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Mid East Info
01-08-2025
- Health
- Mid East Info
The Silent Struggle: Understanding Postpartum Depression in Fathers by Dr. Riyyo Mabborang Specialist Obstetrician and Gynecologist, International Modern Hospital Dubai
When we hear 'postpartum depression,' we often think of new mothers — and rightly so, as maternal mental health is vital. But what about new fathers? While less discussed, paternal postpartum depression (PPD) is a very real condition that affects 10% to 25% of fathers globally, including many in the UAE and Gulf region. Left unrecognized and untreated, it can have serious consequences not only for the father, but also for the partner, child, and overall family dynamics. As the definition of modern fatherhood evolves, it's time to shine a light on this overlooked mental health issue and break the silence surrounding it. How Common Is Paternal Postpartum Depression? Postpartum depression in fathers is more common than many realize. Studies estimate prevalence rates between 10% and 25%, depending on the population and screening methods used. Despite its prevalence, paternal PPD often goes undiagnosed due to a lack of routine screening and societal norms that discourage men from expressing vulnerability. Diagnosis typically involves clinical assessment, the use of standardized screening tools like the Edinburgh Postnatal Depression Scale (EPDS), and mental health referrals. Emotional support networks and group counseling can also play a crucial role in the healing process. How Do Symptoms Differ Between Fathers and Mothers? Although some symptoms of postpartum depression overlap between genders — such as irritability, fatigue, and emotional withdrawal — men may exhibit less obvious signs. These can include: Increased anger or frustration Risk-taking behavior Substance use Withdrawing from family life Physical complaints (e.g., headaches, digestive issues) Gender roles and coping mechanisms often influence how symptoms manifest and how likely men are to seek help. What Are the Risk Factors for Fathers? Several unique risk factors contribute to paternal PPD: History of anxiety or depression Partner's mental health challenges Financial or career stress Lack of sleep Limited social support Unrealistic expectations of fatherhood Cultural pressures and masculinity norms Relationship strain with partner Recognizing these triggers is key to early intervention. Why Do So Many Fathers Go Undiagnosed? There are multiple reasons why paternal depression often goes unnoticed: Stigma around men's mental health Cultural expectations of stoicism and strength Focus on the mother and newborn , sidelining fathers Lack of awareness among healthcare providers Misinterpretation of symptoms (e.g., seen as 'normal stress' or personality traits) As a result, many fathers suffer in silence, unsure whether what they're feeling is 'normal' or worthy of concern. Barriers to Seeking Help The barriers to mental health support for fathers are numerous: Stigma & societal norms Lack of awareness about PPD in men Minimal screening practices during routine checkups Time constraints and work pressures Financial concerns Fear of judgment or appearing 'weak' Poor communication skills or emotional repression Lack of father-focused support networks These hurdles contribute to underreporting and untreated mental health conditions that could otherwise be managed effectively. Are Current Screening Practices Enough? Unfortunately, no — current screening practices are not sufficient for identifying paternal postpartum depression. Most healthcare systems do not routinely screen fathers, and many healthcare professionals are not trained to recognize symptoms in men. Increasing awareness, adopting validated screening tools for men, and integrating paternal mental health into postpartum care are all critical next steps. What the Research Says Several studies highlight the scope and seriousness of the issue: Leach et al. (2016) : Emphasized how paternal depression influences family health and goes widely unrecognized. Paulson & Bazemore (2010) : A literature review showing the prevalence of paternal PPD and need for better screening. Möller-Leimkühler (2003): Highlighted how gender norms can prevent men from seeking help, increasing mental health risks. Postpartum depression in fathers is not a weakness — it's a medical condition that deserves the same recognition and care as maternal mental health. As we advocate for mental wellness across all stages of life, it's time to expand our view of postpartum care to include fathers, remove the stigma, and ensure both parents receive the support they need. Healthy dads contribute to healthier families — emotionally, mentally, and socially.
Health Line
05-07-2025
- Health
- Health Line
What Screening Tools Are Used for Depression?
