Prevalence and Correlates of Paternal Postpartum Depression in Saudi Arabia

Main Article Content

Waleed A. Alghamdi
Huda Y. Alyahyawi
Saeed S. Shaaban
Rame S. Alharbi
Bassam E. Yaghmoor
Sara F. Alnajjar
Hussein M. Alshamrani


Paternal Postpartum Depression (PPPD), Depression, Jeddah, Edinburgh Postnatal Depression Scale, Men’s Health


Background and objective
Literature concerning paternal postpartum depression (PPPD) is rare. However, PPPD is a highly relevant disorder and can have a detrimental effect on the well-being of the family. Paternal care is an essential factor for infants’ mental development, and PPPD has been clearly shown to influence infants’ psychopathology and behavior later in life. This preliminary study aimed to detect the prevalence of PPPD and the correlated demographic and socioeconomic factors in fathers to newborns at the King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia.

Materials and methods
This was a cross-sectional study conducted at KAUH in Jeddah, Saudi Arabia, between January 1, 2017 and June 25, 2018. We collected data telephonically through questionnaires based on previous studies. A PPPD cutoff score of >10 using a validated Arabic translation of the Edinburgh Postpartum Depression Scale was used. We enrolled 150 fathers with a mean age of 36.61±7.72 years in the study.

The results showed that more than a quarter (27.3%) of the participants suffered from PPPD. Factors that correlate with PPPD included a weak relationship with the partner/mother (p=0.001), trouble sleeping (p=0.010), lower self-esteem (p=0.012), family-related problems (p<0.0001), work-related problems (p=0.002), work–family conflict (p<0.0001), and perceived perinatal and postpartum stress (p=0.001 and <0.0001 respectively).

The results confirm that PPPD is prevalent among fathers in Jeddah. Screening for and treatment of PPPD in Saudi Arabia is currently lacking, and the prevalence of PPPD according to these findings indicates that these deficiencies urgently need to be addressed. Counselling and support for managing health, family, and work issues during and after pregnancy could contribute to preventing PPPD.


