Mental health research has long focused on maternal depression as a risk factor for the development of psychopathology in children, but new research suggests that paternal depression should not be overlooked in children with behavioral or emotional problems.

Researchers from the NYU School of Medicine analyzed data from a sample of children, aged 5 to 17 years, using the Columbia Impairment Scale (CIS) to assess emotional or behavioral functioning of children and the Patient Health Questionnaire-2 (PHQ-2) to analyze maternal and paternal depressive symptoms. The Physical Component Scale (PCS) and Mental Component Scale (MCS) were used to investigate maternal and paternal physical and mental health. The study results were published online today in the December 2011 Pediatrics. The authors write:

This study, from a sample of 22,000 children and their mothers and fathers representative of the entire US population, demonstrates that living with fathers with depressive symptoms and other mental health problems is independently associated with increased rates of emotional or behavioral problems among school-aged children and adolescents. The ?ndings also indicate that the risks of child emotional or behavioral problems are much greater if mothers, rather than fathers, have such problems. Paternal mental health problems are independently associated with a 33 percent to 70 percent increased risk, depending on how assessed, whereas maternal mental health problems are associated with a 50 percent to 350 percent increased risk. Most striking, we believe, is the increase in child emotional or behavioral problems when both parents have such problems, with 25 percent of children living in such homes having behavioral or emotional problems.

“The paradigm needs to shift so burden is not always placed on the mother,” said lead author Michael Weitzman, M.D., over the phone. he went on to say that the role of the father needs to be considered when explicating the etiology or formulating approaches to behavioral or emotional problems in children. this may be especially important during a recession, as economic hardship may threaten a father’s perceived role as a provider and contribute to symptoms of depression, which are more likely to present as irritability, anger or substance use in men.

Limitations of this study include only sampling households with both a mother and father present, and using scales and questionnaires rather than diagnostic psychiatric interviews to assess for symptoms, making it difficult to generalize the results and stopping short of identifying specific emotional or behavioral problems in the children sampled.

In my clinical experience, most so-called ADHD children are not receiving sufficient attention from their fathers who are separated from the family, too preoccupied with work and other things, or otherwise impaired in their ability to parent. in many cases the appropriate diagnosis is Dad Attention Deficit Disorder (DADD). The ‘cure’ for these children is more rational and loving attention from their dads. Young people are nowadays so hungry for the attention of a father that it can come from any male adult. Seemingly impulsive, hostile groups of children will calm down when a caring, relaxed and firm adult male is around.

Many are quick to dismiss Dr. Breggin’s opinions as extreme, and by no means are all cases of childhood ADHD, anxiety or depression responsive to more emotionally or physically available fathers, but why does it seem inconvenient to consider it a possibility in some cases? What’s the downside to caregivers trying whatever they can, including treating their own depression or anxiety, to develop stable, loving relationships with their children?

The depression and anxiety experienced by many women after a miscarriage can continue for years, even after the birth of a healthy child, according to a study led by University of Rochester Medical Center researchers and published online today by the British Journal of Psychiatry.

“Our study clearly shows that the birth of a healthy baby does not resolve the mental health problems that many women experience after a miscarriage or stillbirth,” said Emma Robertson Blackmore, Ph.D., assistant professor of Psychiatry at the Medical Center and the lead researcher. “This finding is important because, when assessing if a women is at risk of antenatal or postnatal depression, previous pregnancy loss is usually not taken into account in the same way as other risk factors such as a family history of depression, stressful life events or a lack of social support.”

“We know that maternal depression can have adverse impacts on children and families,” Robertson Blackmore said. “If we offer targeted support during pregnancy to women who have previously lost a baby, we may be able to improve health outcomes for both the women and their children.”

Pregnancy loss by miscarriage or stillbirth affects more than an estimated one million women in the United States annually. Between 50 and 80 percent of women who experience pregnancy loss become pregnant again.

The researchers studied 13,133 pregnant women in the United Kingdom who were taking part in a long-term study known as the Avon Longitudinal Study of Parents and Children. The women were asked to report the number of previous miscarriages and stillbirths they had experienced. They were assessed for symptoms of depression and anxiety twice during their pregnancy and four times after giving birth, at 8 weeks, 8 months, 21 months and 33 months. The majority of women reported no miscarriages. But 2,823 women, or 21 percent, reported having one or more previous miscarriages, while 108 reported having one previous stillbirth and three women had two previous stillbirths.

“We found no evidence that affective symptoms associated with previous prenatal loss resolve with the birth of a healthy child. Rather, previous prenatal loss showed a persisting prediction of depressive and anxiety symptoms well after what would conventionally be defined as the postnatal period,” the researchers concluded.

Of the women who had one miscarriage or stillbirth before giving birth to a healthy child, for example, almost 13 percent still had symptoms of depression 33 months after the birth. of those with two previous losses, almost 19 percent had symptoms of depression 33 months after the birth of a healthy child.

Prenatal loss is not routinely considered a risk factor for antenatal or postpartum depression in the same way as, for instance, personal or family history of depression, exposure to stressful life events or lack of social support, according to the study. Routinely assessing loss history would be valuable as a predictor of current and postpartum risk and as a possible marker for intervention, the researcher.

“Given the adverse outcomes of persistent maternal depression on both child and family outcomes, early recognition of symptoms can lead to preventive interventions to reduce the burden of illness, provide coping strategies to reduce anxiety and depression and promote healthy adjustment of the mother, family and child,” the researchers stated.

more information: Robertson Blackmore E, Côté-Arsenault D, Tang W, Glover V, Evans J, Golding J and O’Connor TG. Previous prenatal loss as a predictor of perinatal depression and anxiety. British Journal of Psychiatry, ePub ahead of print 3 March 2011, doi: 10.1192/bjp.bp.110.083105

Provided by University of Rochester Medical Center (news : web)