Introduction: Fathers are important to child development and behaviour. Maternal depression is associated with adverse child development and behaviour, but there is relatively little research on paternal depression and child outcome. Methods: A pilot phase assessed feasibility of recruiting fathers of young children via healthcare settings (N=194), and explored the association between paternal depressed mood and infant temperament (N=19). A cross-sectional study of biological fathers, mothers and 4-6 year old children assessed prevalence of a DSM IV paternal depressive syndrome (N=365); compared father and mother ratings of child behaviour on the Strengths and Difficulties Questionnaire (SDQ) (N=248); and assessed associations between a paternal depressive syndrome and child behaviour problems on the SDQ, and child consultations with health professionals for behaviour and developmental problems (N=248). Finally, a qualitative and observational study explored parenting attitudes and behaviours among fathers with and without depressed mood (N=22). Results: It was cost-effective to recruit fathers via primary care (41% response, cost £3 per father) and hospital postnatal wards (76% response, cost £8 per father). Paternal depressed mood was associated with a difficult/fussy infant temperament at six months postpartum (coefficient 3.96, SE 0.99, p=0.003). Fathers of 4-6 year old children had a 3.3% and 4.7% prevalence for a DSM IV major and other depressive syndrome respectively. On the SDQ there was higher parental agreement on normal/borderline compared with abnormal child behaviours, however overall agreement was fair. A major paternal depressive syndrome was associated with child prosocial behaviour problems (adjusted OR 8.29, 95% CI 0.98-70.04, p=0.052) and peer problems (adjusted OR 36.31, 95% CI 1.66-792.70, p=0.022), and enhanced child consultations for speech and language (adjusted OR 8.67, 95% CI 1.99-37.67, p=0.004) and externalising behaviour problems (adjusted OR 6.98, 95% CI 1.00-48.76, p=0.050) among 4-6 year olds. Fathers with major depressed mood reported negative, detached and potentially intrusive parenting behaviours. Conclusion: A larger longitudinal study is recommended to investigate the trajectory of the effects of paternal depression on child behaviour and development, elucidate causal mechanisms and assess the individual and cumulative effects of paternal and maternal depression on children
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