Are New Dads More Likely to Need Antidepressants?

For new fathers, previous use of antidepressants was strongly associated with treatment for depression after the birth of a child, but recently having a child was not linked to an increase in treatment for those with no history of antidepressant use, according to a cohort study in the U.K.

Among over half a million men, new fathers who had a recent history of antidepressant treatment were much more likely to receive treatment after the birth of a child compared with new dads with no treatment history (adjusted prevalence risk rate [aPRR] 32.31, 95% CI 30.37-34.38), reported Holly Christina Smith, MSc, of University College London, and co-authors.

There was no difference in antidepressant prescriptions between men who had a child in the previous year and men who did not (aPRR 1.01, 95% CI 0.98-1.04), they noted in JAMA Network Open.

Fathers who were living in the most deprived areas based on the Townsend deprivation index had an 18% higher risk of receiving an antidepressant prescription compared with fathers living in the least deprived areas (aPRR 1.18, 95% CI 1.07-1.30).

“We did find … that having a history of antidepressant treatment made fathers much more likely to need treatment again after they had a child,” Smith told MedPage Today. “As such, it may be beneficial for fathers with previous antidepressant treatment to have a mental health check-up with their [general physician] in the first year after having a child.”

No previous studies have investigated antidepressant treatment initiation among recent fathers, Smith and team said. There is a stigma around mental health treatment for men, especially after the birth of a child when most of the focus is on the health of the mother and baby, they added.

They emphasized the need for more research in trends on mental health among fathers, including how mental health care professionals can identify opportunities to engage with new dads about their mental health.

“Our findings suggest that recent fathers are not more likely to take antidepressants, but the relationship between depression and fatherhood is complex,” Smith said. “Further research is needed to determine whether antidepressant treatment or experiencing depression can be a barrier to fatherhood and whether fatherhood is a barrier to receiving antidepressant treatment.”

The researchers concluded that while recent fatherhood was not associated with increases in antidepressant prescriptions “previous antidepressant treatment and social deprivation were key determinants associated with antidepressant treatment in the year after having a child.”

For this study, Smith and colleagues used primary care electronic health records from the IQVIA Medical Research Database, and included men who had had a child in the previous year, and compared them with up to five men who did not have a child in the same calendar year, from January 2007 to December 2016.

The analysis included 90,736 men who had a child and 453,632 men who did not have a child; 85.2% were ages 25 to 44. Approximately 24% lived in the least deprived areas and 13.3% lived in the most deprived areas.

Overall, 4.9% had at least one antidepressant prescription in the year after they had a child compared with 5.9% who did not have a child.

The researchers used the random-effects Poisson regression to determine associations between the cohorts based on age group, social deprivation, history of antidepressant treatment, and receipt of an antidepressant prescription in the year after having a child.

Smith and team noted that the main limitation of the study was being able to correctly identify fathers, since identification relied on women of a comparable age within the same household having a record of a baby within the study time frame.

“We have no definitive way of confirming that those identified as fathers in our study were fathers,” they wrote. “As such, we will likely underestimate the number of fathers within the data set, but this is unlikely to affect the direction of our findings.”

Furthermore, the researchers focused on men who were prescribed antidepressants, rather than those with symptoms or diagnoses of depression, meaning that they may have underestimated the prevalence of depression among new fathers.