Perinatal affective disorders in fathers: anthropological, neuroendocrine and clinical observations.

Nowadays, the functions and roles of the father are the consequence of a gradual transition from a "patriarchal" family to a contemporary family organization. New fathers today, are increasingly the point of reference of the mother, particularly during the perinatal period, and are ever more involved in the care of their offspring. The significant adjustments in the paternal functions are also accompanied by hormonal, neurobiological and psychological changes. Considering a gender-based approach, this chapter discussed the underlying mechanisms and the characteristics of perinatal affective disorders in fathers, by integrating empirical evidence from neurobiological and behavioral studies with anthropological and clinical observations. Perinatal psychological distress in men can be displayed, not only with traditional depressive-like symptoms, but rather through a wide array of other clinical manifestations (anxiety disorders, somatic complains, behavioral problems, and addictions) which can overlap or mask depressive symptoms, generating complex clinical pictures. Therefore, the definition of Paternal Perinatal Affective Disorders (PPAD) has been proposed to replace the term Paternal Perinatal Depression (PPND). Following this perspective, the chapter includes indications to implement effective prevention, screening and early diagnosis considering male expression of paternal perinatal distress. Implications for treatment are also discussed.