Paternal Depressive Symptoms and Child Behavioral or Emotional Problems in the United States

Michael Weitzman,David G Rosenthal,Ying-Hua Liu

doi:10.1542/peds.2010-3034

Abstract

The negative effects of maternal mental health problems on child health are well documented. In contrast, there is a profound paucity of information about paternal mental health's association with child health. To investigate the association of paternal mental health problems and depressive symptoms and children's emotional or behavioral problems. We analyzed Medical Expenditure Panel Survey data, which included a representative sample of US children (N = 21 993) aged 5 to 17 years and their mothers and fathers. The main outcome measure was child emotional or behavioral problems assessed by using the Columbia Impairment Scale. Paternal depressive symptoms, as assessed using the Patient Health Questionnaire-2, and mental health problems, more generally, assessed by using the Short-Form 12 Scale, were independently associated with increased rates of child emotional or behavioral problems even after controlling for numerous potential confounders including maternal depressive symptoms and other mental health problems. The adjusted odds ratio (aOR) for emotional or behavioral problems among children of fathers with depressive symptoms was 1.72 (95% confidence interval [CI]: 1.33-2.23) and the aOR associated with abnormal paternal scores on the mental component scale of the Short-Form 12 was 1.33 (95% CI: 1.10-1.62) for those within 1 SD below average and 1.48 (95% CI: 1.20-1.84) for those >1 SD below average. To the best of our knowledge, this is the first study to use a representative US sample to demonstrate that living with fathers with depressive symptoms and other mental health problems is independently associated with increased rates of emotional or behavioral problems of children.

Highlights

The negative effects of maternal mental health problems on child health are well documented
The adjusted odds ratio for emotional or behavioral problems among children of fathers with depressive symptoms was 1.72 (95% confidence interval [CI]: 1.33–2.23) and the aOR associated with abnormal paternal scores on the mental component scale of the Short-Form 12 was 1.33 for those within 1 SD below average and 1.48 for those Ͼ1 SD below average
To the best of our knowledge, this is the first study to use a representative US sample to demonstrate that living with fathers with depressive symptoms and other mental health problems is independently associated with increased rates of emotional or behavioral problems of children

Summary

METHODS

Data were used from the Medical Expenditure Panel Survey (MEPS), 2004 – 2008. MEPS, a nationally representative survey of the US civilian, noninstitutionalized population, is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics, and has been conducted annually since 1996. It is administered by a lay interviewer, has been found to have good reliability and validity, and correlates well with clinicians’ scores on the Children’s Global Assessment Scale, mental health service referrals, and school difficulties It has been used in a number of previous studies.[31,32,33] The CIS was administered to adult respondents of participating households for all children ages 5 to 17 years living in those homes. The following inclusion criteria were applied: children aged 5 to 17 years who were members of 2-parent households (including biological, adoptive, or stepparents), in which there was available data for child CIS items, and parental MCS and PCS scores. SUDAAN software (Research Triangle Institute, Research Triangle Park, NC), which enables assessment of national inferences.[41]

RESULTS

DISCUSSION