Screening both mothers and fathers for depression beyond their child's first birthday in pediatric offices – the current standard practice – could identify families in need of mental health and other critical resources, according to a Rutgers study.
Pediatric professionals can play an important role in detecting parental depression. However, the current American Academy of Pediatrics guidelines only recommend that pediatric clinicians screen for maternal depression in the first year of their infant's life. This is especially important for parents who do not have a regular source of health care but attend the children's well visits."
Ava Marie Hunt, Study Lead Author and Student, Robert Wood Johnson Medical School, Rutgers University
Hunt is now a medical intern in the Department of Pediatrics at the Children's Hospital of Philadelphia
The study, published in the journal Pediatrics, examined parental depression or mood disorder screening at pediatric health-care facilities after a child's first birthday. Parental depression affects about one in five U.S. families. Mothers with depression are at increased risk for insecure attachments with their children and harsh parenting behaviors. In addition, maternal depression has been linked to children's cognitive, behavioral and physical health.
In the Rutgers study, researchers reviewed 41 studies that represented more than 32,700 parents and caregivers of children over 12 months old; on average, the studies reported 25 percent of the parents screened positive for depressive symptoms. Structured screening programs outside of the postpartum period in pediatric settings are rare, researchers found, despite the fact that many parents screened positive for depressive symptoms. In many cases, parents who screened positive for depressive symptoms didn't receive the appropriate referrals and follow up, according to the study.
"Although clinicians recognize the importance of screening for depression, many feel uncomfortable and do not screen," said senior author Manuel E. Jimenez, an assistant professor of pediatrics and family medicine at Rutgers Robert Wood Johnson Medical School.
"Those who do screen for depression often rely on observation rather than using validated screening tools, and often overlook fathers," added co-author Sallie Porter, an associate professor at the Rutgers School of Nursing.
The findings suggest that increased screening for parental depression across a wider age range and in a broader array of clinical settings has the potential to identify families in need of resources. More research is needed to identify best practices to link parents who screen positive for depressive symptoms to services and establish protocol for follow-up, according to the study.
Hunt, A. M., et al. (2022) Parental Depression Screening in Pediatric Health Care Settings: A Scoping Review. Pediatrics. doi.org/10.1542/peds.2021-055804