Paternal postpartum depression's relationship to maternal pre and postpartum depression, and father-mother dyads marital satisfaction: A structural equation model analysis of a longitudinal study.

BACKGROUND: Fathers' depression is an understudied subject, and the increasing participation of fathers on the care of their children, this is an issue of great importance. This study aimed to determine the relationship of paternal postpartum depression with prenatal and postpartum depression of mothers and their marital satisfaction. METHODS: This longitudinal study was conducted among 352 expecting couples in 28-40 weeks of pregnancy and 6-8 weeks after delivery from April to September 2019. Eligible participants were selected from primary health care centers in northern Iran using a two-stage sampling method. Socio-demographic information, Edinburgh Postpartum Depression Scale, and ENRICH Couple Scale were used for data collection. The primary basis of data analysis was cross-lagged structural equation modeling to explore the underlying mechanism for paternal postpartum depression. RESULTS: The results showed that a) maternal prenatal depression indirectly (ßstand = 0.32, p = 0.004); b) maternal postpartum depression directly (ßstand = 0.56, p <0.001); c) paternal prenatal depression indirectly (ßstand = 0.11, p = 0.028) were associated with paternal postpartum depression. Also, marital satisfaction directly (ßstand = -0.19, p = 0.002) and indirectly (ßstand = -0.11, p = 0.007) had a relationship to paternal postpartum depression. LIMITATIONS: Culturally-sensitive measures of marital satisfaction, especially in conservative context of developing countries, along with self-reported data of psychological problems may lead to under-reported findings. CONCLUSION: The major contribution of marital satisfaction and maternal depression during prenatal period on the paternal postpartum depression, emphasizes on the prenatal period as the ideal time for fathers' mental health improvement.

Comparison of the Effects of Religious Cognitive Behavioral Therapy (RCBT), Cognitive Behavioral Therapy (CBT), and Sertraline on Depression and Anxiety in Patients after Coronary Artery Bypass Graft Surgery: Study Protocol for a Randomized Controlled Trial.

Objective: The present study aimed at comparing the effects of Religious Cognitive Behavioral Therapy (RCBT), Cognitive Behavioral Therapy (CBT), and sertraline on depression, anxiety, biomarker levels, and quality of life in patients after coronary artery bypass graft (CABG) surgery. Method: This was a randomized controlled trial with parallel groups. A total of 160 patients after CABG surgery will be screened for anxiety and depression according to clinical interviews based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and Hospital Anxiety Depression Scale (HADS) scores (≥ 8). To assess religious attitude, Golriz and Baraheni's Religious Attitude questionnaire will be used. Participants will be randomly allocated to 4 groups of 40 including 3 intervention groups (RCBT, CBT, and sertraline) and 1 control group (usual care). RCBT and CBT programs will consist of 12 one-hour weekly sessions. The participants in the pharmacological intervention group will receive 25-200 mg/d of sertraline for 3 months. The Short Form-36 Health Survey (SF-36) will be administered to assess the patients' quality of life. Blood samples will be taken and biomarker levels will be determined using the enzyme-linked immunosorbent assay (ELISA). The primary outcome will be reduction in anxiety and depression scores after the interventions. The secondary outcomes will be increase in quality of life scores and normalized biomarker levels after the interventions. Discussion: If RCBT is found to be more effective than the other methods; it can be used to improve patients' health status after CABG surgery. Irct ID: IRCT201404122898N5.