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Male Postnatal Depression an overview

by Tina Juhl

January 17th 2007
last updated January 17th 2007

State-of-the-art Knowledge on Men and Mood Disorders Arising in Relation to Parenthood and how to Overcome Gender Stereotypes Concerning Them

“When I feel bad, I can’t enjoy his smile!”

This is the statement of a father seeking psychotherapeutic help. It all started with various physical symptoms. After seeing a lot of physicians without finding an explanation for his condition, he had come to believe the reason for his suffering must be psychological – and he wanted to work with it. The worst thing for him was, feeling emotionally distant and being unable to be there for his son. When it was really bad he had to be away from home for a couple of days and take sick-leave from work.

(Each subtitle is supposed to start with a small introduction to the whole text and be followed by a read more link, where you find the full text)

The fact that women can suffer from postnatal depression has been well known and acknowledged for many years. Conversely men’s mood disorders in relation to parenthood constitute a very recent field both in the research world and in public awareness.

State of the Art
Numerous studies have focused on postnatal depression in women. Postnatal depression is often screened for with the so-called Edinburgh Postnatal Depression Scale (EPDS). Using this scale there is international agreement that approximately 10-14% of women are affected postpartum. A growing number of studies on postnatal depression in women do also examine the father’s psychological wellbeing, but only a few studies have had paternal depression as their main focus. Existing studies – most of which feature small sample sizes – report the rate of paternal postnatal depression to run between 2-24%. Looking at Europe there are prevalence-studies for postnatal depression in men in United Kingdom (4% of fathers), Portugal (4.8%), and Denmark (6.5%). These divergent findings reflect not only different methods and cut-offs but also the fact that this is a very new research area.

Many studies have found a correlation between maternal postpartum depression and paternal postpartum depression, showing that the prevalence for fathers is higher when the mother has a diagnosis of postpartum depression. This correlation has also been noted in studies with a paternal focus.

Gender Differences
In the general population twice as many women as men are diagnosed with depression. The same proportional occurrence appears to be reflected in the few available studies on postnatal depression. Traditionally it has often been hypothesized that these differences are due to women’s physiology of reproductive functioning. Since the late 1990s more studies have focused on whether men in fact display other symptoms of depression than women and the concept of male depression has been discussed.

Recently a Danish study was the first to include male depression symptoms in a prevalence study on fathers and postnatal depression.

A Danish Study – Traditional and Particularly Male Symptoms of Postnatal Depression in Men
Madsen, S.Aa. & Juhl, T. (2007). Paternal depression in the postnatal period assessed with traditional and male depression scales. Int Journ Men’s Health & Gender 2007. Vol 4 Issue I, March, 26-31.

The occurrence of postnatal depression in fathers has begun to receive attention in the international research literature. The EPDS assessment tool has been validated for men. However, identification of such men has been hindered by the use of assessment tools that may not be sensitive to the particular depressive symptoms experienced by men. So far the problem of male depressive symptoms has not been included in research on men's postnatal depressions. Methods: As part of a fatherhood research programme, the Edinburgh postnatal depression scale (EPDS) and the Gotland Male Depression Scale (GMDS) were administered to 607 fathers six weeks after the birth of their child. Results: 549 (90.4%) fathers were assessed for the presence of depressive symptoms. The prevalence was 5.0% with EPDS (cutoff ≥10), and 3.4% with GMDS (cut-off ≥13). While 2.1% of the fathers had scores above cut off on both scales 3.1% were assessed using only the EPDS and 1.3% with only the GMDS. Conclusion: Our findings indicate that better methods for identifying men with postnatal depression need to be developed and should consist of assessment scales that also include male depressive symptoms.

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