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Published in: BMC Pregnancy and Childbirth 1/2020

Open Access 01-12-2020 | Mood Disorders | Research article

Postpartum depression in mothers and fathers: a structural equation model

Authors: Zhizhou Duan, Yuanyuan Wang, Ping Jiang, Amanda Wilson, Yan Guo, Yongliang Lv, Xiaonan Yang, Renjie Yu, Shuilan Wang, Zhengyan Wu, Mengqing Xia, Guosheng Wang, Ye Tao, L Xiaohong, Ling Ma, Hong Shen, Jue Sun, Wei Deng, Yong Yang, Runsen Chen

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

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Abstract

Background

Post-partum depression (PPD) is a growing mental health concern worldwide. There is little evidence in the Chinese context of the relationship between paternal PPD and maternal PPD. Given the growing global concerns this relationship requires further exploration.

Methods

A survey was conducted with 950 total couples from March 2017 to December 2018. The study was conducted using a standardized questionnaire that included basic demographic information, information on the relationship between the mother-in-law and daughter-in-law, marital satisfaction (both maternal and paternal), and PPD symptoms. Structural Equation Modelling (SEM) analysis was used to explore the underlying mechanism for PPD symptoms in mothers and fathers.

Results

In 4.4% of the couples both the wife and the husband showed depressive symptoms. Maternal marital satisfaction showed a significant mediating effect on paternal PPD (B = -0.114, p < 0.01), and there was a direct effect of maternal PPD on paternal PPD (B = 0.31, p < 0.001).

