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      Depression in fathers in the postnatal period: Assessment of the Edinburgh Postnatal Depression Scale as a screening measure

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          Abstract

          Background

          Postnatal depression commonly affects women after the birth of a child, and is associated with an increased risk of adverse outcomes for their children. A wide variety of measures have been used to screen for depression in the postnatal period but little research has investigated such measures with men. However depression can also affect men at this time, and this is associated with an independently increased risk of adverse child outcomes. The present study aimed to determine whether a reliable cut off point for the Edinburgh Postnatal Depression Scale (EPDS) can be established to screen fathers.

          Method

          A sample of fathers was sent the EPDS at 7 weeks after the birth of their child. A structured clinical interview was conducted with 192 men to determine whether they were suffering from depression.

          Results

          Fathers with depression scored significantly higher on the EPDS than non-depressed fathers. A score of greater than 10 was found to be the optimal cut off point for screening for depression, with a sensitivity of 89.5% and a specificity of 78.2%.

          Limitations

          The relatively modest participation rate means the results may not be fully generalisable to the whole population.

          Conclusion

          The EPDS is shown to have reasonable sensitivity and specificity at a cut off score of over 10. The study shows that it is possible to screen fathers for depression in the postnatal period and it may be valuable to administer this measure to new fathers.

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          Most cited references23

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          Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

          The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
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            The validation of the Edinburgh Post-natal Depression Scale on a community sample.

            The Edinburgh Post-natal Depression Scale (EPDS) was validated on a community sample of 702 women at six weeks post-partum using Research Diagnostic Criteria for depression. The estimates of sensitivity, specificity and positive predictive value, being based on a large random sample, offer improved guidelines for the use of the EPDS by the primary care team.
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              Paternal depression in the postnatal period and child development: a prospective population study.

              Depression is common and frequently affects mothers and fathers of young children. Postnatal depression in mothers affects the quality of maternal care, and can lead to disturbances in their children's social, behavioural, cognitive, and physical development. However, the effect of depression in fathers during the early years of a child's life has received little attention. As part of a large, population-based study of childhood, we assessed the presence of depressive symptoms in mothers (n=13,351) and fathers (n=12,884) 8 weeks after the birth of their child with the Edinburgh postnatal depression scale (EPDS). Fathers were reassessed at 21 months. We identified any subsequent development of behavioural and emotional problems in their children (n=10,024) at age 3.5 years with maternal reports on the Rutter revised preschool scales. Information was available for 8431 fathers, 11,833 mothers, and 10,024 children. Depression in fathers during the postnatal period was associated with adverse emotional and behavioural outcomes in children aged 3.5 years (adjusted odds ratio 2.09, 95% CI 1.42-3.08), and an increased risk of conduct problems in boys (2.66, 1.67-4.25). These effects remained even after controlling for maternal postnatal depression and later paternal depression. Our findings indicate that paternal depression has a specific and persisting detrimental effect on their children's early behavioural and emotional development.
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                Author and article information

                Journal
                J Affect Disord
                J Affect Disord
                Journal of Affective Disorders
                Elsevier/North-Holland Biomedical Press
                0165-0327
                1573-2517
                September 2010
                September 2010
                : 125
                : 1-3
                : 365-368
                Affiliations
                [a ]Section of Child and Adolescent Psychiatry, University of Oxford, Oxford, UK
                [b ]Milton Keynes Specialist CAMHS, Milton Keynes, UK
                Author notes
                [* ]Corresponding author. University of Oxford Department of Psychiatry, Warneford Hospital, Headington, Oxford, OX3 7JX, UK. Tel.: + 44 1865 226491. paul.ramchandani@ 123456psych.ox.ac.uk
                Article
                JAD4489
                10.1016/j.jad.2010.01.069
                2927780
                20163873
                737f39c0-67df-4352-b6f6-728b6b6bcfe2
                © 2010 Elsevier B.V.

                This document may be redistributed and reused, subject to certain conditions.

                History
                : 25 August 2009
                : 19 January 2010
                : 19 January 2010
                Categories
                Brief Report

                Clinical Psychology & Psychiatry
                depression,fathers,postnatal
                Clinical Psychology & Psychiatry
                depression, fathers, postnatal

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