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ABSTRACT: To examine incidence, trends, and correlates of parental depression in primary care from 0 to 12 years of child age.
Prospective cohort study.
Primary care records from more than 350 general practices in The Health Improvement Network database from 1993 to 2007.
A total of 86 957 mother, father, and child triads identified in The Health Improvement Network database by linking mothers and babies and then identifying an adult household man. Depressed parents were identified using Read code entries for depression and antidepressant prescriptions.
Child age, parental age at the birth, and area deprivation quintile.
Incidence rates for maternal and paternal episodes of depression.
Overall incidences of depression from the birth of the child up to age 12 years were 7.53 per 100 person-years for mothers and 2.69 per 100 person-years for fathers. Depression was highest in the first year post partum (13.93 and 3.56 per 100 person-years among mothers and fathers, respectively). By 12 years of child age, 39% of mothers and 21% of fathers had experienced an episode of depression. A history of depression, lower parental age at the birth of the child, and higher social deprivation were associated with a higher incidence of parental depression.
Parents are at highest risk for depression in the first year after the birth of their child. Parents with a history of depression, younger parents, and those from deprived areas are particularly vulnerable to depression. There is a need for appropriate recognition and management of parental depression in primary care.
Archives of pediatrics & adolescent medicine 11/2010; 164(11):1038-44. · 3.73 Impact Factor
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ABSTRACT: This paper demonstrates how compilation of medical and drug code lists for outcomes or exposures of interest for studies using primary care databases can be carried out efficiently using Stata. Use of Stata do-files to record and execute the commands provides good documentation and ease of replication of the procedure.
Pharmacoepidemiology and Drug Safety 06/2009; 18(8):704-7. · 2.53 Impact Factor
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ABSTRACT: It is well established that maternal depression is associated with enhanced child consultation for developmental and behaviour problems, but there is a dearth of research on paternal depression and child outcome.
To assess the association of major paternal depressed mood and child consultation for developmental and behaviour problems.
Cross-sectional study.
General practices in London and Hertfordshire, UK.
Fathers of children aged 4-6 years were recruited via 13 general practices. A sample of 248 biological father and mother dyads completed measures on depressive syndrome (Patient Health Questionnaire), child consultations with health professionals for developmental and behaviour problems, fathering, couple relationship quality, alcohol misuse, other psychiatric impairment, and sociodemographic factors.
Eight out of 248 fathers (3%) had a major depressive syndrome. Sixty-five out of 247 (26%) fathers reported they were responsible for taking their child to see the doctor at least half the time compared with mothers. Children of fathers with a major depressive syndrome were almost nine times more likely to have consulted a health professional for speech and language problems (adjusted odds ratio [OR] = 8.67, 95% confidence interval [CI] = 1.99 to 37.67, P = 0.004) and seven times more likely to have consulted for externalising behaviour problems (adjusted OR = 6.98, 95% CI = 1.00 to 48.76, P = 0.05).
Children of fathers with major depression were more likely to consult for speech and language problems and externalising behaviour problems. A longitudinal study is recommended to identify causal mechanisms.
British Journal of General Practice 04/2009; 59(560):180-5. · 1.83 Impact Factor
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ABSTRACT: Maternal depression is associated with adverse child development, however little is known about paternal depression and child outcome. The aim of this study was to estimate the prevalence of paternal depression and assess its association with abnormal child behaviours among 4- 6-year-olds. Parents of 4- 6-years-olds were recruited via general practices and completed measures on child behaviour (Strengths and Difficulties Questionnaire), depression (Patient Health Questionnaire), and other covariates. The association of major and other paternal depressive syndrome with mother reported child behaviour was analysed. Eight percent (29/365) of fathers had depression (3.3 and 4.77% a major and other depressive syndrome, respectively). Major but not other paternal depressive syndrome was associated with an 8 and 36 times greater likelihood of child prosocial behaviour problems and peer problems respectively.