Key Takeaways Depression screening tools are self-report surveys used to help diagnose depression by evaluating the presence and severity of depressive symptoms. These tools are not 100% reliable but can help healthcare professionals determine the next best steps for treatment. Common assessment tools include the Patient Health Questionnaire (PHQ), Beck Depression Inventory (BDI), Children's Depression Inventory (CDI), Geriatric Depression Scale (GDS), and Edinburgh Postnatal Depression Scale (EPDS). Each is tailored for different age groups or circumstances. Following a test, a healthcare professional can recommend a treatment plan, which may include medications psychotherapy and self-care strategies like yoga, meditation, and exercise. Depression is a common experience affecting up to 6% of the world's population. It typically includes a set of symptoms in varying intensity that affect both mood and behavior. In the worst case, depression can also interfere with your ability to work or maintain relationships. Healthcare professionals are trained to diagnose conditions with the help of tools and technology. Depression screening tests are one type of tool that professionals can use to screen you for the presence of depressive symptoms. If you've been experiencing symptoms of depression and are thinking about seeing a mental health professional, you may be given a depression screening test. The test is simple and easy, and will be followed by a treatment plan. What are depression screening tools? Depression screening tools refer to a number of different self-report surveys used to determine if you've been experiencing symptoms of major depressive disorder. They're mostly pen-and-paper assessments, but you can also fill them out electronically. How does a depression test work? Depression tests list various questions related to depression symptoms, and some will also ask you to rate the severity of those symptoms. Symptom severity corresponds to either the frequency or degree that you experience them. A health professional will give you the test to fill out during your visit. There are various types of depression tests. Some tests are used for specific age groups, whereas others are used for specific circumstances. None are 100% reliable, but several commonly used tests can help diagnose depression with good overall accuracy. The tests usually take a few minutes to complete and are straightforward, requiring no past medical history or other information. After you complete the test, the health professional will then evaluate your responses and determine the next best step. Most common depression assessment instruments Patient Health Questionnaire (PHQ) The Patient Health Questionnaire (PHQ) is often a first-choice tool used by primary care professionals for most people. This is because it can help diagnose depression between 78% and 94% of the time. It can either be a two-question survey (PHQ-2) or a nine-question survey (PHQ-9). The PHQ-2 is typically given first to assess for the overall presence of depressed mood. If necessary, it will be followed by the PHQ-9, which is more detailed and can help detect the overall severity of depression. The PHQ asks how many days per week you experience specific symptoms. Beck Depression Inventory (BDI) The Beck Depression Inventory (BDI) consists of 21 depression-related questions. It asks that you rate the presence of key symptoms on a scale between 0 and 3. Higher scores indicate a more severe form of depression. The BDI is generally considered a reliable and accurate test. Children's Depression Inventory (CDI) The Children's Depression Inventory (CDI) is given to children and adolescents between the ages of 7 and 17. It's written in simple language at a first-grade reading level. It has between 10 and 27 questions. A 2016 study showed that it's between 44% and 76% effective at helping diagnose depression in children. Geriatric Depression Scale (GDS) The Geriatric Depression Scale (GDS) is used for older adults ages 60 and over. The questions are in a yes-or-no format rather than a severity rating. It can have from 4 to 30 questions, and helps diagnose depression with 75% to 86% accuracy. Edinburgh Postnatal Depression Scale (EPDS) If you've recently given birth and have been feeling blue, you may be given the 10-question Edinburgh Postnatal Depression Scale (EPDS). The Edinburgh scale asks you to rate the presence of certain symptoms experienced over the past week. A 2019 study found that the EPDS was approximately 94% effective. Who can administer a depression test? Any healthcare professional involved in some aspect of mental or behavioral health can administer the test. A specialist isn't required. This is because these tests are simple to administer and interpret. This means you can speak with a primary care professional, a licensed mental health counselor, a social worker, or a psychologist. After taking the test, your healthcare professional can help you determine your best treatment plan. Bottom line Depression screening tools are a valuable and simple asset for healthcare professionals. They're mostly accurate at determining both the presence and degree of depressive symptoms, and they're generally easy to fill out. If you're feeling symptoms of depression, visiting a healthcare professional is the first step in evaluating you for major depressive disorder. Based on your results, a mental health professional can work with you to determine a treatment plan.
