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Li H. Maternal-Infant Attachment and its Relationships with Postpartum Depression, Anxiety, Affective Instability, Stress, and Social Support in a Canadian Community Sample. Psychiatr Q 2023; 94:9-22. [PMID: 36469258 DOI: 10.1007/s11126-022-10011-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/20/2022] [Accepted: 11/20/2022] [Indexed: 12/07/2022]
Abstract
As a crucial component of child development, maternal-infant attachment influences a child's cognitive, psychological, and social development. Maternal depression, anxiety, stress, and social support have been identified as risk factors for poor maternal-infant attachment in some studies, while others did not find such relationships. The aim of this study was to examine the associations of maternal-infant attachment with depression, anxiety, affective instability, stress, social support, and other variables in a community sample of Canadian postpartum women. A total of 108 Canadian postpartum women participated in this cross-sectional study. The Depression, Anxiety, and Stress Scale-21 (DASS-21) assessed depression, anxiety, and stress, and the Affective lability Scale-18 measured affective instability (AI). Multiple linear regression was conducted to examine the association between maternal-infant attachment and other variables. The findings revealed a significant association of maternal-infant attachment with postpartum depression, and infant temperament, while anxiety, AI, stress, and social support were not identified as predictors for maternal-infant attachment. The results implicate the importance of addressing maternal depression and maternal-infant attachment, consequently decreasing the risk for childhood psychopathology.
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Affiliation(s)
- Hua Li
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, S7N 2Z4, Canada.
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2
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Herrman H, Patel V, Kieling C, Berk M, Buchweitz C, Cuijpers P, Furukawa TA, Kessler RC, Kohrt BA, Maj M, McGorry P, Reynolds CF, Weissman MM, Chibanda D, Dowrick C, Howard LM, Hoven CW, Knapp M, Mayberg HS, Penninx BWJH, Xiao S, Trivedi M, Uher R, Vijayakumar L, Wolpert M. Time for united action on depression: a Lancet-World Psychiatric Association Commission. Lancet 2022; 399:957-1022. [PMID: 35180424 DOI: 10.1016/s0140-6736(21)02141-3] [Citation(s) in RCA: 301] [Impact Index Per Article: 150.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Sangath, Goa, India; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Claudia Buchweitz
- Graduate Program in Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania L Vanvitelli, Naples, Italy
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Myrna M Weissman
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Dixon Chibanda
- Department of Psychiatry, University of Zimbabwe, Harare, Zimbabwe; Centre for Global Mental Health, The London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Louise M Howard
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christina W Hoven
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Shuiyuan Xiao
- Central South University Xiangya School of Public Health, Changsha, China
| | - Madhukar Trivedi
- Peter O'Donnell Jr Brain Institute and the Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Lakshmi Vijayakumar
- Sneha, Suicide Prevention Centre and Voluntary Health Services, Chennai, India
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3
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Abd Rahman FN, Wong YY, Khalib AQ. Relationship Between Postnatal Depression of Mental Health Patients and the Psychological Health of Their Offspring. Front Psychiatry 2022; 12:772744. [PMID: 35046852 PMCID: PMC8761655 DOI: 10.3389/fpsyt.2021.772744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Postnatal depression is a major illness affecting maternal and family health. The rate of postnatal depression among mental health clients is postulated to be higher than in the community due to the added brain assault. Children of parents who are mental health clients are more likely to have psychological problems compared to children from other parents in the community. This study investigates the rate of postnatal depression among mental health clients and their offspring's psychological health. A total of 140 mental health clients were assessed using the Edinburgh Postnatal Depression Scale (EPDS). They subsequently completed the Strength and Difficulties Questionnaire (SDQ) regarding their children. The majority ethnicity was the Kadazan (40.7%). The mean age of mothers was 38.6 (7) years with most having a secondary education (53.6%) and a household income per month of < RM1000 per month (27.1%). The postnatal depression rate was 47.8%. Higher EPDS scores were associated with higher total SDQ scores in their offspring. Model 1 was unadjusted, giving an OR of 5.65 [95% CI (3.74, 7.55)], p < 0.001. After adjustment for confounders, Model 2 had an OR of 5.51 [95% CI (3.57, 7.46)], p < 0.001. More efforts need to be given to the early detection of maternal depression and its prompt treatment in mental health clients because of the relationship with the psychological health of the offspring.