European Child & Adolescent Psychiatry 04/2008; 17(5):306-15. · 2.82 Impact Factor
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ABSTRACT: To date there has been no comparison of father and mother report on the Strengths and Difficulties Questionnaire (SDQ), a standardised measure of child behaviour used widely in the UK in clinical practice and research. The objectives of the study were to investigate differences and agreement between parents on the various SDQ domains of child behaviour. Parents of 4-6 years olds were recruited via 13 UK general practices, and completed the SDQ and measures on depression, parenting, couple relationship, alcohol use and demographics. Parental SDQ ratings were compared. The SDQ was completed by 248 parent dyads. Mother and father ratings were correlated, however fathers reported higher mean scores than mothers for externalising behaviours. Higher reporting by fathers was related to alcohol misuse, the couple relationship, fathering, and father employment. Fathers did not report significantly more abnormal behaviours than mothers except for hyperactivity. There was high interparental agreement on normal/borderline behaviours (94.8-98.3% agreement), but lower agreement on abnormal behaviours (7.7-37.9%). There was higher interparental agreement on male rather than female children, but fathers were four times more likely to report hyperactivity among their boys compared with girls. Using combined parental reports in clinical settings would enhance the sensitivity of identifying children requiring clinical attention for their problem behaviours.
Child Psychiatry and Human Development 03/2008; 39(4):399-413. · 1.93 Impact Factor
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ABSTRACT: Fathers are underrepresented in research on mental health and child outcome. We tested a range of methods of recruitment of fathers to establish feasibility and recruitment rates to obtain a sample for a study on paternal depression and child development. The study took place in North London. Fathers of children aged 6 years and under were approached via: general practice surgeries by post and by face-to-face contact with attendees; child health surveillance clinics face-to-face or via their partners and via hospital postnatal wards face-to-face or by post. Researcher time and associated costs were monitored for each method, and symptoms of depression and anxiety measured using the Hospital Anxiety and Depression Scale (HADS). Face-to-face recruitment of fathers on the postnatal ward generated the highest return rate of HADS (28/37; 76%), followed by postal recruitment through general practice (41%;124/303). Lower response rates were observed with postal recruitment via postnatal wards (31%), recruitment in child health surveillance clinics (20%) and approaching attendees in general practice (16%). Twelve percent (23/194) and 30% (58/194) of fathers respectively reported depression and anxiety above the cut-off for case-definition. Costs were calculated on pro-rata researcher time. Costs of recruiting one participant ranged from 3 pounds sterling (general practice postal) to 11.75 pounds sterling (child health surveillance clinics), however the general practice attender method was disproportionately expensive (52.50 pounds sterling). This feasibility study shows that it is possible to recruit fathers to mental health studies and provides clear guidance on planning, costing and the expected levels of recruitment for future studies on fathers of young children.
Child Psychiatry and Human Development 02/2006; 36(3):295-309. · 1.93 Impact Factor
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ABSTRACT: Maternal depression is associated with adverse child development, but little is known about the effects of paternal depression. This pilot study estimated the prevalence of paternal depression and mood state, and assessed the relationship between paternal mood and infant temperament. The participants in the study were 98 fathers of newborn babies. Fathers were initially screened for depressed mood (Hospital anxiety and depression scale, and Edinburgh postnatal depression scale), and at 6 months parental mood, infant temperament, couple relationship quality, alcohol use, adverse life events, parenting, and demographics were recorded. Infant fussiness was analysed in relation to paternal mood and other contextual factors using multiple regression. Of the 98 fathers, 48 (49%) completed depression-screening measures. Of these 48 fathers, 4 (8%) reported depressive symptoms above the cut-off for case definition. A total of 48% (N=19) completed measures at follow-up. In the adjusted model, higher paternal depression scores, more traditional attitudes towards fathering, and increased recent life events were related to higher infant fussiness scores; and better couple relationship quality was related to lower fussiness scores. This study showed that 1 in 12 fathers had depressed mood, and lower mood was associated with negative infant temperament. Since the findings of this feasibility study were based on a small sample size the association of paternal mood and child development merits further study using a larger sample of fathers.
British Journal of Developmental Psychology 11/2005; 23(4):609-21. · 1.57 Impact Factor
