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Men Likely to Need Antidepressants Again After Having a Child

Men in the UK who previously used antidepressants were significantly more likely to be prescribed them again after becoming fathers, compared with those who had no history of antidepressant use, according to researchers.

It is estimated that depression affects approximately three in 100 men aged between 16 and 55 years in England. The authors of the observational study, published recently in JAMA Network Open, highlighted that previous evidence suggested men might be at higher risk for depression after the birth of their child, with as many as one in 10 men having depression in the first year.

Researchers at University College London (UCL) set out to determine whether having a new child was associated with increased antidepressant treatment among men in the UK. 

"After the birth of a child, attention is normally focused on the health of the mother and baby," noted lead author, Holly Smith, a PhD candidate from the UCL's Institute of Epidemiology and Health.  

The team analysed information on 90,736 men aged 15 to 55 years old who had a child in the previous year and 453,632 who had not. The data was drawn from primary care electronic health records from the IQVIA Medical Research Database, from January 2007 to December 2016. 

The researchers then examined how many men in each category had received an antidepressant prescription.

Most (85.2%) men in the study were aged between 25 and 44 years, with more men living in the least deprived areas than the most deprived areas — 23.9% versus 13.3%, respectively.

Previous Antidepressant Treatment, Social Deprivation Increase Risk

The researchers found no difference in antidepressant treatment between the two groups.

Although almost one in twenty (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 in the same year, no difference in antidepressant treatment was identified between the groups once confounding factors were taken into account.

These findings suggest that recent fatherhood was not associated with an increase in antidepressant treatment, the authors point out.

However, new fathers were much more likely to take antidepressants in the first year after having a child if they had a recent history of the treatment, the authors emphasise. In fact, fathers who had recently received antidepressant treatment were "over thirty times" more likely to receive antidepressant treatment after childbirth compared with fathers with no history of antidepressant treatment, they note.

The researchers also found that social deprivation was a key factor for whether new fathers were prescribed antidepressants, with those who lived in the most deprived areas having an 18% higher risk of receiving an antidepressant prescription, compared with fathers living in the least deprived areas.

The authors acknowledge some limitations of the study, such as only including men where women of a similar age in the same household had a baby within the study timeframe. This meant that there may have been an underestimate of the number of fathers in the data set, they point out. In addition, the research focused on men who were prescribed antidepressants, rather than only those with symptoms or diagnoses of depression.

Mental Health Check-Up for Fathers Too

"Our findings show that the relationship between depression and fatherhood is complex and that previous antidepressant treatment is a key determinant associated with antidepressant use in the year after having a child," explained Ms Smith.

"This may be because the men are continuing treatment they were on before having a child, or these men may be more susceptible to having feelings of depression again, and the challenges of having a new child may exacerbate this," she postulated.

The authors call for further research to determine whether antidepressant treatment or experiencing depression could be a barrier to fatherhood and whether fatherhood was a barrier to receiving antidepressant treatment.

For men with a history of antidepressant treatment, and for those living in deprived areas, it could be "beneficial" for them to have a mental health check-up with their GP in the first year after having a child, the authors suggest.

Paul Bannister, from the charity ManHealth, commented to Medscape News UK in an email that"much more work needs to be done in supporting perinatal dads, at what can be a challenging time in their lives".

Ms Smith agreed. "We need to ensure that new dads get the care they need, too, by improving research on new fathers and how to engage with them about their mental health," she said.

The study was funded by the National Institute for Health and Care Research. The authors have disclosed no relevant financial relationships.

JAMA Netw Open. Published online 31 May 2023. Full text 

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