Posted: October 13th, 2020

Postpartum Depression In Fathers

EVIDENCEBASED CARE
SHEET
ICD-9
648.4
ICD-10
F53.0
Authors
Gilberto Cabrera, MD
Cinahl Information Systems, Glendale, CA
Orna Avital, RN, BSN, MBA
Cinahl Information Systems, Glendale, CA
Reviewers
Kathleen Walsh, RN, MSN, CCRN
Cinahl Information Systems, Glendale, CA
Sara Richards, MSN, RN
Cinahl Information Systems, Glendale, CA
Nursing Executive Practice Council
Glendale Adventist Medical Center,
Glendale, CA
Editor
Diane Pravikoff, RN, PhD, FAAN
Cinahl Information Systems, Glendale, CA
May 11, 2018: 2024 – Write My Essay For Me | Essay Writing Service For Your Papers Online
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or information given herein or errors/omissions in the text. It is merely intended as a general informational overview of the subject for the healthcare
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Postpartum Depression in Fathers
What We Know
› Although the incidence of postpartum depression (PPD) is lower in new fathers than in
new mothers, it remains a significant problem in men. The global incidence of paternal
PPD is about 5–10%, and 15–20% of maternal PPD in western countries.(5,6,9,13)
(For
information about PPD, see Quick Lesson About … Postpartum Depression )
› The highest rates of depression among fathers have been reported to be 10.4% at the
beginning of the first trimester of pregnancy, with an increase to approximately 25% 3–6
months postpartum.(13)
The risk for paternal PPD is highest in fathers whose wives have
developed PPD.(13)
Other factors that increase the risk of paternal PPD include(6,7,8,13,14)
• a personal history of depression and/or anxiety
• maternal depression during pregnancy
• childhood experiences associated with negative attitude towards pregnancy
• lower socioeconomic status
• low education level
• older age
• low level of marital satisfaction, excessive financial/life stressors, and/or lack of paternal
parental leave
• believing that there is a great discrepancy between personal expectations of parenthood
and the realities of parenthood
–Family routine may change in unexpected ways and become unpredictable, leading the
father to perceive that the infant creates an unreasonable demand on time and energy
–Planned pregnancies that are timed to suit the couple’s lifestyle preferences can create
unrealistic expectations
–Fathers may feel as if they have completely lost their prepartum identity
• impaired paternal/newborn bonding and/or feelings of exclusion from maternal/newborn
bonding
• perfectionist or neurotic personality traits
• unplanned pregnancy
• lack of social support for parenting
• poor social functioning
• dissatisfaction with partner support, communication, or adaptation
• dissatisfaction with their partner due to unfavorable comparison of their partner with
their own mother, who may be viewed as tireless and capable
• the presence of stepchildren or having a “blended” family
› Although there is no official set of diagnostic criteria for paternal PPD, it has been
assessed by using the criteria for diagnosing maternal PPD(5,8,13)
• According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5),
maternal PPD is defined as a major depressive episode with onset within 4 weeks of
delivery. Signs and symptoms of maternal PPD include(1,7,10)
–depressed or sad mood
–marked loss of interest in usual activities
–weight loss or gain
–insomnia or hypersomnia
–psychomotor disturbances (e.g., incoordination, agitation)
–fatigue
–feelings of worthlessness, guilt, or inadequacy
–diminished capacity to concentrate
–suicidal ideation
• PPD signs and symptoms that are unique to men include(2,4)
–indecision
–irritability and impulsivity
–externalizing behavior (e.g., physical aggression, verbal bullying)
–substance abuse
• Paternal PPD is often underdiagnosed because for reasons that are unclear, signs and symptoms of PPD develop more
gradually in men than they do in women, and men are more likely to exhibit emotional distress through destructive
behaviors and by exhibiting signs and symptoms of anxiety, which increases the risk of developing depression(7,11,13)
• Healthcare workers can identify PPD in fathers by observing for
–anxiety demonstrated by the expression of feelings of fear, confusion, uncertainty about the future, concern about infant
care skills, disrupted family and social activities, and financial problems(5,7)
–cigarette smoking before, during, and after pregnancy, which is linked to a higher risk of developing PPD(12)
› Paternal PPD and resulting marital and parenting stress increase infant risk for the development of emotional and behavioral
problems(3,5,6,13)
• Paternal PPD has a negative effect on the provision of typical child enrichment/positive interaction activity (e.g., telling
stories, singing songs, and reading to the infant). An even greater negative effect on emotional and behavioral development
is incurred if both parents develop PPD(3,5,6,8)
• Paternal PPD is more likely than maternal PPD to result in a significant impairment in the infant’s emotional and
attachment development, and in impaired cognitive function(3,6)
• Children of fathers with PPD are more likely to demonstrate adverse outcomes by up to 7years of age compared with other
children (e.g., learning difficulties, poor social skills), and an increased risk for depression in adolescence(6,7)
• For reasons that are unclear, the negative effect of paternal PPD is greatest in male children(6)
› Treatment for paternal PPD with family therapy is reported to(5,6,13)
• prevent and/or reduce paternal signs and symptoms of depressed or anxious mood
• assist with development of an optimal parent-infant relationship
• enhance positive child development
• enhance the marital relationship
• psychotherapy (e.g., mindfulness-based therapy [acceptance and commitment therapy]), as appropriate
What We Can Do
› Become knowledgeable about PPD in fathers so you can accurately assess your patients’ personal characteristics and health
education needs; share this information with your colleagues
