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Towards effective screening for paternal perinatal mental illness: a meta-review of instruments and research gaps
Philipp Schöch1,2, Laura Hölzle1,2, Astrid Lampe3
1Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria.
Insights
Paternal perinatal mental illness (PPMI) is under-recognized in fathers, with current screening tools inadequately assessing male symptoms. New, father-specific assessment tools are needed to address these gaps and improve paternal mental health care.
Area of Science:
- Perinatal Mental Health
- Men's Mental Health
- Psychometrics
Background:
- Paternal perinatal mental illness (PPMI) affects approximately 10% of fathers.
- Social stigma and reluctance to seek help contribute to under-recognition of PPMI.
- Neglecting paternal mental health impacts fathers, families, and children.
Purpose of the Study:
- To systematically identify and evaluate instruments for assessing PPMI symptoms.
- To assess the psychometric properties and applicability of these instruments.
- To identify gaps and limitations in PPMI symptom assessment literature.
Main Methods:
- Conducted a systematic literature review across multiple databases (PubMed, PsycNet APA, Cochrane, Web of Science).
- Supplemented database searches with hand searches.
- Performed narrative analysis of extracted data from included studies.
Main Results:
- The Edinburgh Postnatal Depression Scale (EPDS) is widely used but inadequately captures atypical male depressive symptoms.
- Lack of consensus on cutoff scores and variable instrument sensitivity due to socio-demographic factors.
- Many identified tools are general and not specific to perinatal mental health in fathers.
Conclusions:
- Current screening practices for PPMI have limitations and gaps.
- Existing tools, including EPDS, are not optimally suited for fathers.
- There is a critical need for screening instruments specifically designed for paternal perinatal mental health.
Background:
Paternal perinatal mental illness (PPMI), which affects around one in 10 fathers, is under-recognised despite increasing awareness of men's mental health in the perinatal period. Social stigma and men's reluctance to seek help exacerbate this gap. Neglecting the mental health needs of new fathers not only puts them at increased risk for mental illness themselves, but also has a profound and long-lasting impact on their families, children and their own self-esteem as they navigate their new role in the family dynamic.
Objective:
This meta-review systematically identifies instruments assessing PPMI symptoms, evaluates their psychometric properties and applicability, presents key findings from studies using these tools, and identifies gaps and limitations in the literature on PPMI symptom assessment.
Methods:
A systematic literature review was conducted using search strategies applied to PubMed, PsycNet APA, Cochrane, and Web of Science, supplemented by hand searches. Relevant information was extracted from each included study. Extracted data were analysed narratively to address the research questions.
Results:
Findings identified limitations and gaps in current screening practices. While the Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening tool for both fathers and mothers, it inadequately captures atypical depressive symptoms in men. Cutoff scores lack consensus, and instrument sensitivity varies significantly due to cultural and sociodemographic factors. A number of other screening tools have been identified, most of which are more general and not specifically designed for perinatal mental health.
Conclusion:
This meta-review broadens perspectives on PPMI screening instruments, highlighting key themes, patterns, and differences across the included reviews. While a variety of screening tools are used, the review underscores the necessity for tools specifically tailored to fathers during the perinatal period.
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