Dear Colleagues,

The birth of a child is an event that triggers significant changes on an emotional, relational, and existential level, which can expose both parents to adaptation problems and psychological difficulties. Although the scientific literature on post-partum maternal depression has been extensive for decades, only recently has research been dedicated to paternal perinatal depression with the aim of evaluating its clinical manifestations, epidemiology, relationship with maternal depression and its influence on the psychophysical development of the child.

Despite the methodological difficulties encountered in research on men, meta-analyses in this area have shown that fathers suffer from perinatal depression almost as much as mothers but tend to express their difficulties differently. Contemporary research, in fact, has highlighted the need to assess perinatal distress using gender-specific tools for mothers and fathers ^[1,2]. It is essential to develop new instruments to evaluate a broad range of depressive equivalents in order to increase the sensitivity and specificity of the screening.

Furthermore, given the frequent comorbidity of anxiety disorders with depressive disorders in both parents and the frequent onset of symptoms in the prenatal period, the correct diagnostic definitions should be Paternal Perinatal Affective Disorder (PPAD) in the father and Maternal Perinatal Affective Disorder (MPAD) in the mother.

Prevention and treatment protocols for these disorders are still poorly explored within the field, especially in fathers. In these cases, it is necessary to consider not only the individual difficulties, but also the couple dynamics and the attachment relationship between the partners.

This Special Issue of Behavioral Sciences, entitled “Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment”, aims to present the latest research in this area.

[1] Walsh, T.B.; Davis, R.N.; Garfield, C. A Call to Action: Screening Fathers for Perinatal Depression. Pediatrics 2020, 145, https://doi.org/10.1542/peds.2019-1193.

[2] Baldoni, F.; Giannotti, M. Perinatal Distress in Fathers: Toward a Gender-Based Screening of Paternal Perinatal Depressive and Affective Disorders. Front. Psychol. 2020, 11, https://doi.org/10.3389/fpsyg.2020.01892.

Prof. Dr. Franco Baldoni
Guest Editor

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• perinatal
• father
• mother
• parents
• depression
• affective disorders
• attachment
• pregnancy
• screening
• assessment
• treatment
• prevention

Title: Preventive intervention for parents' perinatal affective disorders and for the promotion of the child's neuromental development. An Italian multicentre study for the application of Dialogic Book-Sharing training
Authors: Cena Loredana1, Trainini Alice1, Murray Lynne2, Cooper Peter2, Belluardo Mauro3, Buizza Chiara4
Affiliation: 1 Department of Clinical and Experimental Sciences, Section of Neuroscience, Observatory of Perinatal Clinical Psychology, University of Brescia, Brescia, Italy. 2 School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK. 3 Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy. 4 Department of Clinical and Experimental Sciences, Section of Neuroscience, University of Brescia, Brescia, Italy.
Abstract: ABSTRACT Background: Neuroscience has highlighted how the experiences in the first thousand days of life are important for the child's constructing mind and how this occurs mainly in parent-child relationships. In the perinatal period, the good quality of these relationships represents a protective factor for the child’s neuromental development. Perinatal affective disorders such as anxiety, depression and distress are frequent among parents in the prenatal and postnatal period. These disorders can represent an obstacle to promoting good primary relationships, with a negative impact on the child's development. Preventive interventions to support parent-child cognitive and emotional communication are therefore essential. The Dialogic Book-Sharing (DBS) developed by Lynne Murray and Peter Cooper is an international evidence-based intervention that has been applied in several countries (e.g. South Africa, Brazil, England). The DBS is based on a dyadic intersubjective communication through an interactive form of using books with children. The Observatory of Perinatal Clinical Psychology of the University of Brescia promoted the application of the DBS for the first time in Italy with the aim to assess the effects of this intervention on the quality of the parent-child relationships and on child’s language, communication and attention development. Methods: It was conducted a randomized controlled trial involving 12 health, educational and maternal-child Centres (family centres, nursery schools, mother-child protected communities) on the Italian territory (Brescia, Bergamo, Milan, Mantua, Como, La Spezia, Florence, Rome, Naples, Salerno). Parents of 14–20-month-old infants were involved in the study and randomized in two groups: the experimental group attended 4-weeks training in book sharing and the control group was on the waiting list. The study design used mixed-methods and included questionnaires for parents (Socio-demographic information Form; HADS Hospital Anxiety and Depression Scale; PSI-SF Parenting Stress Index; CDI MacArthur-Bates Communicative Development Inventory and CBCL Child Behavior Checklist) and video recordings of parent-child interactions. The study protocol was approved by the Ethics Committee of the ASST Spedali Civili of Brescia (reference number NP5205 27.09.2022). The trial was registered on the ISRCTN registry: number ISRCTN11755019. Results: Sixty-eight parent-child dyads (36 experimental group and 32 control group) were involved in the study. Parents' responses to the questionnaires were analyzed and no significant differences were found at baseline between the two groups. Significant differences between the two groups were instead found at the end of the intervention: the experimental group showed a lower level of parents’ anxiety and a lower score in child’s externalizing problems than the control group. Moreover, the results showed pre-post intervention differences in the two groups: after 4 weeks the experimental group had an improvement in the affective states (anxiety and depression) of the parents, a reduction in the children's hyperactivity problems and an improvement in their language (number of words understood and pronounced). In the control group, after 4 weeks, an increase in children's emotional reactivity problems was detected. Conclusions: Preliminary data highlight the positive effect of applying the DBS programme in early childhood. It is simple and inexpensive to deliver and represent an interesting preventive intervention that can be extended to a wider perinatal population. It could enhance the educational resources offered by Italian health, educational and maternal-child centres supporting parental affective states and child’s development.