Conclusions

This is the first study to investigate the possible correlation between maternal PPD, mother-in-law and daughter-in-law relationship satisfaction, maternal marital satisfaction, paternal marital satisfaction, and paternal PPD. It is important for future PPD interventions to target both maternal and paternal mental health, as well as the mechanisms identified that can lead to PPD.
Literature
1.
go back to reference O’Hara MW, McCabe JE. Postpartum depression: current status and future directions. Ann Rev Clin Psychol. 2013;9:379–407.CrossRef O’Hara MW, McCabe JE. Postpartum depression: current status and future directions. Ann Rev Clin Psychol. 2013;9:379–407.CrossRef
2.
go back to reference Xiong R, Deng A, Wan B, Liu Y. Prevalence and factors associated with postpartum depression in women from single-child families. Int J Gynaecol Obstet. 2018;141(2):194–9.CrossRef Xiong R, Deng A, Wan B, Liu Y. Prevalence and factors associated with postpartum depression in women from single-child families. Int J Gynaecol Obstet. 2018;141(2):194–9.CrossRef
3.
go back to reference Beardslee WR, Versage EM, Gladstone TR. Children of Affectively Ill Parents: A Review of the Past 10 Years. Journal of the American Academy of Child Adolescent Psychiatry. 1998;37(11):1134–41.CrossRef Beardslee WR, Versage EM, Gladstone TR. Children of Affectively Ill Parents: A Review of the Past 10 Years. Journal of the American Academy of Child Adolescent Psychiatry. 1998;37(11):1134–41.CrossRef
4.
go back to reference Paulson JF, Bazemore SD. Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. Jama. 2010;303(19):1961–9.CrossRef Paulson JF, Bazemore SD. Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. Jama. 2010;303(19):1961–9.CrossRef
5.
go back to reference Musser AK, Ahmed AH, Foli KJ, Coddington JA. Paternal Postpartum Depression: What Health Care Providers Should Know. Journal of Pediatric Health Care. 2013;27(6):479–85.CrossRef Musser AK, Ahmed AH, Foli KJ, Coddington JA. Paternal Postpartum Depression: What Health Care Providers Should Know. Journal of Pediatric Health Care. 2013;27(6):479–85.CrossRef
6.
go back to reference Brockington I. Postpartum psychiatric disorders. Lancet. 2004;363(9405):303–10.CrossRef Brockington I. Postpartum psychiatric disorders. Lancet. 2004;363(9405):303–10.CrossRef
7.
go back to reference Murray L, Halligan S. Postnatal depression and young children’s development. 2018. p. 172–86. . Murray L, Halligan S. Postnatal depression and young children’s development. 2018. p. 172–86. .
8.
go back to reference Ramchandani P, Stein A, Evans J, O’Connor TG. Paternal depression in the postnatal period and child development: a prospective population study. The Lancet. 2005;365(9478):2201–5.CrossRef Ramchandani P, Stein A, Evans J, O’Connor TG. Paternal depression in the postnatal period and child development: a prospective population study. The Lancet. 2005;365(9478):2201–5.CrossRef
9.
go back to reference Perez CF, Brahm MP. [Paternal postpartum depression: Why is it also important?]. Revista chilena de pediatria. 2017;88(5):582–5.CrossRef Perez CF, Brahm MP. [Paternal postpartum depression: Why is it also important?]. Revista chilena de pediatria. 2017;88(5):582–5.CrossRef
10.
go back to reference Edward K, Castle D, Mills C, Davis L, Casey J. An Integrative Review of Paternal Depression. American Journal of Men’s Health. 2014;9(1):26–34.CrossRef Edward K, Castle D, Mills C, Davis L, Casey J. An Integrative Review of Paternal Depression. American Journal of Men’s Health. 2014;9(1):26–34.CrossRef
11.
go back to reference Anding JE, Rohrle B, Grieshop M, Schucking B, Christiansen H. Couple comorbidity and correlates of postnatal depressive symptoms in mothers and fathers in the first two weeks following delivery. J Affect Disord. 2016;190:300–9.CrossRef Anding JE, Rohrle B, Grieshop M, Schucking B, Christiansen H. Couple comorbidity and correlates of postnatal depressive symptoms in mothers and fathers in the first two weeks following delivery. J Affect Disord. 2016;190:300–9.CrossRef
12.
go back to reference Nishimura A, Fujita Y, Katsuta M, Ishihara A, Ohashi K. Paternal postnatal depression in Japan: an investigation of correlated factors including relationship with a partner. BMC Pregnancy Childbirth. 2015;15:128.CrossRef Nishimura A, Fujita Y, Katsuta M, Ishihara A, Ohashi K. Paternal postnatal depression in Japan: an investigation of correlated factors including relationship with a partner. BMC Pregnancy Childbirth. 2015;15:128.CrossRef
13.
go back to reference Bergstrom M. Depressive symptoms in new first-time fathers: associations with age, sociodemographic characteristics, and antenatal psychological well-being. Birth (Berkeley, Calif). 2013;40(1):32–8. .CrossRef Bergstrom M. Depressive symptoms in new first-time fathers: associations with age, sociodemographic characteristics, and antenatal psychological well-being. Birth (Berkeley, Calif). 2013;40(1):32–8. .CrossRef
14.
