Men's mood disorders in connection with the birth of their child S.A. Madsen, D. Lind
Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark

In international research it is slowly being acknowledged that men as well as women might develop mood disorders during transition to parenthood. The prevalence of pre- and postpartum depressions for women is 10-15 % while there are no well-established estimates of the prevalence for men. International research mention estimates between two and twelve percent. This study explores the thoughts and feelings of fathers with mood disorders pre- and postpartum. The aim is to enlighten and elaborate the mechanisms leading to such disorders in men, to explore the individual and relational levels of depression, and to suggest methods of treatment. The material consists of statements from psychotherapies with 37 men with mood disorders pre and postpartum. The statements were analysed on these levels: 1) The man's individual symptoms; 2) The man's pictures of himself as a father; 3) His relationship with the infant; 4) His experiences with and models of caregiving in own childhood; 5) His relations with own parents present and in childhoods. Results from this analysis were compared with analysis of two hours long interviews with 41 randomly selected non-clinical fathers before and after the birth of their child.
Results from the study show that men's mood disorders in connection with the birth of their child are very similar to the well-established female diagnosis postpartum depression. The essential resemblance seems to be that the disorder has roots in both men's and women's relations with own mother. It is notable that there seems to be no significant relation between the disorder and the man's relationship with his own father. Furthermore both men and women with this disorder express aggressive feelings about their infant, while the direction of the aggression seems to be different: Men are concerned with fears of loosing their temper in interaction with the infant. Men with this disorder seem to benefit from double focused psychotherapy working with the man's past and present relation with his mother alternating with his relations to the infant. In such treatment representations of the mother seem to be linked with the father's actual relationship with his infant and his experiences of fatherhood.

Men in Psychotherapy
D. Lind 1 , S.V.A.A. Madsen 2 . 1 Department of Child And Adolescence Psychiatry, University Hospital of Copenhagen, Bispebjerg, Copenhagen, Denmark; 2 Clinic of Psychology, Play Therapy and Social Work, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet , Copenhagen, Denmark

Gender specific differences between male and female patients in the course of psychotherapy are only seldomly considered in classical and contemporary literature on therapeutic intervention and. Very few studies on men in therapy are reported till now.
In the Danish research program, Fathers Relations to Their Infants, men with psychological difficulties during the time of pregnancy, birth and infancy were offered psychological treatment at the university hospital of Copenhagen. 37 men received treatment with psychotherapy. The therapies lasted from 3 to 27 sessions. Two experienced male clinical psychologists conducted the treatments.
These psychotherapies have generated important general knowledge on menÌs gender-specific motivation for receiving psychological treatment and on menÌs ways of interacting with the therapist in therapy.
Some of the male gender characteristics derived from the psychotherapies are:
Almost all participants in the program claimed that problems relating to the new family were the main motivating factor for entering treatment (for example worries about loosing contact with infant and/or spouse). Despite even serious personal problems in their life none had ever before considered seeking therapeutic help earlier.
This suggests that a manÌs personal motivation in the search for help often is presented as inter psychic instead of intra psychic.
Most men are unfamiliar with talking about and examining relationships and feelings. This fact has to be taken into consideration when establishing the therapeutic alliance. In many cases it will be necessary to establish a way of experiencing and talking about relational feelings. In many cases it is difficult for men to expose their vulnerability in presence of the therapist as a consequence of an experienced need to express strength and control.
It is important to regard the transmission to parenthood as a period with special opportunities for intervention and personal change for men as well as for women.
More knowledge on the psychological functioning of men and systematic comparisons of male and female characteristics are needed in the future. Psychotherapy is regarded as a promising area of further research.