Medscape
21-05-2025
- Health
- Medscape
New Tool IDs Women at High Risk for Postpartum Depression
LOS ANGELES — Researchers have developed and externally validated a simple, machine learning model that can help identify women at a high risk for postpartum depression (PPD) immediately after childbirth, even before they leave the hospital. Untreated PPD is a significant contributor to maternal morbidity and mortality. It's estimated to play a role in up to 10% of maternal deaths by suicide. Earlier identification will improve the health of patients as they won't have to wait to begin treatment for 6 or 8 weeks after delivery, when symptoms might become much more severe, lead investigator Mark A. Clapp, MD, maternal-fetal medicine specialist at Massachusetts General Hospital and assistant professor in the Department of Obstetrics and Gynecology, Harvard Medical School, both in Boston, told Medscape Medical News . 'It's an opportunity for collaboration between obstetricians and psychiatrists to ensure high-risk patients are seen promptly,' said Clapp. The findings were presented on May 19 at American Psychiatric Association (APA) 2025 Annual Meeting and simultaneously published online in The American Journal of Psychiatry. A Common Problem PPD, which can affect up to 15% of women after childbirth, is linked to an increased risk for suicide and self-harm. The condition has a profound impact on a woman's physical and mental health, ability to function, and relationships with her newborn and family. Until 2023, the American College of Obstetricians and Gynecologists (ACOG) recommended first PPD screening at the postpartum visit. ACOG now recommends screening at the initial prenatal visit, later in pregnancy, and at the postpartum visit. The Edinburgh Postnatal Depression Scale (EPDS) has traditionally been used to screen for the condition. Clapp noted only an estimated 60% of women appear at their postpartum visit, 'so about 4 in 10 patients are actually not presenting for postpartum care,' he said. The study included 29,168 women (media age, 33 years; 70% White) with available EPDS scores and no recent history of a depressive disorder, who gave birth at two large academic hospitals (Brigham and Women's Hospital and Massachusetts General Hospital), and six surrounding community-based hospitals sharing a common electronic health record (EHR) system. A PPD risk stratification model based on EHRs of women having a baby in a hospital makes sense given the widespread use of EHRs in healthcare facilities, where over 98% of pregnant women deliver, said Clapp. Researchers divided participants into a model development group (15,018 participants delivering at five hospitals) and a model validation group (14,150 participants delivering at three hospitals). All information for the model was readily available through EHRs, including maternal medical history, medication use, pregnancy history, and demographic factors. Researchers also incorporated other factors known or hypothesized to influence the risk for PPD such as maternal age; education level; marital status; primary language; public or private insurance; and pregnancy factors such as gestational age, mode of delivery, number of prenatal visits, and length of hospital stay. The primary outcome was PPD, defined as the presence of a mood disorder, an antidepressant prescription, or a positive screen on the EPDS (score ≥ 13) within 6 months of delivery. For both the training and testing sets, researchers assessed model discrimination by the area under the receiver operating characteristic curve (AUROC), as well as positive predictive value (PPV) and negative predictive value (NPV) using a screen-positive threshold and a set specificity of 90%. High Specificity Of the total number of participants, 9.2% met at least one criterion for PPD within 6 months of delivering their baby. Top factors contributing to the risk for PPD included anxiety/fear-related disorders, antiemetic use, headache disorders, gastrointestinal disorders, and prenatal EPDS score. For the primary model, the AUROC was 0.750 (95% CI, 0.721-0.778), indicating the model had good discrimination. The Brier score was 0.073 (95% CI, 0.067-0.080), indicating the model was well calibrated. At the set threshold of 90% specificity, the PPV was 24.4% (95% CI, 21.3%-27.6%) and the NPV was 94.7% (95% CI, 93.9%-95.5%). In the external validity cohort, the AUROC was 0.721 (95% CI, 0.709-0.736) and the Brier score was 0.087 (95% CI, 0.083-0.091). At a specificity of 90%, the PPV was 28.8% (95% CI, 26.7%-30.8%) and the NPV was 92.2% (95% CI, 91.8%-92.7%). 'Using the predefined specificity, we were able to identify about 30% of individuals who were predicted to be at high risk where the diagnosis of postpartum depression occurred,' said Clapp. 'Remember, the overall population risk was about 10%, but of those that we flagged as high risk, the rate of postpartum depression was 30% — or three times the population rate.' In addition to distinguishing between higher- and lower-risk populations, the model performed similarly across patient subgroups by race, ethnicity, age, and hospital type, suggesting the model could be applied equitably in diverse populations, said Clapp. The researchers hope to pair the model with tailored interventions, which in some cases could merely involve a phone call during the postpartum period, said Clapp. 'People at high risk for postpartum depression benefit from a simple phone call, so having a nurse or doctor call them to say, 'Hey, how are you doing?'' can make a big difference, he noted. A limitation of the study is that it only reflects practice patterns in eastern Massachusetts and southern New Hampshire in a single health system. Other limitations were that most patients were White, college-educated, and privately insured, and misclassification may have occurred, as is the case with any study using diagnostic codes. 'We're working to integrate this model into our electronic health record to facilitate real-time predictions' of high PPD risk, said Clapp. The team is also investigating how the model can be used to reduce the incidence, severity, and consequences of PPD. Clinically Important Tool Commenting for Medscape Medical News , reproductive psychiatrist Misty Richards, MD, associate clinical professor, Department of Psychiatry and OB-GYN, University of California at Los Angeles, noted that PPD is the most common complication of childbirth, highlighting the need for better diagnostics. 'We're talking about 1 in 5 women', many of whom, especially those with no history of depression, 'don't tend to get diagnosed,' said Richards, who was not part of the research. 'We try to catch people with postpartum depression before it becomes a forest fire' but 'oftentimes we miss it,' she said. 'Having predictive tools like thisis very, very important clinically, so we can catch things early.' Only one medication — zuranolone, a GABA A receptor–positive allosteric modulator — is approved by the US Food and Drug Administration for PPD, said Richards. Ned Kalin, MD, professor and chair, Department of Psychiatry, and director of the HealthEmotions Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, who was not part of the study, highlighted in a press briefing that patients in the study who developed PPD didn't have a history of depression. 'These are people that otherwise would probably go completely undetected, so this is really a critical advance in that regard.'
