Couple comorbidity and correlates of postnatal depressive symptoms in mothers and fathers in the first two weeks following delivery.

BACKGROUND: Postnatal depression affects a significant number of parents; however, its co-occurrence in mothers and fathers has not been studied extensively. Identifying predictors and correlates of postnatal depressive symptoms can help develop effective interventions. METHODS: Questionnaires on several socio-demographic and psychosocial factors were administered to 276 couples within two weeks after birth. Depressive symptoms in mothers and fathers were assessed using the Edinburgh Postnatal Depression Scale (EPDS). After calculating the correlation coefficient between mothers and fathers' EPDS scores, univariate and multivariate linear regression analyses were performed to identify significant correlates of postnatal depressive symptoms in mothers and fathers. RESULTS: Prevalence of maternal and paternal postnatal depressive symptoms was 15.9% (EPDS>12) and 5.4% (EPDS>10), respectively. There was a moderate positive correlation between mothers and fathers' EPDS scores (r=.30, p<.001). Multivariate analyses indicated that parental stress was the strongest predictor for maternal and paternal postnatal depressive symptoms. Pregnancy- and birth-related distress and partners' EPDS scores were also associated with depressive symptoms in both parents. Relationship satisfaction was only inversely related with fathers' EPDS scores, while mothers' EPDS scores were additionally associated with critical life events, history of childhood violence, and birth-related physiological complaints. LIMITATIONS: Since information about participation rates (those who declined) is unavailable, we cannot rule out sampling bias. Further, some psychosocial factors were assessed using single items. CONCLUSION: Since co-occurrence of depressive symptoms in mothers and fathers is high, developing and evaluating postnatal depression interventions for couples may be beneficial. Interventions to reduce parenting stress may help prevent parental postnatal depression.

Children of mentally ill parents-a pilot study of a group intervention program.

OBJECTIVE: The transgenerational transmission of mental disorders is one of the most prominent risk factors for the development of psychological disorders. Children of mentally ill parents are a vulnerable high risk group with overall impaired development and high rates of psychological disorders. To date there are only a few evidence based intervention programs for this group overall and hardly any in Germany. We translated the evidence based Family Talk Intervention by Beardslee (2009) and adapted it for groups. First results of this pilot study are presented. METHOD: This investigation evaluates a preventive group intervention for children of mentally ill parents. In a quasi-experimental design three groups are compared: an intervention group (Family Talk Intervention group: n = 28), a Wait Control group (n = 9), and a control group of healthy children (n = 40). Mean age of children was 10.41 years and parental disorders were mostly depressive/affective disorders (n = 30), but a small number also presented with Attention-Deficit/Hyperactivity Disorder (n = 7). RESULTS: Children of mentally ill parents showed higher rates of internalizing/externalizing disorders before and after the intervention compared to children of parents with no disorders. Post intervention children's knowledge on mental disorders was significantly enhanced in the Family Talk Intervention group compared to the Wait Control group and the healthy control group. Parental ratings of externalizing symptoms in the children were reduced to normal levels after the intervention in the Family Talk Intervention group, but not in the Wait Control group. DISCUSSION: This pilot study of a group intervention for children of mentally ill parents highlights the importance of psycho-education on parental mental disorders for children. Long-term effects of children's enhanced knowledge about parental psychopathology need to be explored in future studies.

Early Detection of Postpartum Depressive Symptoms in Mothers and Fathers and Its Relation to Midwives' Evaluation and Service Provision: A Community-Based Study.

BACKGROUND: Postpartum parental mental health problems pose a serious risk for child development and often remain undetected in postpartum primary care. Within the framework of the German Midwifes Prevention Study, the aim of this study was to investigate the presence of postpartum emotional distress in mothers and fathers, and the detection of distressed parents by midwives in a primary care setting. We also examined whether a temporal extension of the postpartum midwife care period is associated with greater use of midwife contacts and higher rates of referral to further professional support if needed. METHODS: Mothers, fathers, and midwives filled out questionnaires at 2 weeks (t 1) and 6 months (t 2) postpartum. Compared to standard care in the control group (CG), midwives in an intervention group (IG) offered extended postpartum care of 6 months postpartum. Parental psychological distress was assessed using the Edinburgh postnatal depression scale (EPDS). Midwives reported on parental psychological distress as well as the number of postpartum contacts and referrals to additional social- and health-care providers. RESULTS: Based on their ratings, midwives identified half of mothers and around one-quarter of fathers with elevated depressive symptoms according to the EPDS at t 1 and t 2. IG mothers used significantly more midwife contacts than CG mothers. IG mothers with high-postnatal psychological distress at t 2 used significantly more contacts than mothers with lower levels of distress. IG mothers with high-psychological distress at t 2 were referred to additional support services more often than mothers with lower levels of distress.