Postnatal Depression in Fathers – Myth or Reality – Evidence from a Longitudinal Study.

Abstract

Introduction: Postnatal depression (PND) is well recognised in mothers with an incidence ranging from 6.5-20%. Healthcare services have implemented screening programs for PND to detect and treat this condition in mothers. However, there is debate as to whether new fathers also develop PND. Consequently, no equivalent screening and treatment services exist for new fathers. To explore whether new fathers also develop PND in an identical fashion to new mothers, we performed a prospective longitudinal study as part of the Australian Fathers Study.

Methods: A longitudinal study of 1000 fathers were followed from the antenatal to postnatal period. All fathers completed an evaluation for depressive symptoms with the Hospital Anxiety and Depression Scale - depression subscale (HADS-depression) at all time points. Fathers were recruited through the pregnant mother and provided informed consent. The study had ethics approval. To ensure a comprehensive and representative sample of fathers, non-English speaking fathers were involved using interpreters. Strategies to ensure retention included text messages and emails. Descriptive data was collected and a p-value of 0.05 was considered significant.

Results: Data on depression outcomes were available for 1000, 934 and 950 fathers at each time point. The demographics of the cohort were like those of the wider population of Australian fathers. A positive case score for depression based on the HADS-depression tool was observed in 8.4%, 10.1% and 12.4% of fathers at the prenatal, delivery and postnatal time points respectively. There was a significant increase in the incidence of a positive depression case score between prenatal and postnatal time points (P<0.004), but not between other time points. The increase in new cases of depression were substantially new cases of depression that were not present in the earlier time points.

Conclusion: This longitudinal study provides compelling evidence that new fathers experience PND at equivalent rates to mothers. Whilst many cases of PND occurred in fathers who also had a positive prenatal HADS-depression outcome, a significant increase in new cases occurred in the postnatal period. Health services should consider screening both parents for PND to ensure optimal parent-child interactions and family health outcomes.