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Biaggi A, Hazelgrove K, Waites F, Bind RH, Lawrence AJ, Fuste M, Conroy S, Howard LM, Mehta MA, Miele M, Seneviratne G, Pawlby S, Pariante CM, Dazzan P. Mother-infant interaction and infant development in women at risk of postpartum psychosis with and without a postpartum relapse. Psychol Med 2024; 54:823-834. [PMID: 37706314 DOI: 10.1017/s0033291723002568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND This study aimed to investigate mother-infant interaction and infant development in women at-risk of postpartum psychosis (PP), with and without a postpartum relapse. METHODS 103 women (and their offspring) were included, 43 at-risk-of-PP because of a diagnosis of bipolar disorder, schizoaffective disorder or previous PP, and 60 with no current/previous mental illness or family history of PP. Of the at-risk women, 18 developed a psychiatric relapse within 4 weeks after delivery (AR-unwell), while 25 remained symptom-free (AR-well). Mother-infant interaction was assessed using the CARE-Index at 8 weeks' and 12 months' postpartum and infant development using the Bayley-III at 12 months' postpartum. RESULTS Women at-risk-of-PP as a group, regardless of whether they developed a psychiatric relapse within 4 weeks after delivery, had less synchronous mother-infant interactions and had infants with less optimal cognitive, language, motor and socio-emotional development than healthy controls. In particular, boys of at-risk women had the lowest scores in cognitive, language and motor development and in mother-infant interaction, while girls of the at-risk women had the lowest scores in socio-emotional development. The synchrony in the dyad predicted infant cognitive and language development. There was no evidence for a difference in mother-infant interaction nor in infant development between the AR-unwell and AR-well groups. CONCLUSIONS These results suggest that, while there is a lack of evidence that an early postpartum relapse in women at-risk-of-PP could represent a risk for the infant per se, maternal risk for PP may be associated with less optimal mother-infant interaction and infant development.
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Affiliation(s)
- Alessandra Biaggi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Katie Hazelgrove
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Freddie Waites
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Rebecca H Bind
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Andrew J Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Montserrat Fuste
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
- Perinatal Parent-Infant Mental Health Service, Goodmayes Hospital, North East London Foundation Trust, London, IG3 8XD, UK
| | - Susan Conroy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Mitul A Mehta
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, SE5 8AF, UK
| | - Maddalena Miele
- Perinatal Mental Health Service, St Mary's Hospital, Imperial College London and Central North West London NHS Foundation Trust, London, W2 1PF, UK
| | - Gertrude Seneviratne
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Susan Pawlby
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9RX, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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Schrijver L, Robakis TK, Kamperman AM, Bijma H, Honig A, van Kamp IL, Hoogendijk WJG, Bergink V, Poels EMP. Neurodevelopment in school-aged children after intrauterine exposure to antipsychotics. Acta Psychiatr Scand 2023; 147:43-53. [PMID: 36333825 PMCID: PMC10099404 DOI: 10.1111/acps.13517] [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: 04/26/2022] [Revised: 09/22/2022] [Accepted: 10/30/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Antipsychotics are increasingly prescribed in pregnancy, yet little is known about potential long-term developmental effects on children. In this study, we investigated the effect of prenatal antipsychotic exposure on neurodevelopmental functioning in school-aged children. METHODS We performed a cross-sectional neurodevelopmental assessment of 91 children aged 6-14 years whose mothers had severe mental illness and were either exposed or unexposed to antipsychotic medication during pregnancy. Neurodevelopmental outcomes were assessed using validated neurodevelopmental assessment instruments to examine the child's IQ and global cognitive functioning, and the presence of any psychiatric disorders and/or learning problems in the child was assessed by parental report. RESULTS No statistically significant associations were found between antipsychotic exposure during pregnancy and either adverse neurodevelopmental outcomes (IQ, neuropsychological function), likelihood of psychiatric diagnosis, or learning problems based on parental report. Analyses were likely limited in power to detect subtler differences in neurodevelopmental functioning because of small sample size and heterogeneity of the sample. CONCLUSIONS In this exploratory cohort study, intrauterine exposure to antipsychotics was not associated with any adverse effect on IQ or neurodevelopmental functioning in a cohort of school-aged children (6-14 years).
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Affiliation(s)
- Lisanne Schrijver
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Psychiatry, Reinier van Arkel's-Hertogenbosch, The Netherlands
| | - Thalia K Robakis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Astrid M Kamperman
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hilmar Bijma
- Department of Obstetrics and Gynaecology, Division Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Adriaan Honig
- Department of Psychiatry, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Inge L van Kamp
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Witte J G Hoogendijk
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Veerle Bergink
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Eline M P Poels
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
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ALPTEKİN FB, GÜNGÖR BB, ÖZTÜRK N, AYDIN N. Mother-Infant Bonding in Patients with Bipolar Disorder. Noro Psikiyatr Ars 2022; 59:183-187. [PMID: 36160074 PMCID: PMC9466629 DOI: 10.29399/npa.27896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 12/17/2021] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION The quality of mother-infant bonding might play a role in future psychopathologies of the infant. The present study aims to compare the mother-infant bonding in mothers with remitted bipolar disorder (BD) and healthy mothers. METHODS We included 51 mothers who have bipolar disorder in remission and 53 healthy mothers during postpartum one-year period. All participants were interviewed with Structured Clinical Interview for DSM-IV (SCID-IV). Young Mania Rating Scale and the Hamilton Depression Rating Scale were given to the patient group to evaluate depressive and manic symptoms. Mother-infant bonding in both groups were evaluated with the Postpartum Bonding Questionnaire (PBQ). RESULTS There was no significant difference in PBQ scores between the bipolar group and the control group. Age was negatively correlated with PBQ scores in the patient group. CONCLUSION Women with bipolar disorder can develop healthy bonding patterns with their babies, during remission.
