Abstract
Background and ObjectivesUp to 10% of fathers experience perinatal depression, often accompanied by anxiety, with a detrimental impact on the emotional and behavioural development of infants. Yet, few evidence-based interventions specifically for paternal perinatal depression or anxiety exist, and few depressed or anxious fathers engage with support. This mini-review aims to build on the evidence base set by other recent systematic reviews by synthesising more recently available studies on interventions for paternal perinatal depression and anxiety. Secondarily, we also aimed to identify useful information on key implementation strategies, if any, that increase the engagement of men.MethodsWe drew upon three major previous systematic reviews and performed an updated search of PubMed/Medline; Psycinfo; Cochrane Database; Embase and Cinahl. The search was limited to trials, feasibility studies or pilot studies of interventions published between 2015 and 2020 that reported on fathers' perinatal mental health. We included psychological, educational, psychosocial, paternal, couple-focused, or group therapies, delivered face-to-face, via telephone and/or online that reported on either paternal depression, anxiety or both.ResultsEleven studies satisfied search criteria (5 of which were not included in previous reviews). The majority were randomised controlled trials. Most interventions incorporated counselling, therapy or psychoeducation and took an indirect approach to perinatal mental health through antenatal or postnatal education and were couple-focused. No studies reported a presence of diagnosed depression or anxiety at baseline, although five studies reported a positive effect on sub-threshold symptoms.DiscussionThere was some evidence that these approaches may be useful in the initial engagement of fathers with perinatal supports and improve depression and anxiety scores. No studies targeted the explicit treatment of clinically depressed or anxious men, and this remains the most substantial gap in the peer-reviewed evidence base. Our results highlight the need to deliver perinatal interventions specifically designed for men and evaluate them in populations with clinical levels of depressive and anxious symptomatology.
Highlights
The transition to fatherhood can present as a fundamental shift in a man’s life
We identified 5 new studies, our updated findings confirm a continuing lack of interventions targeting perinatal depression or anxiety in fathers, in particular when compared to the large body of literature on maternal perinatal depression and anxiety interventions
Of greatest note was the absence of evidence-based psychological treatments for diagnosed depression and anxiety in men
Summary
Along with the traditional challenges of learning new skills and knowledge, changes in personal identity, the couple relationship and financial commitments may lead to new fathers being overwhelmed by feelings of confusion, exhaustion, helplessness, loneliness and feeling trapped (Rowe et al, 2013). These factors can culminate in increased vulnerability to depression and anxiety. Up to 10% of fathers experience perinatal depression, often accompanied by anxiety, with a detrimental impact on the emotional and behavioural development of infants. We aimed to identify useful information on key implementation strategies, if any, that increase the engagement of men
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