A population study on perinatal psychological distress in Mexican fathers

Ma. Asunción Lara, Shoshana Berenzon, Lourdes Nieto, Laura Navarrete, Clara Fleiz, Marycarmen Bustos, Jorge Villatoro

DOI: https://doi.org/10.17711/SM.0185-3325.2021.035


Introduction. The transition to parenthood can be a source of stress for fathers and, in some cases, it can be accompanied by emotional distress. This aspect has been neglected in Mexican research.

Objective. To estimate the prevalence of emotional distress and the sociodemographic factors associated with it in Mexican fathers.

Method. Cross-sectional study. A subsample of 997 fathers, over 18 years of age, was taken from the data of a national survey, whose partners were pregnant or had given birth in the last six months. The Kessler Emotional Distress Scale (K6) was used.

Results. About 25% of the fathers experienced moderate emotional distress during their partner's pregnancy and 29.5% during the postpartum period; 1.0% and 1.9% showed serious emotional distress in those periods, respectively. Being between 18 and 29 years old (PR = .10; CI [.01, .79]), having lower educational attainment (PR = 5.59; CI [1.19, 26.21]), and going through postpartum (PR = 4.11; CI [1.00, 16.78]) were at higher risks for severe emotional distress; having one or two children (PR = .16; CI [.05, .55]) or more than three (PR = .08; CI [.01, .44]) was a higher risk than being a first-time father.

Discussion and conclusion. It is necessary to continue studying paternal perinatal mental health due to the impact it has on the mother and the infant, and to design tailored interventions. Parental emotional distress needs to be better understood considering recent changes in the paternal role in developing countries.


Psychological distress; fathers; peripartum period; mental health; risk factors

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Addis, M. E. (2008). Gender and depression in men. Clinical Psychology Science and Practice, 15(3), 153-168. doi: 10.1111/j.1468-2850.2008.00125.x

Baldwin, S., Malone, M., Sandall, J., & Bick, D. (2018). Mental health and wellbeing during the transition to fatherhood: a systematic review of first time fathers’ experiences. JBI Database of Systematic Reviews and Implementation Reports, 16(11), 2118-2191. doi: 10.11124/JBISRIR-2017-003773

Banks, L. M., Kuper, H., & Polack, S. (2017). Poverty and disability in low- and middle-income countries: A systematic review. PLoS One, 12(12), e0189996. doi: 10.1371/journal.pone.0189996

Bergström, M. (2013). Depressive symptoms in new first-time fathers: Associations with age, sociodemographic characteristics, and antenatal psychological well-being. Birth, 40(1), 32-38. doi: 10.1111/birt.12026

Borges, G., Medina-Mora, M. E., Wang, P. S., Lara, C., Berglund, P., & Walters, E. (2006). Treatment and adequacy of treatment of mental disorders among respondents to the Mexico National Comorbidity Survey. American Journal of Psychiatry, 163(8), 1371-1378. doi: 10.1176/ajp.2006.163.8.1371

Button, S., Thornton, A., Lee, S., Shakespeare, J., & Ayers, S. (2017). Seeking help for perinatal psychological distress: a meta-synthesis of women’s experiences. British Journal of General Practice, 67(663), e692-e699. doi: 10.3399/bjgp17X692549

Cameron, E. E., Sedov, I. D., & Tomfohr-Madsen, L. M. (2016). Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. Journal Affective Disorders, 206, 189-203. doi: 10.1016/j.jad.2016.07.044

Chhabra, J., McDermott, B., & Li, W. (2020). Risk factors for paternal perinatal depression and anxiety: A systematic review and meta-analysis. Psychology of Men & Masculinities, 21(4), 593-611. doi: 10.1037/men0000259

Cochran, S. V., & Rabinowitz, F. E. (2000). Men and depression: Clinical and empirical perspectives (Practical resources for the mental health professional). Academic Press.

