New fathers face delayed mental health risks after childbirth

By Dr. Priyom Bose, Ph.D.Reviewed by Lauren HardakerMar 26 2026

Early signs may be missed: fathers show fewer diagnoses during pregnancy but face rising mental health risks months later.

Study: Psychiatric Disorders Among Fathers in Sweden Before, During, and After Partner Pregnancy. Image credit: Monkey Business Images/Shutterstock.com

A recent study in JAMA Network Open examined the incidence patterns of paternal psychiatric disorders before, during, and after a partner’s pregnancy.

The overlooked burden of psychiatric disorders in new fathers

Parental mental health shapes family functioning and child development across multiple domains, yet psychiatric disorders among fathers have received considerably less research attention than those among mothers. This disparity persists despite evidence that paternal perinatal mental illness elevates risk for adverse outcomes in both partners and children. Typically, fathers face compounding barriers to care, including stigma and delayed clinical recognition, which allow family-level consequences to go unaddressed.

Becoming a father brings both rewards and challenges. While many men experience strong emotional bonding, the perinatal period can also introduce relationship strain, less communication with partners, and disrupted sleep from new caregiving demands. Together, these pressures make paternal mental health harder to track, and without clearly defined high-risk periods, it remains difficult to implement timely screening - unlike the more established support systems available for mothers in many healthcare settings.

Existing data indicate that the prevalence of paternal psychiatric disorders is elevated in the first six months postpartum relative to the general male population. Yet prevalence estimates alone cannot identify when new episodes emerge, a significant challenge for clinical resource allocation and mechanistic understanding.

Assessing paternal psychiatric risk across the perinatal period

This nationwide cohort study examined the incidence of clinically diagnosed paternal psychiatric disorders among fathers whose child was born in Sweden between January 1, 2003, and December 31, 2021, using linked national register data. Births were identified from the Medical Birth Register (MBR), which captures 98 % of all births in Sweden. Any incorrect and duplicate records were excluded.

Fathers were followed from up to one year before pregnancy (or from immigration or January 1, 2003, whichever occurred later) until the first psychiatric diagnosis, one year postpartum, emigration, death, or December 31, 2022, although approximately one-quarter of births did not have a complete one-year preconception observation window. Psychiatric diagnoses were identified using data from the National Patient Register (NPR), covering nationwide inpatient care since 1973 and specialist outpatient visits since 2001, thereby capturing diagnoses made in specialist care rather than all mental health symptoms or primary care encounters.

The primary outcome assessed in this study was any psychiatric disorder; secondary outcomes included depression, anxiety, stress-related disorder, alcohol, tobacco, and drug use disorders, bipolar disorder, psychosis, and attention-deficit/hyperactivity disorder (ADHD).

Annual incidence rates (IRs) of any and disorder-specific psychiatric conditions were estimated across the three periods from 2003 to 2021, standardized by age at childbirth, and additionally calculated at weekly intervals across the perinatal timeline.

Psychiatric disorder incidence in fathers peaks in the late postpartum period

The study cohort comprised 1,096,198 fathers and 1,915,722 childbirths. Approximately 77 % of fathers were born in Sweden, and 61.2 % of the cohort resided in Central Sweden. The majority cohabited with their partner, and 46.1 % of the cohort had 10-12 years of education. The mean paternal age at childbirth was 33.8 years, and half were first-time fathers.

IRs of any psychiatric disorder consistently increased across all perinatal periods from 2003 to 2013, then declined through 2021. This pattern held for depression, anxiety, stress-related disorder, alcohol use disorder, and drug use disorder. Tobacco use disorder and bipolar disorder increased gradually before stabilizing, psychosis remained stable, and ADHD continued to rise throughout the study period, albeit more slowly after 2013.

Paternal psychiatric disorder IRs were lower during pregnancy and early postpartum than in preconception weeks, reaching a low point of approximately 4 per 1000 person-years in late pregnancy before recovering to preconception levels by year’s end. Depression and stress-related disorders slightly exceeded preconception rates by the close of the postpartum year, while tobacco use disorder, ADHD, bipolar disorder, and psychosis remained largely stable throughout.

Relative to corresponding preconception weeks, IRRs of any paternal psychiatric disorder were modestly elevated in early pregnancy, declined through mid-pregnancy, then recovered to preconception levels by late postpartum, even though absolute incidence rates during pregnancy remained lower than in the preconception period overall. Depression and stress-related disorders showed the sharpest postpartum rise, with IRRs exceeding preconception levels by more than 30 % in the final weeks of the first year. Tobacco use disorder, ADHD, bipolar disorder, and psychosis showed no meaningful deviation throughout.

Sensitivity analyses restricted by psychiatric history, geographic region, completeness of preconception follow-up, and birth order yielded consistent results, with IRRs slightly higher in analyses limited to Stockholm County, where primary care data supplement specialist records.

Fathers with lower educational attainment had substantially higher IRs of psychiatric disorder across all perinatal periods, though the relative pattern of IRRs was similar across educational strata. Year of childbirth, country of birth, and number of children did not significantly influence incidence rates or ratios.

Conclusions

This nationwide Swedish cohort study found that paternal psychiatric disorder incidence was lower during pregnancy and early postpartum relative to preconception, recovering to baseline by late postpartum.

Depression and stress-related disorders showed the most pronounced late postpartum rise, suggesting that the transition to fatherhood may carry delayed psychiatric risk or reflect delayed detection related to reduced help-seeking and underrecognition during the perinatal period.

The authors also note that, in contrast to mothers, fathers did not exhibit an early postpartum peak in disorders such as depression or psychosis, highlighting distinct sex-specific temporal patterns. These findings may in part reflect underdetection driven by reduced help-seeking among fathers. Together, the findings underscore the need for targeted paternal mental health surveillance extending through the full first postpartum year.

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