Symptoms of depression in Swedish fathers in the postnatal period and development of a screening tool

Methods for detecting depression in fathers after the birth of their child are scarce. The Edinburgh Postnatal Depression Scale (EPDS), used to screen mothers for postpartum depression (PPD), lacks somatization and externalizing items. This potentially decreases its sensitivity in detecting depression in fathers, as many men actually express depression with somatization or externalizing symptoms. The present study assessed depressive symptoms in fathers of children 0-18 months old, and evaluated whether addressing both typical depression and externalizing, so-called "depressive equivalent" symptoms, might be more suitable for such assessment. The Beck Depression Inventory-II (BDI-II), EPDS, and Gotland Male Depression Scale (GMDS) were responded to by 447 Swedish fathers online. Among participants, 27% reported depressive symptoms above the BDI-II cut-off suggestive of depression. Most fathers reported both traditional and depressive equivalent symptoms and a subgroup expressed exclusively depressive equivalent symptoms. Consistently, a scale combining items from the EPDS and GMDS showed higher sensitivity than the EPDS alone in identifying fathers with elevated depressive symptoms, at equal levels of specificity. Our findings suggest that a combination of EPDS and depressive equivalent symptom items results in a more suitable instrument for screening for depression in fathers during the postnatal period.