Top Papers Of The Month

Screening for Paternal Depression at Well-Child Visits

Author:
Jessica Tomaszewski, MD
Primary Care Pediatrics, Nemours Children’s Health System, Wilmington, Delaware

Citation:
Tomaszewski J. Screening for paternal depression at well-child visits [published online August 28, 2018]. Consultant360.

Cheng ER, Downs SM, Carroll AE. Prevalence of depression among fathers at the pediatric well-child care visit [published online July 23, 2018]. JAMA Pediatr. doi:10.1001/jamapediatrics.2018.1505.

Guidelines from the American Academy of Pediatrics recommend that pediatricians screen parents for depression at well-child care visits,1 but studies that include screening for paternal depression have not been wide-reaching. A new study in JAMA Pediatrics indicates that paternal depression may occur with similar frequency to maternal depression in the postnatal period.

Cheng and colleagues analyzed data gathered from the Child Health Improvement Through Computer Automation (CHICA) system, a 20-item prescreening form (PSF) administered to parents prior to pediatric well visits for children aged 15 months or younger. Among the 20 items was a modified 3-item version of the Edinburgh Postnatal Depression Scale, an incredibly sensitive tool used to detect maternal depression in primary care. This questionnaire also identified who answered the PSF and who attended the visit. The CHICA system operates in 5 community health care centers in Indianapolis, Indiana. Most families attending CHICA clinics are covered by public insurance.

Parent responses were examined from 9572 clinic visits that occurred from August 1, 2016, through December 31, 2017. Fathers attended 2946 (30.8%) of these visits and were the PSF respondents at 806 visits (8.4%). Among the fathers who answered the PSF, 36 (4.4%) screened positive for depression. This percentage coincides with findings of previous studies.2 While the overall proportion of mothers who were primary respondents was higher, the number of mothers who screened positive for depression (273, or 5.0%) was fairly comparable to the number of fathers who screened positive for depression.

There is growing emphasis for the pediatrician to detect maternal postpartum depression, but fathers are not often included in this conversation. The comparable positive screens between mothers and fathers for depression seen in this study should encourage providers to address both parents in screening, and take a family-centered approach to care. Creating opportunities to detect postnatal depression in parents would help ensure overall improved health for the entire family.

References:

  1. Earls MF; American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010;126(5):1032-1039.
  2. Paulson JF, Bazemore SD. Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. JAMA. 2010;303(19):1961-1969.