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Uriko K, Christoforou A, Motrico E, Moreno-Peral P, Kömürcü Akik B, Žutić M, Lambregtse-van den Berg MP. Paternal peripartum depression: emerging issues and questions on prevention, diagnosis and treatment. A consensus report from the cost action Riseup-PPD. J Reprod Infant Psychol 2025; 43:646-664. [PMID: 37818835 DOI: 10.1080/02646838.2023.2266470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Paternal peripartum depression (P-PPD) is a serious and understudied public health problem associated with impaired family functioning and child development. The lack of recognition of P-PPD may result in limited access to both information and professional help. OBJECTIVE The aim of the study was to review studies on paternal peripartum depression and to identify issues and questions where future research and theory formation are needed. METHODS A literature search for systematic reviews, meta-analyses and primary studies was conducted using PubMed, Web of Science, Embase, Scopus, Medline, PsychInfo and Informit databases. Key results within the retrieved articles were summarised and integrated to address the review objectives. RESULTS Based on the literature, the knowledge related to prevalence, screening, risk factorsunique to fathers, management strategies and outcomes of P-PPD is lacking. Currently, there is no consensual understanding of the definition of P-PPD and recommendations for dealing with P-PPD. Limited data were available regarding the barriers preventing fathers from accessing support systems. CONCLUSION Emerging issues that need to be addressed in future research include: P-PPD definition and pathogenetic pathways; prevention strategies and assessment tools; self-help seeking and engagement with interventions; the cost-effectiveness of P-PPD management; needs of health professionals; effect on child development, and public awareness. Future studies and clinical practice should account the complexities that may arise from the father's perceptions of health care services. Results from this review highlights the critical issues on how to plan, provide and resource health services, to meet the health needs of fathers.
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Affiliation(s)
- Kristiina Uriko
- School of Natural Sciences and Health, Department of Psychology and Behavioural Sciences, Tallinn University, Tallinn, Estonia
| | - Andri Christoforou
- Department of Social and Behavioural Sciences, European University Cyprus, Nicosia, Cyprus
| | - Emma Motrico
- Department of Psychology, University Loyola Andalucia, Seville, Spain
| | - Patricia Moreno-Peral
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA). Biomedical Research Institute of Malaga (IBIMA plataforma Bionand), Malaga, Spain
| | | | - Maja Žutić
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
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Orsolini L, Yılmaz-Karaman IG, Bottaro M, Bellagamba S, Francesconi G, Volpe U. Preconception paternal mental health history as predictor of antenatal depression in pregnant women. Ann Gen Psychiatry 2025; 24:18. [PMID: 40119441 PMCID: PMC11929265 DOI: 10.1186/s12991-025-00554-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Accepted: 03/08/2025] [Indexed: 03/24/2025] Open
Abstract
BACKGROUND Depression occurring during the perinatal period (PND) could affect both future mother and father. PND may lead to several adverse physical and mental health outcomes for the whole family. Several psychopathological determinants have been identified, even though few studies investigated the role of paternal mental health in the onset of maternal perinatal depression (MPND). Hence, a retrospective cohort study was carried out in order to investigate the relationship between paternal mental health and the occurrence of antenatal maternal depression as well as identifying potential sociodemographic, clinical and obstetrical predictors in the development of MPND. METHODS All pregnant women afferent to the Perinatal Mental Health Outpatient Service of the Unit of Clinical Psychiatry at the University Hospital of Marche, Polytechnic University of Marche, Ancona, Italy, between April 2021 to February 2022, were consecutively recruited and longitudinally screened for antenatal depression. The sample was divided in two groups, based on the screening by using the Edinburgh Postpartum Depression Scale (EPDS) for PND. A stepwise binary logistic regression analysis was performed in order to evaluate the predictors associated with the presence of antenatal depression (vs. the absence of antenatal depression). RESULTS A total of 106 participants among all 460 screened from April 2021 to February 2022, were retrospectively included. In our sample, a prevalence of 13.2% in antenatal depression was found. The binary logistic regression model showed that the higher maternal age (OR = 1.320; p = 0.005), gestational comorbidity (OR = 10.931; p = 0.010), pregnant women's (OR = 19.001; p = 0,001) and their partner's positive history (OR = 16.536; p = 0.004) for mental disorder significantly predicted the presence of antenatal depression in our sample. CONCLUSIONS Our study suggests the need to investigate the pre-existing psychopathology of the pregnant woman's partner as a potential risk factor for MPND, particularly for antenatal depression. Overall, a better understanding and investigation of all potential risk and/or protective factors for the onset and/or maintenance and/or worsening of MPND could help clinicians in early identifying treatment strategies to improve maternal mental health as well as future father's mental health.
