Women and Children's Health Research Unit, The Gertner Institute for Epidemiology and Health Policy Research, Ltd. Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel.
Women and Children's Health Research Unit, The Gertner Institute for Epidemiology and Health Policy Research Ltd., Ramat Gan, Israel.
Perspect Public Health. 2019 Jul;139(4):195-198. doi: 10.1177/1757913918790597. Epub 2018 Jul 25.
This report aims to present a concise overview and synthesis of current research findings regarding paternal depression in the perinatal period.
A literature search was conducted, primarily via PubMed and PsychNET, for English-language research studies and meta-analyses using combinations of the terms 'perinatal', 'pregnancy', 'postpartum', 'depression' AND 'fathers' OR 'paternal'. Peer-reviewed articles were considered, and a representative sample of literature, with an emphasis on recent publications from a broad range of populations was summarized for each of the following sub-sections: prevalence, risk factors, impact on the infant/child, and healthcare costs.
Reported prevalence has ranged from 2.3% to 8.4%, with a significant degree of heterogeneity in rates, due to differences in multiple aspects of the methodology (timing, instruments, etc.). Nevertheless, rates of maternal depression remain higher than paternal depression, and higher rates of one are associated with higher rates of the other. The primary risk factors for paternal depression are maternal depression and the father's history of severe depression, or symptoms of depression or anxiety prenatally. Biological mechanisms may underlie paternal depression, with changes reported in testosterone, cortisol and prolactin levels during this period. Paternal depression has been related to children's behavioral, emotional and social function at 36 months and psychiatric disorders at 7 years, adjusting for maternal depression. Healthcare costs may also be impacted by paternal postpartum depression, with higher father-child dyad costs found after controlling for potential confounders.
Focusing on fathers' emotional well-being in the perinatal period is important in itself, as well as for their wives and children. Programs recommending screening for maternal perinatal mood and anxiety disorders should include inquiry regarding the father's emotional state, and if his distress is reported it should be clarified and followed-up by support and intervention as necessary.
本报告旨在对围产期父亲抑郁的当前研究结果进行简要概述和综合。
通过 PubMed 和 PsychNET 主要进行文献检索，使用“围产期”、“妊娠”、“产后”、“抑郁”和“父亲”或“父系”的组合术语搜索英文研究论文和荟萃分析。考虑了同行评议的文章，并对以下各小节中的每一个小节进行了总结，重点是来自广泛人群的最新出版物，以代表性的文献样本为代表：患病率、危险因素、对婴儿/儿童的影响和医疗保健费用。
报告的患病率从 2.3%到 8.4%不等，由于方法学的多个方面（时间、仪器等）的差异，发病率存在很大的异质性。然而，母亲的抑郁率仍然高于父亲的抑郁率，一种疾病的发病率较高与另一种疾病的发病率较高相关。父亲抑郁的主要危险因素是母亲的抑郁和父亲的严重抑郁史，或产前抑郁或焦虑的症状。生物学机制可能是父亲抑郁的基础，在此期间报告了睾丸激素、皮质醇和催乳素水平的变化。在调整母亲抑郁后，父亲抑郁与 36 个月时儿童的行为、情绪和社会功能以及 7 岁时的精神障碍有关。产后父亲抑郁也可能影响医疗保健费用，在控制潜在混杂因素后，发现父亲-子女对子的成本更高。
关注围产期父亲的情绪健康本身很重要，对其妻子和孩子也很重要。建议对产妇围产期情绪和焦虑障碍进行筛查的计划应包括询问父亲的情绪状态，如果报告其痛苦，应予以澄清，并根据需要提供支持和干预。
