Paternal Depression and Risk of Depression Among Offspring: A Systematic Review and Meta-Analysis

IMPORTANCE: Existing epidemiological evidence is equivocal as to whether paternal depression poses a consequent risk of depression in offspring; meta-analysis of findings can help inform preventative intervention efforts. OBJECTIVE: To conduct a systematic review and meta-analysis of observational studies examining the association between paternal and offspring depression. DATA SOURCES: Embase, PubMed, PsycINFO, Scopus, and Web of Science databases were searched between inception and December 2022. STUDY SELECTION: The review included all observational studies that investigated the association between paternal and offspring depression and 10 606 studies were initially identified. DATA EXTRACTION AND SYNTHESIS: This systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. The review protocol was prospectively registered in PROSPERO. Summary odds ratios (ORs) and 95% CIs were pooled using inverse variance weighted random effect meta-analysis. Subgroup and sensitivity analyses were performed. MAIN OUTCOMES AND MEASURES: The main outcome of interest was offspring depression measured using recognized depression assessment tools. RESULTS: Sixteen observational studies published between 2002 and 2021 were included, with a combined sample of 7 153 723 father-child dyads. A meta-analysis of these studies showed that paternal depression was associated with an increased risk of depression in offspring (OR, 1.42; 95% CI, 1.17-1.71). The risk was higher among offspring exposed to paternal depressive disorders (OR, 1.65; 95% CI, 1.28-2.12) than those exposed to depression as defined by a nonclinical symptom scale (OR, 1.12; 95% CI, 1.06-1.19). Sensitivity analysis revealed consistent pooled estimates ranging from 1.35 (95% CI, 1.12-1.62) to 1.45 (95% CI, 1.18-1.78). CONCLUSIONS AND RELEVANCE: Paternal depression was associated with subsequent offspring depression. This finding shows the intergenerational transmission of mental health problems and suggests that mental health interventions benefit not only the patient but also the family as a whole, including both parents.