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Am Fam Physician. 1998;58(7):1670

Many studies have evaluated depression among women during and after pregnancy, but information is limited on the impact of the birth of a child in men. Deater-Deckard and colleagues studied the prevalence of depressive symptoms in men before and after the birth of a child and any relationship between depression and family structure.

Male partners of 6,667 women who gave birth during the nine-month study period completed two surveys that assessed depressive symptoms. The first survey was performed when the pregnancy was at 18 weeks of gestation, and the other was conducted eight weeks after the birth of the infant. The content of the surveys covered depression measures, life events, social support, qualities of the partnership and basic demographic information. The mothers completed similar surveys.

The men were categorized according to four family structures: traditional families, with both parents residing in the home and all children biologically related to both partners; stepfather families, with both parents living in the home along with the father's stepchildren, with or without biological children of the couple; stepmother families, with both parents living in the home along with the mother's stepchildren, with or without biological children of the couple; and single-mother families, with the mother not living with the child's father.

The survey revealed that 2.9 percent of the men in a traditional family had depression scores of more than 12 when their partners were at 18 weeks of gestation, and 3.0 percent had such scores eight weeks after delivery. In contrast, in stepfather families, 6.8 percent of the men had depression scores of more than 12, both at 18 weeks of gestation and eight weeks postpartum. In stepmother families, 10.3 percent of the men had depression scores of more than 12 during the pregnancy, and 7.3 had such scores eight weeks after the birth of the child. In single-mother families, 11.5 percent of the men had depression scores of more than 12 at the 18-week survey, but this rate fell to 5.1 percent eight weeks after delivery.

The higher levels of depressive symptoms in the men who were stepfathers were found to correlate with higher rates of depression among the partners, less education, more life events, less social support, smaller social networks and more aggression within their relationships. The level of the women's depressive symptoms was the strongest correlate of the men's depressive symptoms.

The authors conclude that men in stepfamilies and men who are partners of single mothers are more likely than men from traditional families to have depressive symptoms before and after the birth of a child. The authors point out that their data did not provide diagnostic information for the participants. Thus, these findings may not be generalizable to studies that used more precise measures of depression in men. Nevertheless, the findings suggest that men in stepfamilies may be at increased risk of depression compared with men in traditional families, and this risk is closely linked to their partners' depressive symptoms.

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