UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne University, INSERM, Paris, France.
UMS 011 Population-based Cohorts Unit, Paris Cité University, Paris Saclay University, Versailles Saint-Quentin-en-Yvelines University, INSERM, Paris, France.
J Affect Disord. 2024 Oct 1;362:363-374. doi: 10.1016/j.jad.2024.07.008. Epub 2024 Jul 8.
The arrival of one's first child is a known risk factor for mental illness, yet investigations on fathers' mental health are limited. We conducted a longitudinal investigation on paternal depression and anxiety in the nine years surrounding the transition to fatherhood.
Using a national cohort of French men (CONSTANCES, n = 6299), we investigated the prevalence and associated risk factors of mental illness amongst first-time fathers. Responses to the Center for Epidemiological Studies Depression (CES-D) and 12-item General Health Questionnaire (GHQ-12) scales were used to identify clinically significant symptom scores. Self-declared mental illness was also reported by participants. Group-based modelling was used to identify latent trajectory groups for both measures.
Levels of self-declared anxiety (averaging 4.9 % pre-fatherhood, 7.8 % post) exceeded that of depression (1.9 % pre- fatherhood, 3.3 % post) or other disorders. However, rates of clinically significant symptom scores (17-27 %) were consistently higher. Participants' mental health appeared to worsen from two-years prior to their child's arrival and improve from two-years after. We identified three trajectory groups for fathers' self-declared mental illness: Low stable (90.3 %); Low risk with high temporary increase (5.6 %); and Consistent high risk (4.1 %). Risk factors associated with worsening mental health trajectories were unemployment, not living with one's partner, having had adverse childhood experiences and foregoing healthcare due to financial reasons.
All measures of mental illness relied on participant self-reports and are thus subject to bias.
This study reveals an important period of heightened psychological vulnerability amongst first-time fathers, emphasising the need for increased and better adapted paternal mental health screening.
初为人父是精神疾病的已知风险因素，但对父亲心理健康的调查有限。我们对初为人父前后九年的父亲抑郁和焦虑情况进行了纵向调查。
我们利用法国男性的全国队列（CONSTANCES，n=6299），研究了初为人父者精神疾病的患病率及其相关危险因素。使用中心流行病学研究抑郁量表（CES-D）和 12 项一般健康问卷（GHQ-12）量表的回答来确定具有临床意义的症状评分。参与者还自我报告了精神疾病。使用基于群组的模型来确定这两种措施的潜在轨迹组。
自我报告的焦虑水平（初为人父前平均为 4.9%，初为人父后为 7.8%）高于抑郁（初为人父前为 1.9%，初为人父后为 3.3%）或其他疾病。然而，具有临床意义的症状评分率（17-27%）始终较高。参与者的心理健康状况似乎在孩子出生前两年恶化，在孩子出生后两年改善。我们确定了父亲自我报告的精神疾病的三种轨迹组：低稳定组（90.3%）；低风险高临时增加组（5.6%）；以及持续高风险组（4.1%）。与心理健康状况恶化轨迹相关的风险因素包括失业、与伴侣不住在一起、有不良的童年经历以及因经济原因而避免医疗保健。
所有精神疾病的衡量标准都依赖于参与者的自我报告，因此可能存在偏差。
这项研究揭示了初为人父者心理脆弱的重要时期，强调了需要增加和更好地适应父亲心理健康筛查的必要性。