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Affiliation(s)
| | - Yun Yaw Wong
- Ministry of Health (Malaysia), Putrajaya, Malaysia
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Cimino S, Tambelli R, Di Vito P, D'Angeli G, Cerniglia L. The quality of father-child feeding interactions mediates the effect of maternal depression on children's psychopathological symptoms. Front Psychiatry 2022; 13:968171. [PMID: 36072463 PMCID: PMC9444047 DOI: 10.3389/fpsyt.2022.968171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Research has shown that Postnatal maternal depression (PND) is associated with children's emotional and behavioral problems during infancy, but the possible effect of father-child relationship quality on this association is yet to be thoroughly investigated. We recruited 401 families (802 parents; 401 children) via mental health clinics in Central Italy. We divided families into two groups: Group 1 included families with mothers with PND; Group 2 included families with mothers without PND (control group). The assessment took place at T1 (18 months of age of children) and T2 (36 months of age of children): postnatal maternal depression was measured through the Edinburgh Postnatal Depression Scale (EPDS); parent-child relationship quality was assessed through the Scale for the Assessment of Feeding Interactions (SVIA); and the child emotional-behavioral functioning was evaluated with the Child-Behavior-Checklist (CBCL). Compared to the control group, the children of the groups where mothers had PND, showed overall higher scores (i.e., more maladaptive) on the CBCL. A direct effect of postnatal maternal depression on children's emotional-behavioral functioning was found, both at T1 and at T2. A mediation effect of father-child relationship quality between postnatal maternal depression and child outcomes was also found. These results could inform prevention and intervention programs in families with mothers with PND.
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Affiliation(s)
- Silvia Cimino
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Renata Tambelli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Paola Di Vito
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Gessica D'Angeli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Rome, Italy
| | - Luca Cerniglia
- International Telematic University Uninettuno, Rome, Italy
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Aran P, Lewis A, Watson S, Galbally M. Major depression and generalised anxiety disorder: An analysis of the effects of remission status and comorbidity on mother-infant emotional availability in the perinatal period. J Clin Psychol 2021; 78:570-589. [PMID: 34398975 DOI: 10.1002/jclp.23235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/21/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The effects of maternal depression on mother-infant relationship quality likely vary according to depression heterogeneity. We investigated the effects of different presentations of major depression on mother-infant emotional availability (EA). METHODS Data were obtained from 115 mother-infant dyads from a longitudinal pregnancy cohort. Disorders, symptoms, and antidepressant use were assessed in pregnancy and postpartum, and EA was observed 6-month postpartum. Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) were assessed using the Structured Clinical Interview for the DSM-5. A series of multivariate analyses of covariance analyses' examining the effects of disorder on EA were conducted. RESULTS After controlling for maternal age, antidepressant use, and postpartum depressive symptoms, MDD accounted for 20% of the variance in EA. In the MDD/GAD group, 93% of interactions were rated as emotionally unavailable, nearly threefold the comparison group rate. CONCLUSIONS Findings demonstrate that different presentations of major depression are associated with observed differences in mother-infant EA.
