Psychological symptoms and associated psychosocial factors among fathers attending a tertiary children’s hospital in Nepal

Little has been done to focus on paternal mental health in Nepal despite evidence that fathers' depression, anxiety, and stress can hurt family functioning and child development. This research measured the prevalence of depressive, anxiety, and stress symptoms among fathers visiting a tertiary children's hospital in Kathmandu and analyzed the related psychosocial variables.A cross-sectional analytical study was conducted at Kanti Children's Hospital, Kathmandu, among 312 biological fathers of children under two years. Data on psychosocial factors, including stressful life events, financial burden, work-life balance, family support, partner communication, masculinity norms, and child health conditions, were collected using interviewer-administered questionnaires. Psychological symptoms were assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21), and masculinity norms using the Macho Scale. Descriptive statistics and multivariate logistic regression were used to estimate adjusted odds ratios (AORs) with 95% confidence intervals. Most fathers reported no psychological symptoms: depression (86.9%), anxiety (93.3%), and stress (95.8%). Moderate to severe depressive symptoms, moderate anxiety, and mild to moderate stress were reported by 4.1%, 3.8%, and 4.2% of participants, respectively. Stressful life events during the past year were significantly associated with depression (AOR 4.16, 95% CI: 1.90-9.14), anxiety (AOR 4.66, 95% CI: 1.22-17.84), and stress (AOR 4.07, 95% CI: 1.19-13.95). Lack of family support independently predicted depression, anxiety, and stress. Anxiety was also associated with financial burden and high machismo attitudes.Although most fathers reported low psychological distress, stressful life events, limited family support, financial burden, and traditional masculine norms were significantly associated with depression, anxiety, and stress. Family-centered mental health services and routine screening in pediatric settings may help identify and support vulnerable fathers.