{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:33:16Z","timestamp":1789014796372,"version":"build-2803163510"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"\n Importance<\/jats:title>\n Male postpartum depression is prevalent across populations; however, there is limited evidence on strategies to address it, particularly in low-income settings.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the effectiveness of Learning Through Play Plus Dads (LTP\u2009+\u2009Dads), a nonspecialist\u2013delivered psychosocial intervention, in improving symptoms of male postpartum depression compared to treatment as usual.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n \n This cluster randomized clinical trial was conducted in Karachi, Pakistan, between June 2018 and November 2019. Assessors were blind to treatment allocation. Participants were recruited from 2 large towns in the city of Karachi via basic health units. Fathers aged 18 years and older with a\n DSM-5<\/jats:italic>\n diagnosis of major depressive episode and a child younger than 30 months were recruited. Of 1582 fathers approached, 1527 were screened and 357 were randomized in a 1:1 ratio to either the intervention or treatment as usual; 328 were included in the final analysis. Data were analyzed from April to June 2022.\n <\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n LTP\u2009+\u2009Dads is a manualized intervention combining parenting skills training, play therapy, and cognitive behavior therapy. The intervention was delivered by community health workers via 12 group sessions over 4 months.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was change in 17-item Hamilton Depression Rating Scale score at 4 months. Secondary outcomes included anxiety symptoms; parenting stress; intimate partner violence; functioning; quality of life; and child social, emotional, and physical health outcomes. Assessments were completed at baseline and 4 and 6 months postrandomization.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 357 fathers included (mean [SD] age, 31.44 [7.24] years), 171 were randomized to the intervention and 186 to treatment as usual. Participants randomized to the intervention demonstrated significantly greater improvements in depression (group difference ratio [GDR], 0.66; 95% CI, 0.47 to 0.91;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), anxiety (GDR, 0.62; 95% CI, 0.48 to 0.81;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), parenting stress (GDR, \u221212.5; 95% CI, \u221219.1 to \u22126.0;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), intimate partner violence (GDR, 0.89; 95% CI, 0.80 to 1.00;\n P<\/jats:italic>\n \u2009=\u2009.05), disability (GDR, 0.77; 95% CI, 0.61 to 0.97;\n P<\/jats:italic>\n \u2009=\u2009.03), and health-related quality of life (GDR, 12.7; 95% CI, 0.17 to 0.34;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) at 4 months. The difference in depression and parenting stress was sustained at 6 months. Children of fathers randomized to the parenting intervention had significantly greater improvements in social-emotional development scores (mean difference, \u221220.8; 95% CI, \u221228.8 to \u221212.9;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) at 6 months.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The psychosocial parenting intervention in this study has the potential to improve paternal mental health and child development in Pakistan. Further studies in other populations and with longer follow-up are warranted.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT03564847<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2024.2752","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T11:26:54Z","timestamp":1727868414000},"page":"22","source":"Crossref","is-referenced-by-count":12,"title":["A Group Parenting Intervention for Male Postpartum Depression"],"prefix":"10.1001","volume":"82","author":[{"given":"M. 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