Transitioning to fatherhood: Prospective effects of wellbeing on future depression symptoms

Background: Becoming a father is a critical period of life transition. Evidence suggests that a lifetime history of mental health disorder/s and elevated depressive symptoms prior to conception increase risk for men's post-natal depression. Less is understood about the role of positive mental health, or wellbeing, as a protective factor for future depressive outcomes during the transition to fatherhood. The present study investigated whether men's post-natal depressive outcomes were associated with pre-conception levels of wellbeing and whether wellbeing during the post-natal period predicted depressive outcomes post-infancy.

Methods: Secondary analysis of data from a national, longitudinal cohort study of men's health, namely, The Ten to Men (TTM) Study, was conducted. Participants in the pre-conception sample were n = 350 men for whom data were available at both a pre-conception baseline and post-natal follow-up period. The post-natal sample were n = 427 men with post-natal baseline data and post-infancy follow-up data. Multivariate negative binomial regressions and logistic regression models were used to determine pre-conception and post-natal predictors of future depressive outcomes.

Results: Men's pre-conception depressive symptoms were the best predictor of post-natal depressive symptoms (IRR = 1.089, p < 0.001) and risk of moderate-severe depression (IRR = 1.193, p = 0.005) the latter of which was also predicted by a previous mental health diagnosis (IRR = 3.079, p = 0.029). Similarly, post-natal depressive symptoms were the best predictor of post-infancy depressive symptoms (IRR = 1.089, p < 0.001) and risk of moderate-severe depression (IRR = 1.193, p = 0.005) alongside lifetime prevalence of a mental health disorder (symptoms: IRR = 1.317, p = 0.011; moderate-severe depression: IRR = 2.606, p = 0.023). Pre-conception levels of wellbeing predicted lower post-natal depressive symptoms (IRR = 0.988, p < 0.001) and reduced risk of moderate-severe depression (IRR = 0.940, p = 0.002) after controlling for baseline symptoms and socio-demographic and behavioural confounds; however, wellbeing during the post-natal period did not predict either of the depressive outcomes post-infancy.

Limitations: Fatherhood-specific risk factors for mental health outcomes (e.g., conception difficulties, maternal post-natal mental health) were not assessed in the present study, and only one aspect of wellbeing was captured.

Conclusions: Screening for history of common mental health disorders and current symptoms is recommended to inform preventative approaches to paternal mental health care during early fatherhood. Inclusion of wellbeing in such screening procedures may be beneficial; however, further research is required to elucidate the prospective associations between wellbeing and depressive symptoms during the transition to fatherhood.