Paternal Postpartum Depression

Three main points:

Prevalence of paternal depression during the first three postpartum months is about 8 percent. Moderate
positive correlation between paternal and maternal depression
Depression in fathers (not mothers) of preterm infants was associated with significantly lower cognitive
function in the child at 2 years. Paternal postpartum depression associated with psychiatric diagnoses (eg,
oppositional defiant/conduct disorder and anxiety disorders), behavioral problems, and hyperactivity in their
children. Possible reasons why: less likely to engage with their children, are more likely to use aggressive or
harsh discipline, less parent-to-child reading, marital conflict
The EPDS is a suitable screening tool for fathers in the postpartum period, albeit cutoffs are different to
those applicable in women. It is important to note the EPDS does not diagnose depression but can alert the
clinician to the need for a full diagnostic interview
Prevalence and risk factors
The estimated prevalence of postpartum depression for mothers ranges from 8 to 15%
The prevalence of paternal depression during the first three postpartum months was 8%
The prevalence of paternal depression 6 to 12 months after birth was 10%.
The correlation between paternal and maternal depression was positive and moderate in size (r = 0.308; 95%
CI, 0.228-0.384).
Risk factors for postnatal paternal depression: Prenatal anxiety or depression, Lifetime history of severe
depression, Marital discord, Maternal prenatal depression, Other children in the family
Impact on infant outcomes
Behavioral problems and hyperactivity occurred in more children whose fathers had suffered postpartum
depression (even after controlling for maternal depression and other risk factors).
The increased risk for behavioral problems associated with depression in fathers during the infant's early
months also remains after controlling for later paternal depression.
Psychiatric diagnoses (eg, oppositional defiant/conduct disorder and anxiety disorders) were more common
in offspring of depressed fathers than offspring of nondepressed fathers (12 versus 6 percent) independent of
maternal postnatal depression.
Children of fathers with higher depressive symptoms had lower cognitive function at age of 24 months,
even after adjustment for maternal depressive symptoms and childrens biological and social risk factors.
These associations were not found for mothers.
Possible reasons why there was an association with lower cognitive function: Fathers less likely to engage
with their children, are more likely to use aggressive or harsh discipline, less likely to read to their child,
more martial conflict
Screening
A quick self-report screen

1) "Since your new baby was born, have you felt down, depressed, or hopeless?"

2) "Since your new baby was born, have you had little interest or little pleasure in doing things?"

One Yes answer constitutes a positive screen.

The Edinburg Postnatal Depression Scale (EPDS) is a reliable and valid measure of mood in fathers.
Several studies validating it in paternal postpartum depression.
One study from 2001: Screening for depression or anxiety disorders in fathers requires a two point lower
cut-off than screening for depression or anxiety in mothers (7/8), and we recommend this cut-off to be 5/6.

2.3% of fathers endorsed question 9 (I have been so unhappy that I have been crying)
compared to 44.1% of mothers