Muhammad I Husain1, Imran B Chaudhry2, Ameer B Khoso3, Ming W Wan4, Tayyeba Kiran3, Tinevimbo Shiri5, Nasim Chaudhry3, Nasir Mehmood6, Syed F Jafri7, Farooq Naeem1, Nusrat Husain4. 1. Department of Psychiatry, University of Toronto, Toronto, ON M5S, Canada. 2. Department of Psychiatry, Ziauddin Hospital, Karachi 75600, Pakistan. 3. Pakistan Institute of Living and Learning, Karachi 75600, Pakistan. 4. Division of Psychology and Mental Health, University of Manchester, Manchester M13 9PL, UK. 5. Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK. 6. Karwan e Hayat, Karachi 75620, Pakistan. 7. Department of Community Health Sciences, Karachi Medical and Dental College, Karachi 74700, Pakistan.
Abstract
BACKGROUND: Globally, paternal depression is a neglected and under-researched area. AIMS: To feasibility test Learning Through Play Plus Dads (LTP+ Dads), a group parenting psychoeducation program adapted for depressed Pakistani fathers of children under 3 years of age. METHODS: Fathers with depression were recruited in Karachi, Pakistan, for a pre-post feasibility study. Ten sessions of group LTP+ Dads were offered over three months. Clinical assessments were administered at baseline, three (end of intervention), and six (follow-up) months and included the Edinburgh Postnatal Depression Scale, 17-item Hamilton Depression Rating Scale, Brief Disability Questionnaire, Multidimensional Scale of Perceived Social Support, Euro-Qol-5 Dimensions, Rosenberg Self-esteem Scale, Parenting Stress Index, and Knowledge, Attitude and Practices questionnaire. RESULTS: Of the 78 fathers approached, 34 consented to screening and 18 were eligible to participate. Participants had a mean age of 33 years, with a mean of 3.61 children. Most were unemployed and were from low-income households with low education backgrounds. The intervention was feasible and acceptable based on a recruitment rate of 100% of eligible participants and a 100% attendance rate for five of the 10 sessions. Fathers showed, on average, a reduction in depressive symptoms, an increase in most areas of knowledge, and positive attitudes about child development. Perceived social support, self-esteem, and functioning scores also increased. CONCLUSIONS: A low-cost, culturally adapted group intervention was found to be feasible and acceptable. Changes in depression, parenting-related, and other outcomes are promising and inform a future larger trial. TRIAL REGISTRATION: The trial was registered on Clinicaltrials.gov on 9 December 2020 (identifier: NCT04660253).
BACKGROUND: Globally, paternal depression is a neglected and under-researched area. AIMS: To feasibility test Learning Through Play Plus Dads (LTP+ Dads), a group parenting psychoeducation program adapted for depressed Pakistani fathers of children under 3 years of age. METHODS: Fathers with depression were recruited in Karachi, Pakistan, for a pre-post feasibility study. Ten sessions of group LTP+ Dads were offered over three months. Clinical assessments were administered at baseline, three (end of intervention), and six (follow-up) months and included the Edinburgh Postnatal Depression Scale, 17-item Hamilton Depression Rating Scale, Brief Disability Questionnaire, Multidimensional Scale of Perceived Social Support, Euro-Qol-5 Dimensions, Rosenberg Self-esteem Scale, Parenting Stress Index, and Knowledge, Attitude and Practices questionnaire. RESULTS: Of the 78 fathers approached, 34 consented to screening and 18 were eligible to participate. Participants had a mean age of 33 years, with a mean of 3.61 children. Most were unemployed and were from low-income households with low education backgrounds. The intervention was feasible and acceptable based on a recruitment rate of 100% of eligible participants and a 100% attendance rate for five of the 10 sessions. Fathers showed, on average, a reduction in depressive symptoms, an increase in most areas of knowledge, and positive attitudes about child development. Perceived social support, self-esteem, and functioning scores also increased. CONCLUSIONS: A low-cost, culturally adapted group intervention was found to be feasible and acceptable. Changes in depression, parenting-related, and other outcomes are promising and inform a future larger trial. TRIAL REGISTRATION: The trial was registered on Clinicaltrials.gov on 9 December 2020 (identifier: NCT04660253).
Entities:
Keywords:
cognitive behavior therapy; cultural adaptation; low- and middle-income country; parenting; paternal depression