2026 ECNP Congress

PS02-2184

Beyond maternal risk: paternal bonding and perinatal depressive symptoms

Edoardo Grechi — M. Olivola, T. Prodi, R. Anniverno, B.M. Dell'Osso · Università degli Studi di Milano, Department of Mental Health and Addiction Services- ASST Fatebenefratelli-Sacco, Milano, Italy

2026 ECNP Congress

Background

Perinatal depression affects approximately 10–20% of women during pregnancy and the postpartum period and represents a major clinical and public health concern due to its impact on maternal functioning, mother–infant bonding, and child neurodevelopmental outcomes [1]. From an attachment and developmental psychopathology perspective, both parents contribute to the formation of internal working models, and paternal bonding may play a distinct role in fostering autonomy, emotion regulation, and relational expectations—domains that are particularly challenged during the transition to motherhood [2][3].

Aims

The present study aimed to: (1) compare the relative strength of associations between maternal and paternal bonding dimensions (care and overprotection) and perinatal depressive symptoms; (2) determine whether paternal bonding contributes unique variance in predicting depressive symptom severity beyond maternal bonding, state anxiety, and clinical covariates; and (3) examine differences in depressive symptoms across paternal bonding profiles, as well as the potential moderating role of paternal care on the relationship between anxiety and depression.

Methods

A total of 134 women (87 pregnant and 47 postpartum) referred to a specialized perinatal mental health service “psiche donna” Macedonio Melloni hospital in Milan between 2020 and 2024 were included. Participants completed validated psychometric instruments, including the Edinburgh Postnatal Depression Scale (EPDS), the Parental Bonding Instrument (PBI), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory-II (BDI-II). Pearson correlation analyses were conducted to assess associations between parental bonding dimensions and depressive symptoms. Hierarchical multiple regression models were used to evaluate the independent predictive role of paternal bonding after controlling for maternal bonding, anxiety levels, and clinical variables. One-way ANOVA examined differences in EPDS scores across paternal bonding quadrants, and exploratory moderation analyses assessed whether paternal care buffered the relationship between state anxiety and depressive symptoms.

Results

Paternal care demonstrated the strongest inverse association with perinatal depressive symptoms (r = −.31, p < .001), exceeding the association observed for maternal care (r = −.25, p = .004). Both paternal and maternal overprotection were positively associated with EPDS scores, although with smaller effect sizes. In hierarchical regression analyses, paternal care remained a statistically significant independent predictor of depressive symptoms (β = −.18, p = .03) even after controlling for maternal bonding, state anxiety, and clinical history, whereas maternal bonding dimensions were no longer significant. Women reporting “optimal” paternal bonding (high care, low overprotection) exhibited significantly lower EPDS scores compared to those reporting “affectionless control” or “neglectful parenting” (F(3,112) = 5.23, p = .002, η² = .12), indicating clinically meaningful differences in symptom severity. Exploratory analyses suggested that higher paternal care may attenuate the relationship between anxiety and depressive symptoms, although this interaction did not reach conventional statistical significance.

Conclusions

Paternal bonding, particularly perceived emotional warmth and care, emerges as a significant and independent factor associated with perinatal depressive symptoms, beyond maternal bonding and current psychological distress. These findings challenge the traditional maternal-centric framework in perinatal psychiatry and underscore the importance of considering father–daughter attachment relationships in both research and clinical practice.

References

  1. Stein, A., Pearson, R. M., Goodman, S. H., et al., 2014. Effects of perinatal mental disorders on the fetus and child. The Lancet, 384(9956), 1800-1819.
  2. Bifulco, A., Figueiredo, B., Guedeney, N., et al., 2004. Maternal attachment style and depression associated with childbirth: Preliminary results from a European and US cross-cultural study. British Journal of Psychiatry, 184(Suppl. 46), s31-s37.
  3. Ramchandani, P., & Psychogiou, L., 2009. Paternal psychiatric disorders and children’s psychosocial development. The Lancet, 374(9690), 646-653.