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A psychosocial parenting intervention for postpartum depression in men is associated with improved mental health and parenting outcomes among fathers, according to study results published in JAMA Psychiatry.
Postpartum depression in men is disproportionately prevalent in low- and middle-income countries, affecting up to 10% of fathers. Despite its prevalence, there are relatively few evidence-based interventions that address this health disparity.
To evaluate the effectiveness of a nonspecialist-delivered psychosocial intervention for postpartum depression in men, researchers conducted a cluster randomized clinical trial (NCT03564847) across 38 villages in Pakistan between 2018 and 2019. A total of 8 to 10 father-child dyads were recruited in each village, and each village was randomly assigned in a 1:1 ratio to receive the Learning Through Play (LTP) with dad (LTP+Dad) intervention (n=171 fathers) or treatment as usual (n=186 fathers). The primary outcome of interest was the change in 17-item Hamilton Depression Rating Scale (HDRS-17) scores at 4 months.
The LTP+Dad was a group parenting intervention with 12 separate 60- to 90-minute sessions delivered over 4 months that included cognitive behavior therapy adapted for the group context and a Focus on Fathers skill management program. It was also accompanied by a pictorial calendar depicting parent-child play activities in 8 successive stages from birth to 3 years of age.
The fathers had a mean (SD) age of 31.44 (7.24) years, a median (interquartile range [IQR]) of 3 (2-4) children, 22.7% were first-time fathers, 15.4% had experienced the loss of a child, and 40.9% had not attended school. The fathers assigned to the LTP+Dad intervention attended a mean of 10.3 sessions.
At baseline, the LTP+Dad and control groups had median HDRS-17 scores of 25 and 23, respectively. The fathers who participated in the LTP+Dad intervention had significantly greater reductions in HDRS-17 scores at 4 (group difference ratio [GDR], 0.66; P <.001) and 6 (GDR, 0.67; P <.001) months compared with the control group.
The LTP+Dad intervention was also associated with significant changes in 7-item Generalized Anxiety Disorder (GDR, 0.62; P <.001), Brief Disability Questionnaire (GDR, 0.77; P =.03), European Quality of Life 5-Dimension Instrument (GDR, 0.26; P <.001), EuroQoL Visual Analogue Scale (GDR, 12.7; P <.001), Dyadic Adjustment Scale (GDR, 10.8; P <.001), and 3-item Oslo Social Support Scale (GDR, 0.6; P =.03) scores at 4 months relative to treatment as usual. No group differences in outcomes were observed at 6 months.
In addition, the LTP+Dad intervention was associated with significant improvements to the parenting outcomes of Knowledge, Attitude, and Practices questionnaire (KAP) scores at 4 months (mean difference [MD], 2.3; P <.001) and Parenting Stress Index–Short Form (PSI-SF) scores at 4 (MD, -12.5; P <.001) and 6 (MD, -11.3; P =.001) months relative to control.
The children of fathers in the LTP+Dad program had significantly higher Home Observation for Measurement of the Environment (HOME) total scores at 4 months (MD, 4.0; P =.001) and lower The Ages and Stages Questionnaire Social-Emotional version 2 (ASQ-SE-2) scores at 6 months (MD, -20.8; P <.001) compared with those whose fathers were assigned to the control condition.
“The findings suggest that the psychosocial parenting intervention examined in this study has the potential to improve paternal mental health and child developmental outcomes in lower middle–income countries,“ the researchers concluded.
The primary study limitation is that these findings may not be generalizable to higher-income settings.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
This article originally appeared on Psychiatry Advisor
