Dad’s mental impact

A Curtin University-led meta-analysis has confirmed there is a significant link between a father’s depression and an increased risk of mental health issues in their children.

The review, which examined 16 international studies featuring more than seven million fathers, including Australians and their children, undertaken between 2002 and 2021, found that children faced a 42% higher risk of developing depression if their father was impacted long-term by the condition.

Lead author Dr Berihun Dachew, a post-doctoral research fellow in epidemiology from the Curtin School of Population Health, said there was a need to adopt a family-focused approach that addressed both maternal and paternal mental health issues to mitigate negative effects on children’s wellbeing.

“This review highlights the need for a more comprehensive approach that acknowledges the influence of the paternal parents’ mental health on the overall mental wellbeing of the family,” Dr Dachew said.

“We found when fathers had more severe depression requiring clinical assistance, the risk of their children developing depression was even stronger, as opposed to dads with milder symptoms of feeling down.

“The observed association did not alter by the adjustment to confounders, including maternal depression, maternal prenatal and perinatal substance use, parental age, family income, parental education, and other comorbid paternal psychiatric disorders.”

He explained that prior evidence had shown inconsistent findings on the association between paternal depression and its early development among their offspring.

A longitudinal study by Lieb et al. (2010) and a more recent birth cohort study by Liang et al. reported up to a threefold increased risk of depression, whereas a prospective cohort study in Australia and a cross-sectional survey in the Netherlands found none.

The team from Curtin showed that the association between paternal depression and its developmental risk in their offspring has remained consistent since 2010, suggesting that the evidence for a statistical association was sufficient from that time – even though the mechanisms underlying the relationship remained unclear.

“The role of more severe paternal depression in association with child depression may suggest that genetic predispositions play a role in explaining the links we observed. However, more studies are needed to confirm this interpretation,” Dr Dachew said.

“Epigenetic mechanisms could also contribute to the transmission of paternal depression across multiple generations. Existing evidence suggests that DNA methylation and histone modifications, which play an important role in the regulation of cellular functions by mediating communication between the genome and the environment, can reliably differentiate the stable and heritable characteristics of depression.”

A 2010 study that explored the pathophysiology of depression revealed that genetics are responsible for 40% of the risk for depression with other etiological research producing similar outcomes.

“The association has also been explained, in part, by how depression may affect parental sensitivity toward the child, the security of the attachment and parenting, which might in turn, increase the risk of depression in offspring,” Dr Dachew said.

“Similarly, the effect size of the association was higher for offspring exposed to lifetime paternal depression when compared with those exposed to paternal depression during postpartum and early childhood periods.”

He pointed out that the observed associations could also be due to the confounding effects of unmeasured variables.

“For example, our stratified analysis revealed that the risk of offspring depression was considerably higher in studies that involved paternal depressive disorders as exposure compared with those studies that used paternal depressive symptoms as exposure,” Dr Dachew said.

“Additionally, parental substance use and undesirable changes in family situations, including negative parent-child interactions and divorce or separations, can negatively impact the cognitive and psychological development of offspring and later increase the likelihood of depression.”

Senior author and head of the Curtin School of Population Health, Professor Rosa Alati, said the findings emphasised the importance of early intervention and support for fathers experiencing depression.

“Considering the prevalence of male depression and the increasing involvement of fathers in childcare, it is crucial to incorporate paternal mental wellbeing when addressing the wellbeing of offspring,” Professor Alati said.

“By recognising the impact of paternal depression on children, policymakers, healthcare professionals and support services should work towards implementing strategies that promote mental wellness in fathers and provide resources to mitigate the risk of depression in their children.”