go back to reference Serhan N, Ege E, Ayranci U, Kosgeroglu N. Prevalence of postpartum depression in mothers and fathers and its correlates. Journal of clinical nursing. 2013;22(1–2):279–84.CrossRef Serhan N, Ege E, Ayranci U, Kosgeroglu N. Prevalence of postpartum depression in mothers and fathers and its correlates. Journal of clinical nursing. 2013;22(1–2):279–84.CrossRef
15.
go back to reference Da Costa D, Zelkowitz P, Dasgupta K, Sewitch M, Lowensteyn I, Cruz R, Hennegan K, Khalife S. Dads Get Sad Too: Depressive Symptoms and Associated Factors in Expectant First-Time Fathers. Am J Mens Health. 2017;11(5):1376–84.CrossRef Da Costa D, Zelkowitz P, Dasgupta K, Sewitch M, Lowensteyn I, Cruz R, Hennegan K, Khalife S. Dads Get Sad Too: Depressive Symptoms and Associated Factors in Expectant First-Time Fathers. Am J Mens Health. 2017;11(5):1376–84.CrossRef
16.
go back to reference Goodman JH. Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. Journal of advanced nursing. 2004;45(1):26–35.CrossRef Goodman JH. Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. Journal of advanced nursing. 2004;45(1):26–35.CrossRef
17.
go back to reference Pinheiro RT, Magalhaes PV, Horta BL, Pinheiro KA, da Silva RA, Pinto RH. Is paternal postpartum depression associated with maternal postpartum depression? Population-based study in Brazil. Acta psychiatrica Scandinavica. 2006;113(3):230–2.CrossRef Pinheiro RT, Magalhaes PV, Horta BL, Pinheiro KA, da Silva RA, Pinto RH. Is paternal postpartum depression associated with maternal postpartum depression? Population-based study in Brazil. Acta psychiatrica Scandinavica. 2006;113(3):230–2.CrossRef
18.
go back to reference Koh YW, Lee AM, Chan CY, Fong DY, Lee CP, Leung KY, Tang CS. Survey on examining prevalence of paternal anxiety and its risk factors in perinatal period in Hong Kong: a longitudinal study. BMC Public Health. 2015;15:1131–45.CrossRef Koh YW, Lee AM, Chan CY, Fong DY, Lee CP, Leung KY, Tang CS. Survey on examining prevalence of paternal anxiety and its risk factors in perinatal period in Hong Kong: a longitudinal study. BMC Public Health. 2015;15:1131–45.CrossRef
19.
go back to reference Wang YY, Li H, Wang YJ, Wang H, Zhang YR, Gong L, Ma J, Wang Y, Wang MZ, Qiu SX, et al. Living with parents or with parents-in-law and postpartum depression: A preliminary investigation in China. J Affect Disord. 2017;218:335–8.CrossRef Wang YY, Li H, Wang YJ, Wang H, Zhang YR, Gong L, Ma J, Wang Y, Wang MZ, Qiu SX, et al. Living with parents or with parents-in-law and postpartum depression: A preliminary investigation in China. J Affect Disord. 2017;218:335–8.CrossRef
20.
go back to reference Cao H, Yuan X, Fine M, Zhou N, Fang X. Neuroticism and Marital Satisfaction During the Early Years of Chinese Marriage: The Mediating Roles of Marital Attribution and Aggression. Family process. 2019;58(2):478–95.CrossRef Cao H, Yuan X, Fine M, Zhou N, Fang X. Neuroticism and Marital Satisfaction During the Early Years of Chinese Marriage: The Mediating Roles of Marital Attribution and Aggression. Family process. 2019;58(2):478–95.CrossRef
21.
go back to reference Shih KY, Pyke K. Power, Resistance, and Emotional Economies in Women’s Relationships With Mothers-in-Law in Chinese Immigrant Families. J Fam Issues. 2010;31(3):333–57.CrossRef Shih KY, Pyke K. Power, Resistance, and Emotional Economies in Women’s Relationships With Mothers-in-Law in Chinese Immigrant Families. J Fam Issues. 2010;31(3):333–57.CrossRef
22.
go back to reference Top ED, Cetisli NE, Guclu S, Zengin EB. Paternal Depression Rates in Prenatal and Postpartum Periods and Affecting Factors. Arch Psychiatr Nurs. 2016;30(6):747–52.CrossRef Top ED, Cetisli NE, Guclu S, Zengin EB. Paternal Depression Rates in Prenatal and Postpartum Periods and Affecting Factors. Arch Psychiatr Nurs. 2016;30(6):747–52.CrossRef
23.
go back to reference Duan Z, Wang Y, Tao Y, Bower JL, Yu R, Wang S, Wu Z, Lv Y, Yang X, Li X. Relationship between trait neuroticism and suicidal ideation among postpartum women in China: Testing a mediation model. J Affect Disord. 2019;256:532–5.CrossRef Duan Z, Wang Y, Tao Y, Bower JL, Yu R, Wang S, Wu Z, Lv Y, Yang X, Li X. Relationship between trait neuroticism and suicidal ideation among postpartum women in China: Testing a mediation model. J Affect Disord. 2019;256:532–5.CrossRef
24.
go back to reference Lu L, Duan Z, Wang Y, Wilson A, Yang Y, Zhu L, Guo Y, Lv Y, Yang X, Yu R. Mental health outcomes among Chinese prenatal and postpartum women after the implementation of universal two-child policy. J Affect Disord. 2020;264:187–92.CrossRef Lu L, Duan Z, Wang Y, Wilson A, Yang Y, Zhu L, Guo Y, Lv Y, Yang X, Yu R. Mental health outcomes among Chinese prenatal and postpartum women after the implementation of universal two-child policy. J Affect Disord. 2020;264:187–92.CrossRef
25.
