Abstract
Introduction:
Documented literature includes mixed interpretations of the impact of paternal alcoholism on psycho-behavioral well-being in children. A systematic review and a meta-analysis would facilitate the accurate establishment of this association.
Aim:
To evaluate the effects of paternal alcoholism on the psycho-behavioral well-being of children by a systematic review with a meta-analysis and a narrative review component
Methods: This PROPERO registered review (CRD42018114754) was conducted by reviewing searching literature in MEDLINE, EMBASE and PsycINFO databases. Twenty nine articles out of 16398 were selected for data extraction after three selection rounds. Thirteen were included in the meta-analyses for four numerical outcomes and two categorical outcomes. Meta-analysis outcomes included; internalizing behavior, externalizing behavior, depression and anxiety. Heterogeneity, risk of biases and the quality of evidence were assessed. Sensitivity analysis was done by re-analyzing with random-model assumption following the fixed model assumption. Furthermore re-analysis with standardized mean difference was done following the analysis with mean difference. Rev Man (version 5.3) software and “GRADEproGDT” online applications were used. Summary of Findings Tables were prepared. A narrative review was done with studies and sub-groups not included in the meta-analysis, under five identified themes: depression and mood disorders; self-perceived mental health problems and personality; aggression; ADHD and other problems.
Results: With meta-analysis, all four numerical outcomes for demonstrated significant mean differences (MD) with higher values in the group with paternal alcoholism. “Low” level was assigned as the GRADE certainty. For the anxiety when it is regarded as a categorical outcome, the resulting relative effect was significant (OR=2.18, 95% CI= 2.03 to 2.33) with “Moderate” certainty. In sensitivity analysis, associations of similar directions were observed. Narrative review reflected other negative psycho-behavioral consequences of children associated with paternal alcoholism, falling under the five identified themes.
Conclusions:
Robust findings were observed for the positive associations of paternal alcoholism with the selected psycho-behavioral pathologies of children in the meta-analysis. The narrative review further demonstrated negative implications of paternal alcoholism on five identified thematic areas.
Effects of paternal alcoholism on the psycho-behavioural outcomes of the offspring: a systematic review and meta-analysis