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Affiliation(s)
- Pavitra Aran
- Discipline of Psychology, Murdoch University, Perth, Western Australia, Australia
| | - Andrew Lewis
- Discipline of Psychology, Murdoch University, Perth, Western Australia, Australia
| | - Stuart Watson
- Discipline of Psychology, Murdoch University, Perth, Western Australia, Australia.,School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Megan Galbally
- Discipline of Psychology, Murdoch University, Perth, Western Australia, Australia.,School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia.,Women's Health, Genetics and Mental Health, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
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Al Azdi Z, Islam K, Khan MA, Khan N, Ejaz A, Khan MA, Warraitch A, Jahan I, Huque R. Effectiveness of an Integrated Care Package for Refugee Mothers and Children: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e25047. [PMID: 33944793 PMCID: PMC8132976 DOI: 10.2196/25047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/26/2021] [Accepted: 03/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background Thousands of Rohingya refugee mothers at the world’s largest refugee camp located in Bangladesh are at risk of poor mental health. Accordingly, their children are also vulnerable to delayed cognitive and physical development. Objective The aim of this study is to evaluate the effectiveness of an integrated care package in reducing the prevalence of developmental delays among children aged 1 year and improving their mothers’ mental health status. Methods This is a parallel, two-arm, single-blind, cluster randomized controlled trial (cRCT). A total of 704 mother-child dyads residing at the Kutupalong refugee camp in Cox’s Bazar, Bangladesh, will be recruited from 22 clusters with 32 mother-child dyads per cluster. In the intervention arm, an integrated early childhood development and maternal mental health package will be delivered every quarter to mothers of newborns by trained community health workers until the child is 1 year old. Our primary outcome is a reduction in the prevalence of two or more childhood developmental delays of infants aged 1 year compared to the usual treatment. The secondary outcomes include reduced stunting among children and the prevalence of maternal depression. We will also assess the cost-effectiveness of the integrated intervention, and will further explore the intervention’s acceptability and feasibility. Results At the time of submission, the study was at the stage of endpoint assessment. The data analysis started in December 2020, and the results are expected to be published after the first quarter of 2021. Conclusions This study will address the burden of childhood developmental delays and poor maternal mental health in a low-resource setting. If proven effective, the delivery of the intervention through community health workers will ensure the proposed intervention’s sustainability. Trial Registration ISRCTN Registry ISRCTN10892553; https://www.isrctn.com/ISRCTN10892553 International Registered Report Identifier (IRRID) DERR1-10.2196/25047
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Affiliation(s)
| | | | | | - Nida Khan
- Association for Social Development, Lahore, Pakistan
| | - Amna Ejaz
- Association for Social Development, Lahore, Pakistan
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Hazell Raine K, Thorpe K, Boyce P. Perinatal depression screening in Australia: A position paper. Nurs Health Sci 2020; 23:279-287. [PMID: 33241903 DOI: 10.1111/nhs.12793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 01/24/2023]
Abstract
Perinatal depression can have enduring adverse effects on women and their children and families, incurring substantial ongoing economic and personal costs. A significant proportion of the cost of perinatal depression relates to adverse impacts on the child, most likely mediated through impairment to the mother-infant relationship. In recognition of this problem, Australia has invested in routine perinatal depression screening. Our previous research produced convergent findings suggesting that expected benefits for children have not yet been realised through perinatal depression screening. We question the potential of including a measure of personality in current perinatal depression screening for identifying maternal mental health problems and suboptimal mother-infant relationships. This paper reviews our previous research findings within the broader context of perinatal depression screening. We propose a position, that perinatal depression screening in Australia should be redesigned to more precisely detect vulnerable mother-infant relationships, parenting, maternal mental health, and infant psychosocial and psychological development. Practice change to appropriately target antenatal interventions may more efficiently improve both maternal and child outcomes, thereby contributing to greater efficiency and cost savings for the health system.
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Affiliation(s)
- Karen Hazell Raine
- Nursing, School of Health, Faculty of Medicine and Health, University of New England; School of Nursing, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Karen Thorpe
- Institute for Social Science Research (ISSR), The University of Queensland, Brisbane, Queensland, Australia
| | - Philip Boyce
- Discipline of Psychiatry, Sydney Medical School, Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Abstract
Perinatal mental health has become a significant focus of interest in recent years, with investment in new specialist mental health services in some high-income countries, and inpatient psychiatric mother and baby units in diverse settings. In this paper, we summarize and critically examine the epidemiology and impact of perinatal mental disorders, including emerging evidence of an increase of their prevalence in young pregnant women. Perinatal mental disorders are among the commonest morbidities of pregnancy, and make an important contribution to maternal mortality, as well as to adverse neonatal, infant and child outcomes. We then review the current evidence base on interventions, including individual level and public health ones, as well as service delivery models. Randomized controlled trials provide evidence on the effectiveness of psychological and psychosocial interventions at the individual level, though it is not yet clear which women with perinatal mental disorders also need additional support for parenting. The evidence base on psychotropic use in pregnancy is almost exclusively observational. There is little research on the full range of perinatal mental disorders, on how to improve access to treatment for women with psychosocial difficulties, and on the effectiveness of different service delivery models. We conclude with research and clinical implications, which, we argue, highlight the need for an extension of generic psychiatric services to include preconception care, and further investment into public health interventions, in addition to perinatal mental health services, potentially for women and men, to reduce maternal and child morbidity and mortality.
