The mental health of a child's mother during pregnancy is widelyconsidered a risk factor for emotional and behavioral problems later inthe child's life. Now a new study finds that the father's mental healthduring the pregnancy also plays a role.

The study of nearly 32,000 children in Norway, reported today in Pediatrics,is the largest yet to suggest that a risk for future mental healthproblems in young kids may be identified early on by examining theprenatal mental health of the fathers.

It found that childrenwhose fathers scored highly for psychological distress, depression andanxiety at week 17 or 18 of the baby's gestation had higher levels ofemotional and behavioral difficulties at age 3, including disruptivebehavior, anxiety and problems getting along with other children.

Informationwas collected from fathers who answered questions on a screeningquestionnaire about their mental health status during the pregnancy.Mothers later answered questions about their children's development anddifficulties.

Even after controlling for factors such as thefather's age, marital status, physical ailments, alcohol use, cigarettesmoking and the mother's mental health status, researchers found thesame association between expectant fathers' mental health and problemsdeveloping later in the child, says lead study author Anne LiseKvalevaag of Helse Fonna Hospital in Haugesund, Norway.

The datacollected did not address how or why this association exists, butseveral "possible mechanisms" could be at work, she says. Onepossibility is a genetically transmitted risk to the child, she says. Ordepression in the father could affect the mental health of the motherin such a way that the neonatal development of the child is affected.Another possibility: The father's prenatal mental state could predicthis mental state after the child's birth, which "may also account forsome of the associations found," she says.

Only 3% of the fathersin the study had high levels of mental health problems, so thesefindings don't mean that every child with a depressed father will haveproblems, says James Paulson,? an associate professor of psychology atOld Dominion University in Norfolk, Va. "But when this is viewed across alarge population, the effects of prenatal paternal distress are asubstantial public health problem." Paulson, who studies depression infamilies, was not involved in the new study.

In the past decade,"Researchers have learned that paternal postpartum depression presentsmany of the same risks to developing children that are well-documentedin maternal postpartum depression," says Paulson. The new study "foundthat depression in fathers during pregnancy poses risks that are similarto postpartum depression - a finding that mirrors what we know aboutdepression in pregnancy for mothers, but which hasn't previously beendocumented in fathers.

"For parents and physicians, the messageshould be clear," says Paulson. "We need to be aware of depression (in)both parents from the time a pregnancy is realized. This study suggeststhat physicians should screen for depression early and often, and makethe appropriate referral as soon as it's detected."