Condon, J. T., Corkindale, C. J., & Boyce, P. (2004). The First-Time Fathers Study: A Prospective Study of the Mental Health and Wellbeing of Men during the Transition to Parenthood. Australian & New Zealand Journal of Psychiatry, 38(1-2), 56-64. doi: 10.1177/000486740403800102

Darwin, Z., Galdas, P., Hinchliff, S., Littlewood, E., McMillan, D., McGowan, L., & Gilbody S. (2017). Fathers’ views and experiences of their own mental health during pregnancy and the first postnatal year: a qualitative interview study of men participating in the UK Born and Bred in Yorkshire (BaBY) cohort. BMC Pregnancy and childbirth, 17(1), 45. doi: 10.1186/s12884-017-1229-4

Falah-Hassani, K., Shiri, R., & Dennis, C. L. (2017). The prevalence of antenatal and postnatal co-morbid anxiety and depression: a meta-analysis. Psychological Medicine, 47(12), 2041-2053. doi: 10.1017/S0033291717000617

Fisher, J., Cabral de Mello, M., Patel, V., Rahman, A., Tran, T., Holton, S., & Holmes W. (2012). Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bulletin of the World Health Organization, 90(2), 139-149. doi: 10.2471/BLT.11.091850

Giallo, R., Cooklin, A., Wade, C., D’Esposito, F., & Nicholson, J. M. (2014). Fathers’ Postnatal Mental Health and Child Well-Being at Age Five: The Mediating Role of Parenting Behavior. Journal of Family Issues, 35(11), 1543-1562. doi: 10.1177/0192513X13477411

Glasser, S., & Lerner-Geva, L. (2019). Focus on fathers: paternal depression in the perinatal period. Perspectives in Public Health, 139(4), 195-198. doi: 10.1177/1757913918790597

Goldberg, D. (1978). Manual of the General Health Questionnaire. NFER Publishing Company.

Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9(1), 139-145. doi: 10.1017/S0033291700021644

Instituto Nacional de Estadística, Geografía e Informática (INEGI). (2015). Porcentaje de población que no posee nacionalidad mexicana (Porcentaje), 2015. México: INEGI. Retrieved from: https://www.inegi.org.mx/app/indicadores/?ind=6207019025&tm=6#divFV6207019025#D6207019025 (Access date: April 26, 2021)

Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S.-L. T., ... Zaslavsky, A. M.. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959-976. doi: 10.1017/s0033291702006074

Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., … Zaslavsky, A. M. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60(2), 184-189. doi: 10.1001/archpsyc.60.2.184

Kessler, R. C., Green, J. G., Gruber, M. J., Sampson, N. A., Bromet, E., Cuitan, M., … Zaslavsky, A. M. (2010). Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative. International Journal of Methods in Psychiatric Research, 19(Suppl 1), 4-22. doi: 10.1002/mpr.310

Kubzansky, L. D., Kawachi, I., & Sparrow, D. (1999). Socioeconomic status, hostility, and risk factor clustering in the normative aging study: Any help from the concept of allostatic load? Annals of Behavioral Medicine, 21(4), 330-338. doi: 10.1007/BF02895966

Kumar, S. V., Oliffe, J. L., & Kelly, M. T. (2018). Promoting Postpartum Mental Health in Fathers: Recommendations for Nurse Practitioners. American Journal of Men’s Health, 12(2), 221-228. doi: 10.1177/1557988317744712

Lara, M. A., Navarrete, L., & Nieto, L. (2016). Prenatal predictors of postpartum depression and postpartum depressive symptoms in Mexican mothers: a longitudinal study. Archives of Women’s Mental Health, 19(5), 825-834. doi: 10.1007/s00737-016-0623-7

Leach, L. S., Poyser, C., Cooklin, A. R., & Giallo, R. (2016). Prevalence and course of anxiety disorders (and symptom levels) in men across the perinatal period: A systematic review. Journal of Affective Disorders, 190, 675-686. doi: 10.1016/j.jad.2015.09.063

Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales. 2nd ed. Sydney: Psychology Foundation of Australia.