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Affiliation(s)
- Louise M. Howard
- Section of Women's Mental Health, Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Hind Khalifeh
- Section of Women's Mental Health, Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
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9
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Zhang T, Zhao L, Ding W, Ma J, Zhang Y. The influence of perinatal and maternal factors on physical growth at 12 months in prematurely born infants treated in the neonatal intensive care unit: A retrospective chart review and a prospective cohort study. Int J Nurs Stud 2020; 109:103656. [PMID: 32593880 DOI: 10.1016/j.ijnurstu.2020.103656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 04/16/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Growth retardation during the first year of life is frequently observed in prematurely born infants. Few reports have considered the effects of maternal emotional distress and perceptions of care burden on the outcomes of these infants. OBJECTIVES This study investigated the physical growth trajectories of prematurely born infants treated in neonatal intensive care unit and determined the effects of perinatal factors, maternal emotional distress and perceptions of care burden on growth retardation at 12 months' corrected age. DESIGN Retrospective chart review and prospective cohort study. SETTING Single neonatal intensive care unit and follow-up outpatient clinics at a maternity and neonatal hospital. PARTICIPANTS 288 mother-infant pairs in the retrospective chart review and 169 dyads in the prospective cohort study. METHODS Medical records of prematurely born infants, perinatal factors and physical growth over a 1-year period were retrospectively reviewed. For the prospective study, mothers completed the Self-Rating Anxiety Scale, Perinatal Post-traumatic Stress Disorder Questionnaire, and Condition Management Effort Scale when infants reached 3 months' corrected age. The generalized linear mixed model was applied to explore effects of maternal emotional disorders and perceptions of care burden on growth retardation at 12 months' corrected age. RESULTS The retrospective data showed 13.9%, 10.1%, and 10.1% retardation for head circumference, length, and weight, respectively. Birth weight was negatively associated with physical growth retardation. Delayed breastfeeding initiation, younger mothers, and lower 5-min Apgar score were associated with head circumference retardation. Male sex, higher gestational age, and delayed breastfeeding initiation were risk factors for length retardation; male sex, higher gestational age, and younger mothers for weight. The prospective study showed that head circumference, length, and weight retardation rates were 18.3%, 10.3%, and 16.3%, respectively. Male sex and birth weight, were still significant, while others were not. Moreover, alternative models based on these included factors revealed that maternal perceptions of a higher care burden was a risk factor for overall growth retardation and maternal post-traumatic stress disorder only for a weight problem. CONCLUSIONS Physical growth remained a significant problem for prematurely born infants during the first year. This study identified perinatal factors, the level of maternal emotional distress, and perceptions of care burden were related to adverse infant's growth outcomes. Multidisciplinary interventions targeting maternal emotional distress and perceptions of care burden should be developed to promote the growth of prematurely born infants within the first 3 months after birth.
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Affiliation(s)
- Taomei Zhang
- School of Nursing, Shanghai Jiao Tong University, 227 South Chong Qing Road, Building 1, Room 213, Shanghai 200025, China.
| | - Lijin Zhao
- Shanghai First Maternity and Neonatal Hospital affiliated to Tongji Universityy, 550 Hu Nan Road, Shanghai 201204, China.
| | - Wenwen Ding
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, 3 East Qinchun Road, Zhejiang 310000, China
| | - Jiali Ma
- School of Nursing, Shanghai Jiao Tong University, 227 South Chong Qing Road, Building 1, Room 213, Shanghai 200025, China
| | - Ying Zhang
- School of Nursing, Shanghai Jiao Tong University, 227 South Chong Qing Road, Building 1, Room 213, Shanghai 200025, China.