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1. World Health Organization. Fact sheet: Depression, 2018 [Internet]. [cited 2018 June 30]. Available from:
2. World Health Organization. Depression: A global crisis. World Mental Health Day. Occoquan, VA: World Federation for Mental Health; 2012.
3. Peluso, ÉD, Blay, SL. Public stigma in relation to individuals with depression. J Affect Disord 2009;115(1–2):201–6. 2008.08.013
4. Rogge, T. Postpartum depression. U.S. National Library of Medicine, 2014 [Internet]. [cited 2018 June 30]. Available from: https://www.nlm.nih. gov/medlineplus/ency/article/007215.htm
5. Ko JY, Rockhill KM, Tong VT, et al. Trends in  postpartum depressive symptoms—27 states, 2004, 2008, and 2012. MMWR Morb Mortal Wkly Rep 2017;66(6):153. 15585/mmwr.mm6606a1
6. Letourneau N, Duffett-Leger L, Dennis CL, et al. Identifying the support needs of fathers affected by post-partum depression: A pilot study. J Psychiatr Ment Health Nurs 2011;18:41–7. 10.1111/j.1365-2850.2010.01627.x
7. Cameron EE, Sedov ID, Tomfohr-Madsen LM. Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. J  Affect Disord 2016;206:189–203. https://doi. org/10.1016/j.jad.2016.07.044
8. Paulson JF, Bazemore SD. Prenatal and postpar-tum depression in fathers and its association with maternal depression: A meta-analysis. JAMA 2010;303(19):1961–9. 10.1001/jama.2010.605
9. Kim P, Swain JE. Sad dads: Paternal postpartum depression. Psychiatry (Edgmont) 2007;4(2):35.
10. Koh YW, Chui CY, Tang CS, Lee AM. The prev-alence and risk factors of paternal depression from the antenatal to the postpartum period and the relationships between antenatal and postpar-tum depression among fathers in Hong Kong. Dep Res Treat 2014;2014:1–11. 10.1155/2014/127632
11. Anding JE, Röhrle B, Grieshop M, et al. Couple comorbidity and correlates of postnatal depressive symptoms in mothers and fathers in the first two  weeks following delivery. J Affect Disord 2016;190:300–9. 10.033
12. Feldman R. Infant–mother and infant–father synchrony: The coregulation of positive arousal. Infant Ment Health J 2003;24(1):1–23. https://
13. Ramchandani P, Stein A, Evans J, et al. Paternal depression in the postnatal period and child devel-opment: A prospective population study. Lancet 2005;365(9478):2201–5. S0140-6736(05)66778-5
14. Eiden RD, Edwards EP, Leonard KE. Mother– infant and father–infant attachment among alcoholic families. Dev Psychopathol 2002;14(2):253–78. S0954579402002043
15. Morse CA, Buist A, Durkin S. First-time parenthood: Influences on pre- and postnatal adjustment in fathers and mothers. J Psychosom Obstet Gynaecol 2000;21(2):109–20. https://doi. org/10.3109/01674820009075616
16. Martins C, Gaffan EA. Effects of early maternal depression on patterns of infant–mother attachment: A meta-analytic investigation. J  Child Psychol Psychiatry 2000;41(6):737–46. 10.1111/1469-7610.00661
17. Shaheen NA, AlAtiq Y, Thomas A, et al. Paternal postnatal depression among fathers of newborn in Saudi Arabia. Am J Men’s Health 2019;13(1): 1557988319831219. 88319831219
18. Moussa S, Emad M, Khoweiled A, et al. Antenatal depression in expectant fathers (an Egyptian study). Egypt J Psychiatry 2012;33:90–6. https://
19. Alamri Y. Mental illness in Saudi Arabia: Stigma  and acceptability. Int J Soc Psychiatry 2016;62(3):306–7. 764016628896
20. Sewilam AM, Watson AM, Kassem AM, et al. Suggested avenues to reduce the stigma of mental illness in the Middle East. Int J Soc Psychiatry 2015;61(2):111–20. 0020764014537234
21. Zubaran C, Schumacher M, Roxo MR, Foresti K. Screening tools for postpartum depression: Validity and cultural dimensions. Afr J Psychiatry (Johannesbg) 2010;13(5):357–65. 10.4314/ajpsy.v13i5.63101
22. Edmondson O JH, Psychogiou L, Vlachos H, et al. Depression in fathers in the postnatal period: Assessment of the Edinburgh Postnatal Depression Scale as a screening measure. J Affect Disord 2010;125(1–3):365–8. 2010.01.069
23. Ghubash R, Abou-Saleh MT, Daradkeh TK. The validity of the Arabic Edinburgh postnatal depres-sion scale. Soc Psychiatry Psychiatr Epidemiol 1997;32(8):474–6.
24. Philpott LF, Corcoran P. Paternal postnatal depression in Ireland: Prevalence and associated factors. Midwifery 2018;56:121–7. https://doi. org/10.1016/j.midw.2017.10.009
25. Bergström M. Depressive symptoms in new first-time fathers: Associations with age, sociodemo-graphic characteristics, and antenatal psychological well-being. Birth 2013;40(1):32–8. 10.1111/birt.12026
26. Gawlik S, Müller M, Hoffmann L, et al. Prevalence of paternal perinatal depressiveness and its link to  partnership satisfaction and birth concerns. Arch Womens Ment Health 2014;17(1):49–56.
27. Zhang YP, Zhang LL, Wei HH, et al. Post partum depression and the psychosocial predictors in first-time fathers from northwestern China. Midwifery 2016;35:47–52. 2016.01.005
28. Nelson EE, Guyer AE. Postnatal depression in Mexican American fathers: Demographic, cul-tural, and familial predictors. J Affect Disord 2012;1(3):233–45.
29. Nishimura A, Ohashi K. Risk factors of paternal depression in the early postnatal period in Japan. Nurs Health Sci 2010;12(2):170–6. https://doi. org/10.1111/j.1442-2018.2010.00513.x
30. Whisman MA, Uebelacker LA. Prospective associ-ations between marital discord and depressive symptoms in middle-aged and older adults. Psychol Aging 2009;24(1):184–9. a0014759
31. Benazon NR, Coyne JC. Living with a depressed spouse. J Fam Psychol 2000;14(1):71–9. https://
32. Stadtlander L. Paternal postpartum depression. Int J Childbirth Education 2015;30:11–13.
33. Suto M, Isogai E, Mizutani F, et al. Prevalence and factors associated with postpartum depres-sion in fathers: A regional, longitudinal study in Japan. Res Nurs Health 2016;39:253–62. https://
34. Musser A, Ahmed A, Foli K, et al. Paternal post-partum depression: What health care providers should know. J Pediatr Health Care 2012;27:479–85.
35. Koenig HG, Meador KG, Parkerson G. Religion index for psychiatric research. Am J Psychiatry 1997;154:885–6.
36. Mann JR, McKeown RE, Bacon J, et al. Religiosity, spirituality, and depressive symptoms in pregnant women. Int J Psychiatry Med 2007;37(3):301–13.
37. Lara-Cinisomo S, Wood J, Fujimoto EM. A sys-tematic review of cultural orientation and peri-natal depression in Latina women: Are acculturation, Marianismo, and religiosity risks or protective factors? Arch Womens Ment Health    2018;557–67. s00737-018-0920-4