McCoy, B. S. J. (2012). Postpartum Depression in Men. In M. G. Rojas Castillo (Ed.). Perinatal Depression, (pp. 163-176). E-Publishing Inc. Retrieved from http://www.intechopen.com/books/perinatal-depression/postpartum-depression-in-men-

Morales, A., Catalán, A., & Pérez, F. (2018). Los padres también se deprimen en el postparto: comprendiendo el fenómeno desde la voz de sus protagonistas. Polis (Santiago), 17(50), 161-181. doi: 10.4067/S0718-65682018000200161

Ocampo, R., Heinze, G., & Ontiveros, M. P. (2007). Detección de depresión postparto en el Instituto Nacional de Perinatología. Psiquiatría, 23(3), 18-22.

O’Brien, A. P., McNeil, K. A., Fletcher, R., Conrad, A., Wilson, A. J., Jones, D., & Chan S. W. (2017). New Fathers' Perinatal Depression and Anxiety-Treatment Options: An Integrative Review. American Journal of Men’s Health, 11(4), 863-876. doi: 10.1177/1557988316669047

Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A Meta-Analysis. JAMA, 303(19), 1961-1069. doi: 10.1001/jama.2010.605

Philpott, L. F., Leahy-Warren, P., FitzGerald, S., & Savage, E. (2017). Stress in fathers in the perinatal period: A systematic review. Midwifery, 55, 113-127. doi: 10.1016/j.midw.2017.09.016

Philpott, L. F., Savage, E., Leahy-Warren, P., & FitzGerald, S. (2020). Paternal perinatal depression: A narrative review. International Journal of Mens Social and Community Health, 3(1), e1-e15. doi: 10.22374/ijmsch.v3i1.22

Pinheiro, K. A., Coelho, F. M., Quevedo, L. de Á., Jansen, K., Souza, L. de M., Oses, J. P., … Pinheiro, R. T. (2011). Paternal postpartum mood: bipolar episodes? Brazilian Journalof Psyquiatry, 33(3), 283-286. doi: 10.1590/s1516-44462011000300012

Pinheiro, R. T., Magalhães, P. V., Horta, B. L., Pinheiro, K. A., da Silva, R. A., & Pinto, R. H. (2006). Is paternal postpartum depression associated with maternal postpartum depression? Population-based study in Brazil. Acta Psychiatrica Scandinavica, 113(3), 230-232. doi: 10.1111/j.1600-0447.2005.00708.x

Ramírez Rodríguez, J. C., & Cervantes Ríos, J. C. (2013). Los hombres en México: veredas recorridas y por andar. Una mirada a los estudios de género de los hombres, las masculinidades. México: Universidad de Guadalajara.

Schulz, A. (2016). Fatherhood and Psychological Distress: Paternal Depression, Anxiety and Stress in the Perinatal Period, in School of Psychology. Australia: Deakin University.

Skari, H., Skreden, M., Malt, U. F., Dalholt, M., Ostensen, A. B., Egeland, T., & Emblem, R. (2002). Comparative levels of psychological distress, stress symptoms, depression and anxiety after childbirth—a prospective population-based study of mothers and fathers. BJOG: An International Journal of Obstetrics and Gynaecology, 109(10), 1154-1163. doi: 10.1111/j.1471-0528.2002.00468.x

Tena, O. (2014). Malestares laborales y condición masculina. Reflexiones en torno a la flexibilidad laboral. In J. G. Figueroa, (Coord.). Políticas públicas y la experiencia de ser hombre. Paternidad, espacios laborales, salud y educación. México: El Colegio de México.

Vargas, T. B., Villamil, S. V., Rodríguez, E. C., Pérez, R. J., & Cortés, S. (2011). Validación de la escala Kessler 10 (K-10) en la detección de depresión y ansiedad en el primer nivel de atención. Propiedades psicométricas. Salud Mental, 34(4), 323-331.

Vismara, L., Rollè, L., Agostini, F., Sechi, C., Fenaroli, V., Molgora, S., … Tambelli, R. (2016). Perinatal Parenting Stress, Anxiety, and Depression Outcomes in First-Time Mothers and Fathers: A 3- to 6-Months Postpartum Follow-Up Study. Frontiers in Psychology, 7, 938. doi: 10.3389/fpsyg.2016.00938

Wall, G., & Arnold, S. (2007). How involved is involved fathering?:An exploration of the contemporary culture of fatherhood. Gender & Society, 21(4), 508-527. doi: 10.1177/0891243207304973