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10
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Affiliation(s)
- Myrna M Weissman
- Departments of Epidemiology and Psychiatry, Vagelos College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, New York; and Division of Translational Epidemiology, New York State Psychiatric Institute, New York
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11
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Affiliation(s)
- Myrna M Weissman
- Diane Goldman Kemper Family Professor of Epidemiology and Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, Mailman School of Public Health, Chief Division of Translational Epidemiology, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 24, New York, NY 10032, USA
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12
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Ramsauer B, Mühlhan C, Lotzin A, Achtergarde S, Mueller J, Krink S, Tharner A, Becker-Stoll F, Nolte T, Romer G. Randomized controlled trial of the Circle of Security-Intensive intervention for mothers with postpartum depression: maternal unresolved attachment moderates changes in sensitivity. Attach Hum Dev 2019; 22:705-726. [PMID: 31726954 DOI: 10.1080/14616734.2019.1689406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Postpartum depression is related to inadequately sensitive caregiving, putting infants at risk for insecure attachment. Therefore, promoting sensitive maternal caregiving and secure child attachment is particularly important in postpartum depressed mothers and their infants. In this randomized-controlled-trial, we evaluated the efficacy of the Circle of Security-Intensive (COS-I)-intervention in supporting maternal sensitivity and mother-infant-attachment compared to treatment-as-usual (TAU) with unresolved-maternal attachment as a moderator of treatment effect. Eligible mothers with infants (N=72) 4-9 months-old were randomly assigned to treatment (n=36 dyads). Infant attachment was rated at follow-up (child age 16-18 months) (Strange-Situation-procedure). Maternal sensitivity was measured at baseline and follow-up (Mini-Maternal-Behavior-Q-sort). Maternal-unresolved-attachment was assessed at baseline (Adult-Attachment-Interview). We found no significant differences between treatments in infant attachment nor changes in mothers' sensitivity. However, in COS-I, unresolved-mothers exhibited significantly more change in sensitivity than non-unresolved-mothers, whereas in TAU, the opposite was true. These findings may help to optimize clinical use of COS-I.
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Affiliation(s)
- Brigitte Ramsauer
- Medical School Hamburg MSH, University of Applied Sciences and Medical University , Hamburg, Germany.,Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Muenster , Muenster, Germany
| | - Christine Mühlhan
- Medical School Hamburg MSH, University of Applied Sciences and Medical University , Hamburg, Germany
| | - Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf , Hamburg, Germany
| | - Sandra Achtergarde
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Muenster , Muenster, Germany
| | - Jessica Mueller
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf , Hamburg, Germany
| | - Stephanie Krink
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Muenster , Muenster, Germany
| | - Anne Tharner
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam , Amsterdam, The Netherlands
| | | | | | - Georg Romer
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Muenster , Muenster, Germany
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13
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Hazell Raine K, Nath S, Howard LM, Cockshaw W, Boyce P, Sawyer E, Thorpe K. Associations between prenatal maternal mental health indices and mother-infant relationship quality 6 to 18 months' postpartum: A systematic review. Infant Ment Health J 2019; 41:24-39. [PMID: 31524300 DOI: 10.1002/imhj.21825] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Maternal mental disorders can significantly impact on children's psychosocial and psychological development, incurring substantial ongoing economic and personal costs. A key mediating mechanism is mother-infant relationship quality (MIRQ). Research studies and perinatal mental health screening initiatives have predominantly focused on depressive symptoms and perinatal depression as predictors of MIRQ. While maternal depression is associated with suboptimal MIRQ, the findings have not been consistent. Personality characteristics are associated with parenting and proneness to depression, presenting a potential addition to prenatal mental health assessment. We conducted a systematic review of studies that have examined the link between prenatal depressive symptoms and/or personality characteristics with postnatal MIRQ. Our findings suggest that both maternal personality traits and depressive symptoms measured in early pregnancy are associated with postnatal MIRQ. A measure of personality characteristics may enhance prenatal mental health assessment, affording opportunities for targeted intervention commencing in pregnancy to improve MIRQ, parenting, maternal mental health outcomes, and infant psychosocial and psychological development, and thereby contributing to the reduction of human and economic cost burdens.