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Affiliation(s)
| | - Buket Belkız GÜNGÖR
- Bakırköy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Department of Psychiatry, İstanbul, Turkey
| | - Nalan ÖZTÜRK
- Bakırköy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Department of Psychiatry, İstanbul, Turkey
| | - Nazan AYDIN
- Üsküdar University, Faculty of Humanities and Social Sciences, İstanbul, Turkey
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Dubreucq M, Plasse J, Gabayet F, Blanc O, Chereau I, Cervello S, Couhet G, Demily C, Guillard-Bouhet N, Gouache B, Jaafari N, Legrand G, Legros-Lafarge E, Mora G, Pommier R, Quilès C, Verdoux H, Massoubre C, Franck N, Dubreucq J. Being parent is associated with suicidal history in people with serious mental illness enrolled in psychiatric rehabilitation. J Psychiatr Res 2021; 140:395-408. [PMID: 34144443 DOI: 10.1016/j.jpsychires.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
Parenting is a central life experience that could promote recovery in people with Serious Mental Illness (SMI). It could also be challenging for parents with SMI and result in poor recovery-related outcomes. Parenting is often overlooked in psychiatric rehabilitation. The objectives of the present study were to identify the characteristics and needs for care of mothers and fathers with SMI enrolled in a multicentric non-selected psychiatric rehabilitation SMI sample. We consecutively recruited 1436 outpatients from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). The evaluation included standardized scales for clinical severity, psychosocial function, quality of life and satisfaction with life, wellbeing, personal recovery and a broad cognitive battery. We found that parenting was associated to suicidal history in mothers and fathers with SMI. In the multivariate analysis, being mother was best explained by insight (p < 0.015, adjusted OR = 0.76 [0.59-0.90]), current age (p < 0.001, aOR = 1.13 [1.07-1.21]), education level (p = 0.008; aOR = 0.12 [0.02-0.53]) and family accommodation (p = 0.046, aOR = 0.19 [0.03-0.84]). Being father was best explained by suicidal history (p = 0.005, aOR = 3.85 [1.51-10.10]), marital status (in relationship, p < 0.001; aOR = 7.81 [2.73-23.84]), satisfaction with family relationships (p = 0.032, aOR = 1.22 [1.02-1.47]) and current age (p < 0.001, aOR = 1.16 [1.10-1.23]). In short, parenting was associated to increased history of suicide attempt in mothers and fathers with SMI. Mothers and fathers with SMI may have unique treatment needs relating to parenting and recovery-related outcomes. The implementation of interventions supporting the needs of parents with SMI in psychiatric rehabilitation services could improve parent and children outcomes.
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Affiliation(s)
- M Dubreucq
- Centre Référent de Réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France; Fondation FondaMental, Créteil, France.
| | - J Plasse
- Centre ressource de réhabilitation psychosociale et de remédiation cognitive, Hôpital Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, France; Pôle Centre, centre hospitalier Le Vinatier, Lyon, France
| | - F Gabayet
- Centre Référent de Réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France; Fondation FondaMental, Créteil, France
| | - O Blanc
- CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - I Chereau
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - S Cervello
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon, France; Centre ressource de réhabilitation psychosociale et de remédiation cognitive, Hôpital Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, France; Pôle Centre, centre hospitalier Le Vinatier, Lyon, France
| | - G Couhet
- Centre référent de réhabilitation psychosociale C2RP Nouvelle-Aquitaine Sud, Pôle de réhabilitation psychosociale, Centre de la Tour de Gassies, Bruges, France
| | - C Demily
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon, France; Centre de référence maladies rares Génopsy, pôle ADIS, centre hospitalier Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, France
| | | | - B Gouache
- Centre Référent de Réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France
| | - N Jaafari
- CREATIV & URC Pierre Deniker, CH Laborit, Poitiers, France
| | - G Legrand
- Association Hospitalière Sainte Marie, Centre Hospitalier Sainte Marie de Clermont Ferrand, 33 rue Gabriel Péri, CS 9912, 63037, Clermont-Ferrand Cedex 1, France
| | - E Legros-Lafarge
- Centre Référent de Réhabilitation Psychosociale de Limoges C2RL, CH Esquirol, Limoges, France
| | - G Mora
- Association Hospitalière Sainte Marie, Centre Hospitalier Sainte Marie de Clermont Ferrand, 33 rue Gabriel Péri, CS 9912, 63037, Clermont-Ferrand Cedex 1, France
| | - R Pommier
- REHALise, CHU de Saint-Etienne, France
| | - C Quilès
- Centre référent de réhabilitation psychosociale C2RP Nouvelle Aquitaine Sud, Pôle universitaire de psychiatrie adulte, centre hospitalier Charles Perrens, Bordeaux, Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team pharmacoepidemiology, UMR 1219, F-33000, Bordeaux, France
| | - H Verdoux
- Centre référent de réhabilitation psychosociale C2RP Nouvelle Aquitaine Sud, Pôle universitaire de psychiatrie adulte, centre hospitalier Charles Perrens, Bordeaux, Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team pharmacoepidemiology, UMR 1219, F-33000, Bordeaux, France
| | | | | | - N Franck
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon, France; Centre ressource de réhabilitation psychosociale et de remédiation cognitive, Hôpital Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, France; Pôle Centre, centre hospitalier Le Vinatier, Lyon, France
| | - J Dubreucq
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon, France; Centre Référent de Réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France; Fondation FondaMental, Créteil, France; Réseau Handicap Psychique, Grenoble, France
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