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The association between perceived relationship discord at childbirth and parental postpartum depressive symptoms: a comparison of mothers and fathers in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
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2012 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 117, no 4, 430-438 p.Article in journal (Refereed) Published
Abstract [en]

Aim

To examine whether mothers' and fathers' levels of perceived relationship discord at childbirth were associated with postpartum depressive symptoms when the child was 3 months old. Another aim was to examine parents' levels of self-reported depressive symptoms. The hypothesis was that parents with high levels of perceived relationship discord have higher levels of postpartum depressive symptoms than parents with low levels of perceived relationship discord.

Method

One week after childbirth, 305 couples' perceived level of relationship discord was measured using the Dyadic Consensus Subscale (DCS) of the Dyadic Adjustment Scale (DAS). At 3 months postpartum, the same couples answered the Edinburgh Postnatal Depression Scale (EPDS) questionnaire. The relations between perceived level of relationship discord and postpartum depressive symptoms were analysed using standard non-parametric statistical methods.

Results

The mothers and fathers partly differed regarding which areas of their relationship they perceived that they disagreed with their partners about. Furthermore, 16.5% of the mothers and 8.7% of the fathers reported postpartum depressive symptoms, and there was a moderate level of correlation between the DCS and EPDS scores.

Conclusion

These results may be useful for professionals in antenatal care and child health centres as well as for family caregivers who need to be aware that mothers and fathers may have different views on relationship discord and of the high level of depressive symptoms in recent parents. Further research is needed to examine perceived relationship discord and the development of depressive symptoms postpartum over a longer term.

Place, publisher, year, edition, pages
2012. Vol. 117, no 4, 430-438 p.
Keyword [en]
Depression postpartum, Family, Family relations, Fathers, Mothers
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-186016DOI: 10.3109/03009734.2012.684805ISI: 000310372800011OAI: oai:DiVA.org:uu-186016DiVA: diva2:572604
Available from: 2012-11-28 Created: 2012-11-27 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Journey from Pregnancy to Early Parenthood: Perceived Needs of Support, Fathers’ Involvement, Depressive Symptoms and Stress
Open this publication in new window or tab >>Journey from Pregnancy to Early Parenthood: Perceived Needs of Support, Fathers’ Involvement, Depressive Symptoms and Stress
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims: The overall aim was to describe the perceived needs for support and fathers’ involvement among expectant parents, and to examine depressive symptoms and parental stress in early parenthood among mothers and fathers.

Methods: Two qualitative studies using focus groups and individual interviews, and three quantitative comparative studies using three questionnaires were conducted.

Results: The expectant parents had different needs and suggestions for health-care improvement. One improvement of these was better involvement of expectant fathers, as fathers were described as the mothers’ best means of support and also had needs of their own. The fathers used different strategies to get involved during the pregnancy, but sometimes found it difficult to know what was expected of them. The mothers perceived more depressive symptoms and parental stress than the fathers. The mothers also perceived higher dyadic consensus than the fathers. Parents with depressive symptoms reported lower consensus than those without. There was a negative correlation between dyadic consensus and depressive symptoms in both mothers and fathers. Mothers perceived higher parental stress than fathers in the sub-areas ‘Incompetence regarding parenthood’, ‘Role restriction’, ‘Spouse relationship problems’, and ‘Health problems’, and overall. In contrast, fathers perceived higher stress than mothers in the sub-area ‘Social isolation’. Low education, lack of a role model and poor sense of coherence promoted more stress in mothers in the sub-areas ‘Social isolation’ and ‘Spouse relationship problems’, while lack of a role model and low sense of coherence promoted stress in fathers in the sub-area ‘Social isolation’.

Conclusions and clinical implications: The expectant parents’ needs of support were not consistent with the support offered from health care services. These services need to become more client-centred, for example by offering customized individual support and peer support in groups. Further, they should also meet the needs of expectant fathers which can benefit the whole family. To promote parents’ health and family stability, health professionals should consider depressive symptoms and parental stress. They should also take gender norms into account so that parents become prepared for parenthood and get adequate support during early parenthood.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 73 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1057
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-237088 (URN)978-91-554-9119-2 (ISBN)
Public defence
2015-01-28, Samlingssalen, Ingång 29, Västmanlands sjukhus, Västerås, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2014-12-18 Created: 2014-11-26 Last updated: 2015-02-03
2. Depressive Symptoms among Mothers and Fathers in Early Parenthood
Open this publication in new window or tab >>Depressive Symptoms among Mothers and Fathers in Early Parenthood
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims: The overall aims were to study depressive symptoms among mothers and fathers in early parenthood and how depressive symptoms are related to dyadic consensus (DCS), sense of coherence (SOC), perceiving of the child temperament, separation within the couple and bonding to the infant.

Methods: Study I-III was based on the BiT-study, a longitudinal project where 393 couples answered 3 questionnaires including instruments measuring DCS at one week after childbirth, depressive symptoms at 3 months and parental stress at 18 months after childbirth. Study IV was based on the UPPSAT-study, a population based cohort project, where 727 couples answered questionnaires measuring depressive symptoms at 6 weeks and 6 months after childbirth, and impaired bonding at 6 months after childbirth.

Results: In the BiT-study, 17.7% of the mothers and 8.7% of the fathers scored depressive symptoms at 3 months after childbirth, using the Edinburgh Postnatal Depression Scale (EPDS) cut-off of ≥10. There was an association between depressive symptoms and less consensus (DCS), and the parents partly differed regarding which areas of their relationship they perceived that they disagreed about. Parents with depressive symptoms had a poorer SOC and perceived their child as more difficult than parents without depressive symptoms. Among the couples, 20% were separated 6-8 years after childbirth. Separation was associated with less dyadic consensus, more depressive symptoms and parental stress. In the UPPSAT-study, 15.3% of the mothers and 5.1% of the fathers scored depressive symptoms 6 weeks after childbirth, using the EPDS cut-off of ≥10. Further, there was an association between impaired bonding at 6 months and the parents’ depressive symptoms, as well as experience of deteriorated relationship with the spouse.

Conclusions and clinical implications: Health professionals need the knowledge that depressive symptoms are common in both mother and fathers in early parenthood. It is also important to understand how depressive symptoms are associated to dyadic consensus, SOC, separation and impaired bonding in order to optimize conditions for the whole family. This knowledge is also important for the public, so those who are pregnant and new parents as well as the society are aware that there might be problems in early parenthood as depressive symptoms.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 75 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1060
Keyword
depressive symptoms, early parenthood, fathers, gender, health promoting, mothers
National Category
Medical and Health Sciences
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-237060 (URN)978-91-554-9125-3 (ISBN)
Public defence
2015-02-06, Samlingssalen, Ingång 29, Västmanlands sjukhus, Västerås, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2015-01-14 Created: 2014-11-26 Last updated: 2015-03-09Bibliographically approved

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Kerstis, BirgittaWidarsson, MargaretaRosenblad, Andreas

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