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Affiliation(s)
- Karen Hazell Raine
- Discipline of Psychiatry, Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Selina Nath
- Section of Women's Mental Health, King's College, London, United Kingdom
| | - Louise M Howard
- Section of Women's Mental Health, King's College, London, United Kingdom
| | - Wendell Cockshaw
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology, Melbourne, Australia
| | - Philip Boyce
- Discipline of Psychiatry, Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Emily Sawyer
- Faculty of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Karen Thorpe
- Institute for Social Science Research, University of Queensland, Queensland, Australia
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14
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Atukunda P, Muhoozi GKM, Westerberg AC, Iversen PO. Nutrition, Hygiene and Stimulation Education for Impoverished Mothers in Rural Uganda: Effect on Maternal Depression Symptoms and Their Associations to Child Development Outcomes. Nutrients 2019; 11:nu11071561. [PMID: 31373314 PMCID: PMC6683265 DOI: 10.3390/nu11071561] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/05/2019] [Accepted: 07/09/2019] [Indexed: 01/10/2023] Open
Abstract
Optimal nutrition improves child development, and impaired development is associated with maternal depression symptoms, in particular in low resource settings. In this follow-up of an open cluster-randomized education trial, we examined its effects among mothers in rural Uganda on their depression symptoms and the association of these symptoms to child development. The education comprised complementary feeding, stimulation, and hygiene. We assessed 77 intervention mothers and 78 controls using Beck Depression Inventory-II (BDI-II) and Center for Epidemiologic Studies Depression Scale (CES-D) scores. Child development was assessed with Bayley Scales of Infant and Toddler Development-III (BSID-III) composite scores for cognitive, language and motor development. Compared to controls, the intervention reduced depression symptoms’ scores with mean (95% CI) differences: −8.26 (−11.49 to −1.13, p = 0.0001) and −6.54; (−8.69 to −2.99, p = 0.004) for BDI II at 20–24 and 36 months, respectively. Similar results were obtained with CES-D. There was a negative association of BDI-II scores and BSID-III cognitive and language scores at 20–24 (p = 0.01 and 0.008, respectively) and 36 months (p = 0.017 and 0.001, respectively). CES-D associations with BSID-III cognitive and language scores showed similar trends. BSID-III motor scores were associated with depression scores at 36 months for both BDI-II and CES-D (p = 0.043 and 0.028, respectively). In conclusion, the group education was associated with reduced maternal depression scores. Moreover, the depression scores were inversely associated with child cognitive and language development outcomes.
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Affiliation(s)
- Prudence Atukunda
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, 0372 Oslo, Norway.
| | - Grace K M Muhoozi
- Department of Human Nutrition and Home Economics, Kyambogo University, P.O. Box 1, 256 Kyambogo, Uganda
| | - Ane C Westerberg
- Institute of Health Sciences, Kristiania University College, Kirkegata 24 Oslo, Norway
| | - Per O Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, 0372 Oslo, Norway
- Department of Hematology, Oslo University Hospital, 0372 Oslo, Norway
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, 7505 Tygerberg, South Africa
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15
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Goodman JH. Perinatal depression and infant mental health. Arch Psychiatr Nurs 2019; 33:217-224. [PMID: 31227073 DOI: 10.1016/j.apnu.2019.01.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/24/2019] [Indexed: 12/19/2022]
Abstract
A mother's mental health during pregnancy and the first year postpartum is of the utmost importance to the cognitive, social, and emotional development of her child. Perinatal depression is associated with increased risk for wide-ranging adverse child development effects that can affect infant and early childhood mental health. Although effective treatments for perinatal depression exist, it is currently unclear if treatment of maternal depression alone is sufficient to ameliorate the negative effects of maternal depression on child outcomes. Interventions focused on the mother-infant relationship and dyadic interaction may be required to address the potential effect of maternal depression on the child. This paper provides an overview of maternal perinatal depression, the risk it poses for infant/early-childhood mental health, strategies for intervention that include mitigating depression and decreasing risk to the child, and implications for psychiatric nurses who work with perinatal women. Early identification and treatment of perinatal depression are critical to ensure optimal infant development and the child's future mental health.
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Affiliation(s)
- Janice H Goodman
- MGH Institute of Health Professions, School of Nursing, 36 1st Avenue, Boston, MA 02129, United States of America.
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16
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Kessler U. Commentary on "Improvement of postpartum depression and psychosis after electroconvulsive therapy - A population-based study with a matched comparison group". J Affect Disord 2018; 238:351-352. [PMID: 29908473 DOI: 10.1016/j.jad.2018.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/14/2018] [Accepted: 06/04/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Ute Kessler
- Haukeland University Hopsital, Department of Psychiatry, Bergen, Norway; University of Bergen, Bergen, Norway.
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