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Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy.
| | | | - Matteo Bottaro
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Silvia Bellagamba
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Giulia Francesconi
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
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Milgrom J, Garner B, Rodrigues A, Fisher J, Borninkhof J, Kavanagh D, Gemmill AW. National Implementation of Perinatal Mental Health Treatment-The MumSpace Digital Stepped-Care Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:361. [PMID: 40338244 PMCID: PMC11942324 DOI: 10.3390/ijerph22030361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Revised: 02/11/2025] [Accepted: 02/20/2025] [Indexed: 05/09/2025]
Abstract
Perinatal depression is highly prevalent, yet there is a very low rate of treatment uptake and help-seeking. The MumSpace Initiative was funded by the Australian government to invest in digital stepped-care treatments and support for perinatal depression, to improve mental health outcomes and national access. This paper describes the reach of the MumSpace initiative as a one-stop shop offering perinatal depression treatments with a solid evidence base (MumMoodBooster programmes), supported by a prevention programme addressing modifiable risk factors through a smartphone application (MindMum) as well as evidence-based universal prevention programmes. We have brought together multi-skilled teams and a Perinatal Depression Consortium to deliver the programmes and address changing technology. The effectiveness of MumSpace was evaluated through systematic monitoring of consumer reach: data analysis of website traffic and resource uptake. MumSpace has successfully sustained engagement, attracting over 275,000 visits since its launch in 2017, with the number of visitors to the website increasing year on year. The central treatment tools, MumMoodBooster and Mum2BMoodBooster, have reached over 10,000 Australian women, largely through self-referral. Despite the development of a portal for direct clinician referral and monitoring, continuing challenges for implementation involve integrating digital treatments into traditional services and recruiting professionals to directly engage mothers.
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Affiliation(s)
- Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Heidelberg, VIC 3084, Australia; (B.G.); (A.R.); (A.W.G.)
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Brydie Garner
- Parent-Infant Research Institute, Austin Health, Heidelberg, VIC 3084, Australia; (B.G.); (A.R.); (A.W.G.)
| | - Andre Rodrigues
- Parent-Infant Research Institute, Austin Health, Heidelberg, VIC 3084, Australia; (B.G.); (A.R.); (A.W.G.)
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia;
| | - Julie Borninkhof
- PANDA Perinatal Anxiety & Depression Australia, Fitzroy, VIC 3065, Australia;
| | - David Kavanagh
- Centre for Children’s Health Research, Queensland University of Technology, South Brisbane, QLD 4101, Australia;
- School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Alan W. Gemmill
- Parent-Infant Research Institute, Austin Health, Heidelberg, VIC 3084, Australia; (B.G.); (A.R.); (A.W.G.)
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de-Juan-Iglesias P, Gómez-Gómez I, Barquero-Jimenez C, Wilson CA, Motrico E. Effectiveness of online psychological interventions to prevent perinatal depression in fathers and non-birthing partners: A systematic review and meta-analysis of randomized controlled trials. Internet Interv 2024; 37:100759. [PMID: 39149135 PMCID: PMC11325346 DOI: 10.1016/j.invent.2024.100759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 06/29/2024] [Accepted: 07/12/2024] [Indexed: 08/17/2024] Open
Abstract
Little is known about the effectiveness of online preventive interventions for paternal perinatal depression (PPD). This systematic review (SR) and meta-analysis (MA) of randomized controlled trials (RCTs) evaluated the effectiveness of online psychological interventions to prevent PPD in fathers and non-birthing partners. The PRISMA 2020 guidelines were followed. The search was conducted in eight electronic databases and other sources from inception to 12 May 2023. The pooled standardized mean difference (SMD) was computed using random-effect models. Seven RCTs were included in the SR and 6 were included in the MA, representing 1.042 fathers from five different countries. No trials focused on non-birthing partners were found. The pooled SMD was -0.258 [95 % confidence interval - 0.513 to -0.004; p < 0.047]. The heterogeneity was moderate (I2 = 51 %; 95%CI [0 % to 81 %]) and nonsignificant (p = 0.070). However, sensitivity analyses showed that the effectiveness was stable only when the fixed effect model and the Egger's g were used to estimate the pooled SMD. No publication bias was found. Only two RCTs had an overall low risk of bias assessed by using the Cochrane ROB 2.0 tool. The quality of evidence based on GRADE was very low. In conclusion, online psychological interventions may be effective for the prevention of PPD. More high-quality evidence is warranted.
