;DR: This measurement and classification of psychiatric symptoms, it will really give you the good idea to be successful.
Abstract: By reading, you can know the knowledge and things more, not only about what you get from people to people. Book will be more trusted. As this measurement and classification of psychiatric symptoms, it will really give you the good idea to be successful. It is not only for you to be success in certain life you can be successful in everything. The success can be started by knowing the basic knowledge and do actions.
2,617 citations
TL;DR: Postnatal depression had no effect on general cognitive and language development, but appeared to make infants more vulnerable to adverse effects of lower social class and male gender.
Abstract: A large sample of primiparous women was screened for depression after childbirth. Those identified as depressed, women with a previous history of depression and a control group were followed up to 18 months, when their infants were assessed on measures of cognitive, social and behavioral development. Infants of postnatally depressed mothers performed worse on object concept tasks, were more insecurely attached to their mothers and showed more mild behavioural difficulties. Postnatal depression had no effect on general cognitive and language development, but appeared to make infants more vulnerable to adverse effects of lower social class and male gender.
1,040 citations
"Prevalence of postnatal psychiatric..." refers background in this paper
...Furthermore, the items omitted from the 13-item scale to construct the 10-item scale are concerned with irritability and the mother-infant relationship, both being common and important facets of postnatal emotional disorders in mothers (Janssen, 1964; Murray, 1992)....
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TL;DR: Bereavement and preterm birth were the only life events to relate with the onset of depression and bereavement had a greater impact during pregnancy, and depressed mothers were more likely to express negative or mixed feelings about their three-month-old babies.
Abstract: A group of first-time mothers (119) were interviewed repeatedly at fixed intervals during their pregnancies and until their babies were a year old; they were then followed up at four years. A similar investigation was carried out on 38 other primiparae and 39 multiparae, but only postnatally. The incidence of depressive neurosis rose significantly in early pregnancy and in the first three months after delivery (10 per cent and 14 per cent of the main sample respectively). Subjects mainly suffered either from antenatal or postnatal depression, not both. Marital conflict and severe doubts about having the baby were associated with depression at either time. Bereavement and preterm birth were the only life events to relate with the onset of depression and bereavement had a greater impact during pregnancy. Depressed mothers were more likely to express negative or mixed feelings about their three-month-old babies. Many who had become depressed for the first time in their lives continued to experience psychological problems for up to four years after childbirth.
1,015 citations
"Prevalence of postnatal psychiatric..." refers background in this paper
...The samples have not generally been representative of new mothers in the community, with a bias towards the inclusion of married subjects largely from social classes I, II and III (Kumar & Robson, 1984; Murray, 1989)....
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...…of Psychiatry (1994), 164, 782—788 A new era of studies investigating postnatal depression has resulted in prevalence estimates of between 10 and 20% (Pitt, 1968; Paykel et a!, 1980; Cox et a!, 1982; Kumar & Robson, 1984; O'Hara et a!, 1984; Watson el a!, 1984; Nott, 1987; Cooper el a!, 1988)....
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...as parity (Grossman et a!, 1980; Nott, 1987), life events (Paykel eta!, 1980; Cooper & Stein, 1989) and maternal age (Kumar & Robson, 1984; Nott, 1987) the evidence is equivocal....
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...…suggests the importance of a history of depression (Paykel et a!, 1980; O'Hara Ct a!, 1984; Nott, 1989), marital dis harmony (Paykel et al, 1980; Kumar & Robson, 1984; Nott, 1987) and social adversity (Cooper & Stein, 782 Prevalence of Postnatal Psychiatric Morbidity in Mothers and Fathers C.…...
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TL;DR: The Edinburgh Post-natal Depression Scale was validated on a community sample of 702 women at six weeks post-partum using Research Diagnostic Criteria for depression to offer improved guidelines for the use of the EPDS by the primary care team.
Abstract: The Edinburgh Post-natal Depression Scale (EPDS) was validated on a community sample of 702 women at six weeks post-partum using Research Diagnostic Criteria for depression. The estimates of sensitivity, specificity and positive predictive value, being based on a large random sample, offer improved guidelines for the use of the EPDS by the primary care team.
903 citations
"Prevalence of postnatal psychiatric..." refers result in this paper
...Murray & Carothers (1990) had rather less en couraging results with a validation study of the 10-itemEPDS on a community sample of 702 mothers at three months postpartum....
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