go back to reference Wang Y, Li X, Duan Z, Wilkinson MR, Yu R, Li S, Huang L, Guo Y, Ma L, Dong Q. Screening for postpartum hypomania among Chinese women after childbirth. Psychiatry Research-neuroimaging. 2019;282:112591–1.CrossRef Wang Y, Li X, Duan Z, Wilkinson MR, Yu R, Li S, Huang L, Guo Y, Ma L, Dong Q. Screening for postpartum hypomania among Chinese women after childbirth. Psychiatry Research-neuroimaging. 2019;282:112591–1.CrossRef
26.
go back to reference Hare-Mustin RT. China’s Marriage Law: a model for family responsibilities and relationships. Family process. 1982;21(4):477–81.CrossRef Hare-Mustin RT. China’s Marriage Law: a model for family responsibilities and relationships. Family process. 1982;21(4):477–81.CrossRef
27.
go back to reference Association WM. Declaration of Helsinki: ethical principles for medical research involving human subjects. 2008. . Association WM. Declaration of Helsinki: ethical principles for medical research involving human subjects. 2008. .
28.
go back to reference Ip P, Li TMH, Chan KL, Ting AYY, Chan CY, Koh YW, Ho FKW, Lee A. Associations of paternal postpartum depressive symptoms and infant development in a Chinese longitudinal study. Infant Behav Dev. 2018;53:81–9.CrossRef Ip P, Li TMH, Chan KL, Ting AYY, Chan CY, Koh YW, Ho FKW, Lee A. Associations of paternal postpartum depressive symptoms and infant development in a Chinese longitudinal study. Infant Behav Dev. 2018;53:81–9.CrossRef
29.
go back to reference Matthey S, Barnett B, Kavanagh DJ, Howie P. Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners. J Affect Disord. 2001;64(2–3):175–84.CrossRef Matthey S, Barnett B, Kavanagh DJ, Howie P. Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners. J Affect Disord. 2001;64(2–3):175–84.CrossRef
30.
go back to reference Wang Y, Guo X, Lau Y, Chan KS, Yin L, Chen J. Psychometric evaluation of the Mainland Chinese version of the Edinburgh Postnatal Depression Scale. International journal of nursing studies. 2009;46(6):813–23.CrossRef Wang Y, Guo X, Lau Y, Chan KS, Yin L, Chen J. Psychometric evaluation of the Mainland Chinese version of the Edinburgh Postnatal Depression Scale. International journal of nursing studies. 2009;46(6):813–23.CrossRef
31.
go back to reference Jia L, Ji FY, Wu J, Wang Y, Wu CQ. Paternal depressive symptoms during the early postpartum period and the associated factors following the implementation of the two-child policy in China. Arch Psychiatr Nurs. 2020;34(2):43–9.CrossRef Jia L, Ji FY, Wu J, Wang Y, Wu CQ. Paternal depressive symptoms during the early postpartum period and the associated factors following the implementation of the two-child policy in China. Arch Psychiatr Nurs. 2020;34(2):43–9.CrossRef
32.
go back to reference Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model. 1999;6(1):1–55.CrossRef Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model. 1999;6(1):1–55.CrossRef
33.
go back to reference Weston R, Gore PA. A Brief Guide to Structural Equation Modeling. The Counseling Psychologist. 2006;34(5):719–51.CrossRef Weston R, Gore PA. A Brief Guide to Structural Equation Modeling. The Counseling Psychologist. 2006;34(5):719–51.CrossRef
34.
go back to reference Wang T, Xu Y, Li Z, Chen L. [Prevalence of paternal postpartum depression in China and its association with maternal postpartum depression: A Meta-analysis]. Zhong nan da xue xue bao Yi xue ban = Journal of Central South University Medical sciences. 2016;41(10):1082–9.PubMed Wang T, Xu Y, Li Z, Chen L. [Prevalence of paternal postpartum depression in China and its association with maternal postpartum depression: A Meta-analysis]. Zhong nan da xue xue bao Yi xue ban = Journal of Central South University Medical sciences. 2016;41(10):1082–9.PubMed
35.
go back to reference Dudley M, Roy K, Kelk N, Bernard D. Psychological correlates of depression in fathers and mothers in the first postnatal year. Journal of Reproductive Infant Psychology. 2001;19(3):187–202.CrossRef Dudley M, Roy K, Kelk N, Bernard D. Psychological correlates of depression in fathers and mothers in the first postnatal year. Journal of Reproductive Infant Psychology. 2001;19(3):187–202.CrossRef
36.
go back to reference Gawlik S, Muller M, Hoffmann L, Dienes A, Wallwiener M, Sohn C, Schlehe B, Reck C. Prevalence of paternal perinatal depressiveness and its link to partnership satisfaction and birth concerns. Arch Women Ment Health. 2014;17(1):49–56.CrossRef Gawlik S, Muller M, Hoffmann L, Dienes A, Wallwiener M, Sohn C, Schlehe B, Reck C. Prevalence of paternal perinatal depressiveness and its link to partnership satisfaction and birth concerns. Arch Women Ment Health. 2014;17(1):49–56.CrossRef
Metadata
Title
Postpartum depression in mothers and fathers: a structural equation model
Authors
Zhizhou Duan
Yuanyuan Wang
Ping Jiang
Amanda Wilson
Yan Guo
Yongliang Lv
Xiaonan Yang
Renjie Yu
Shuilan Wang
Zhengyan Wu
Mengqing Xia
Guosheng Wang
Ye Tao
L Xiaohong
Ling Ma
Hong Shen
Jue Sun
Wei Deng
Yong Yang
Runsen Chen
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-03228-9

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