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Affiliation(s)
- Paula de-Juan-Iglesias
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen del Rocío, CSIC, University of Seville, Spain
- Department of Developmental and Educational Psychology, Universidad de Sevilla, Spain
| | | | - Carlos Barquero-Jimenez
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen del Rocío, CSIC, University of Seville, Spain
- Department of Developmental and Educational Psychology, Universidad de Sevilla, Spain
| | - Claire A Wilson
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom
- South London and Maudsley NHS Foundation Trust, United Kingdom
| | - Emma Motrico
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen del Rocío, CSIC, University of Seville, Spain
- Department of Developmental and Educational Psychology, Universidad de Sevilla, Spain
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Seid J, Mohammed E, Cherie N, Yasin H, Addisu E. The magnitude of perinatal depression and associated factors among women in Kutaber woreda public health institution and Boru Meda general hospital, Ethiopia, 2022: a cross-sectional study. Front Psychiatry 2024; 14:1302168. [PMID: 38318482 PMCID: PMC10838999 DOI: 10.3389/fpsyt.2023.1302168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/26/2023] [Indexed: 02/07/2024] Open
Abstract
Background Perinatal depression, characterized by the presence of depressive symptoms during pregnancy and/or within the first 12 months postpartum, poses a significant global public health concern. It contributes to a multitude of health risks for mothers, their infants, and their families. Understanding of perinatal depression and its associated factors is crucial for effective prevention and intervention strategies. However, there is a lack of comprehensive research on this topic in Ethiopia. Therefore, this study aims to determine the prevalence and factors contributing to perinatal depression among Ethiopian women. Methods An institutional-based cross-sectional study was conducted, involving 552 women receiving perinatal services at Kutaber district health institution and Boru Meda General Hospital. Study participants were selected through systematic random sampling techniques. Perinatal depression was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21). The associations between various determinants and perinatal depression were examined using binary logistic regression, and factors with a p-value of less than 0.2 were included in the multiple logistic regression analysis. A p-value less than 0.05 was considered statistically significant. Results The prevalence of perinatal depression was found to be 32.2%. The prevalence of perinatal depression was found to be 32.2%. Factors significantly associated with perinatal depression included being a student [adjusted odds ratio (AOR) = 4.364, 95% confidence interval (CI): 1.386, 13.744], experiencing excessive pregnancy-related concerns (AOR = 1.886, 95% CI: 1.176, 3.041), past substance use (AOR = 2.203, 95% CI: 1.149, 4.225), the presence of anxiety symptoms (AOR = 3.671, 95% CI: 2.122, 6.352), experiencing stress symptoms (AOR = 6.397, 95% CI: 3.394-12.055), and daytime sleepiness (AOR = 2.593, 95% CI: 1.558, 4.316). Conclusion The findings of this study indicate a relatively high prevalence and valuable factors associated with perinatal depression. It highlights the need for a comprehensive approach to perinatal mental health that takes into account not only the biological aspects of pregnancy but also the psychological, social, and lifestyle factors that can impact a person's mental well-being during this critical period.