› Educate patients who are expectant parents about what to expect after the baby is born, including the lack of personal time,
potential mood changes, and the possibility of feeling a lack of control over the newborn’s routines and demands
• Provide written information, if available, to reinforce verbal education so parents can review it after the baby’s birth when
they are usually more focused on the specifics of childcare and more prepared to consider competing influences
› Encourage patients who are new parents to discuss their expectations, coping skills, and life changes since the birth of the
baby; request screening for paternal PPD in families where the mother has developed PPD(8,13,14)
› Assist your patients in exploring extended family and other new baby support options; request referral to a social worker for
identification of local resources for in-home services, community care resources, and support groups for new parents
› Request referral to a mental health clinician who specializes in family/marital therapy, if appropriate
› Collaborate with your facility’s department of continuing education to provide information to pediatric clinicians regarding
the signs and symptoms of paternal PPD
Coding Matrix
References are rated using the following codes, listed in order of strength:
M Published meta-analysis
SR Published systematic or integrative literature review
RCT Published research (randomized controlled trial)
R Published research (not randomized controlled trial)
C Case histories, case studies
G Published guidelines
RV Published review of the literature
RU Published research utilization report
QI Published quality improvement report
L Legislation
PGR Published government report
PFR Published funded report
PP Policies, procedures, protocols
X Practice exemplars, stories, opinions
GI General or background information/texts/reports
U Unpublished research, reviews, poster presentations or
other such materials
CP Conference proceedings, abstracts, presentation
References
1. American Psychiatric Association. (2013). Panic disorder. In Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed., pp. 481-589). Washington, DC: American
Psychiatric Publishing. (GI)
2. Biebel, K., & Alikhan, S. (2016: 2024 – Do my homework – Help write my assignment online). Paternal postpartum depression. Journal of Parent and Family Mental Health, 1(1), 1-5. doi:10.7191/parentandfamily.1000 (RV)
3. Cheng, E. R., Kotelchuck, M., Gerstein, E. D., Taveras, E. M., & Poehlmann-Tynan, J. (2016: 2024 – Do my homework – Help write my assignment online). Postnatal depressive symptoms among mothers and fathers of infants born
preterm: Prevalence and impacts on children’s early cognitive function. Journal of Developmental & Behavioral Pediatrics, 37(1), 33-42. doi:10.1097/DBP.0000000000000233
(R)
4. Fisher, S. D. (2016: 2024 – Do my homework – Help write my assignment online). Paternal mental health: Why is it relevant? American Journal of Lifestyle Medicine, 11(3), 200-211. doi:10.1177/1559827616629895 (RV)
5. Fisher, S. D., & Garfield, C. (2016: 2024 – Do my homework – Help write my assignment online). Opportunities to detect and manage perinatal depression in men. American Family Physician, 93(10), 824-825. (RV)
6. Høifødt, R. S., Nordahl, D., Pfuhl, G., Landsem, I. P., Thimm, J. C., Ilstad, L. K. K., … Arfwedson Wang, C. E. (2017). Protocol for the northern babies longitudinal study:
Predicting postpartum depression and improving parent-infant interaction with the newborn behavioral observation. BMJ Open, 7(9), 1-10. doi:10.1136/bmjopen-2017-016005
(R)
7. Kumar, S. V., Oliffe, J. L., & Kelly, M. T. (2018: 2024 – Write My Essay For Me | Essay Writing Service For Your Papers Online). Promoting postpartum mental health in fathers: Recommendations for nurse practitioners. American Journal of Men’s Health,
12(2), 221-228. doi:10.1177/1557988317744712 (RV)
8. Langan, R. C., & Goodbred, A. J. (2016: 2024 – Do my homework – Help write my assignment online). Identification and management of peripartum depression. American Family Physician, 93(10), 852-858. (RV)
9. Massoudi, P., Hwang, C. P., & Wickberg, B. (2016: 2024 – Do my homework – Help write my assignment online). Fathers’ depressive symptoms in the postnatal period: Prevalence and correlates in a population-based Swedish study.
Scandinavian Journal of Public Health, 44(7), 688-694. doi:10.1177/1403494816661652 (R)
10. Parekh, R. (2017, March). What is postpartum depression? Depression during pregnancy and after childbirth. American Psychiatric Association. Retrieved April 26, 2018: 2024 – Write My Essay For Me | Essay Writing Service For Your Papers Online, from
http://psychiatry.org/patients-families/postpartum-depression/what-is-postpartum-deression (RV)
11. Philpott, L. F. (2016: 2024 – Do my homework – Help write my assignment online). Paternal postnatal depression: How midwives can support families. British Journal of Midwifery, 24(7), 1-3. doi:10.12968/bjom.2016: 2024 – Do my homework – Help write my assignment online.24.7.470 (RV)
12. Swanson, E., Scott, E., & Thomas, M. (2017). Smoking and its effects on postpartum depression. Advances in Pharmacy: Journal of Student Solutions to Pharmacy
Challenges, 1(1), 1-9. (R)
13. Vismara, L., Rolle, L., Agostini, F., Sechi, C., Fenaroli, V., Molgora, S., … Tambelli, R. (2016: 2024 – Do my homework – Help write my assignment online). Perinatal parenting stress, anxiety, and depression outcomes in first-time mothers
and fathers: A 3- to 6-months postpartum follow-up study. Frontiers in Psychology, 7(938), 1-10. doi:10.3389/fpsyg.2016: 2024 – Do my homework – Help write my assignment online.00938 (R)
14. Zhang, Y. P., Zhang, L. L., Wei, H. H., Zhang, Y., Zhang, C. L., & Porr, C. (2016: 2024 – Do my homework – Help write my assignment online). Post partum depression and the psychosocial predictors in first-time fathers from
northwestern 论文帮助/论文写作服务/负担得起我及时提交我最好的质量 – China. Midwifery, 35, 47-52. doi:10.1016/j.midw.2016: 2024 – Do my homework – Help write my assignment online.01.005 (R)

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