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Affiliation(s)
- Jemal Seid
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Emam Mohammed
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Nigusie Cherie
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Husnia Yasin
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Elsabeth Addisu
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Xie EB, Jung JW, Kaur J, Benzies KM, Tomfohr-Madsen L, Keys E. Digital Parenting Interventions for Fathers of Infants From Conception to the Age of 12 Months: Systematic Review of Mixed Methods Studies. J Med Internet Res 2023; 25:e43219. [PMID: 37494086 PMCID: PMC10413237 DOI: 10.2196/43219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 04/27/2023] [Accepted: 06/06/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Digital interventions help address barriers to traditional health care services. Fathers play an important parenting role in their families, and their involvement is beneficial for family well-being. Although digital interventions are a promising avenue to facilitate father involvement during the perinatal period, most are oriented toward maternal needs and do not address the unique needs of fathers. OBJECTIVE This systematic review describes the digital interventions that exist or are currently being developed for fathers of infants from conception to 12 months postpartum. METHODS A systematic search of the MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials, Embase (using Ovid), and CINAHL (using EBSCO) databases was conducted to identify articles from database inception to June 2022, of which 39 met the inclusion criteria. Articles were included if they were peer-reviewed and described a digital intervention that targeted fathers of fetuses or infants aged ≤12 months. Systematic reviews, meta-analyses, and opinion pieces were excluded. Data from these studies were extracted and themed using a narrative synthesis approach. Quality appraisal of the articles was conducted using the Mixed Methods Appraisal Tool. RESULTS A total of 2816 articles were retrieved, of which 39 (1.38%) met the inclusion criteria for eligibility after removing duplicates and screening. Eligible articles included 29 different interventions across 13 countries. Most articles (22/29, 76%) described interventions that were exclusively digital. There were a variety of digital modalities, but interventions were most commonly designed to be delivered via a website or web-based portal (14/29, 48%). Just over half (21/39, 54%) of the articles described interventions designed to be delivered from pregnancy through the postpartum period. Only 26% (10/39) of the studies targeted fathers exclusively. A wide range of outcomes were included, with 54% (21/39) of the studies including a primary outcome related to intervention feasibility. Qualitative and mixed methods studies reported generally positive experiences with digital interventions and qualitative themes of the importance of providing support to partners, improving parenting confidence, and normalization of stress were identified. Of the 18 studies primarily examining efficacy outcomes, 13 (72%) reported a statistically significant intervention effect. The studies exhibited a moderate quality level overall. CONCLUSIONS New and expecting fathers use digital technologies, which could be used to help address father-specific barriers to traditional health care services. However, in contrast to the current state of digital interventions for mothers, father-focused interventions lack evaluation and evidence. Among the existing studies on digital interventions for fathers, there seem to be mixed findings regarding their feasibility, acceptability, and efficacy. There is a need for more development and standardized evaluation of interventions that target father-identified priorities. This review was limited by not assessing equity-oriented outcomes (eg, race and socioeconomic status), which should also be considered in future intervention development.
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Affiliation(s)
| | - James Wonkyu Jung
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Jasleen Kaur
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Karen M Benzies
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Elizabeth Keys
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- School of Nursing, The University of British Columbia, Okanagan Campus, Kelowna, BC, Canada
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The Effectiveness of Interventions for the Prevention or Treatment of Paternal Perinatal Anxiety: A Systematic Review. J Clin Med 2022; 11:jcm11226617. [PMID: 36431094 PMCID: PMC9692859 DOI: 10.3390/jcm11226617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/30/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022] Open
Abstract
Background: The worldwide prevalence of paternal perinatal anxiety (PPA) ranges between 3.4% and 25.0% antenatally, and 2.4% and 51.0% postnatally. Experiencing PPA can adversely impact the individual, partners, and infants. Research concerning PPA is lagging and fragmented compared to research for new mothers. Objectives: To establish the effectiveness of prevention or treatment interventions for PPA in adults identifying as male. Data sources: We completed searches of Medline, EMBASE, PsycINFO and Web of Science from inception to 2 December 2021, as well as hand searches of references from relevant papers. Search selection and data extraction: Randomised controlled trials delivering prevention or treatment interventions and reporting anxiety outcomes for new/expectant fathers in the perinatal mental health period were included. Our review follows the PRISMA reporting guidelines. One reviewer independently screened 5170 titles/abstracts; second reviewers screened 50%. Two reviewers independently screened full text, extracted data, and conducted risk of bias assessments. Synthesis: Cochrane's collaboration tool 2 was used to assess quality. Primarily results are synthesised narratively, a post-hoc sub-group analysis was completed on four studies using the same outcome measure. Main results: Twelve of the 5170 studies fulfilled the inclusion criteria. Studies used psychoeducational or practical skills interventions. Interventions mostly involved couple-dyads and three studies assessed PPA as a primary outcome. Included interventions were prevention-based; no treatment interventions were found. Father-only interventions consistently reported a significant reduction of PPA. Conclusions: Systematic searching yielded no treatment interventions, highlighting a substantial gap in the evidence base. Within a limited and heterogenous sample, no studies targeted diagnosed PPA. Evidence suggested father-focused interventions may be effective in preventing PPA, regardless of the intervention delivery mode or intervention content. However, consistency between study design and options within the field are lacking compared to interventions available for mothers.
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