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The important negative effects observed at 18 months on mother and infant of maternal PDS at 3 months confirm the need for early identification and therapeutic or preventive interventions.

This pilot study explores the effects of a brief individual psychoanalytic therapy on perinatal depressive symptoms. This intervention is based on the Geneva's mother-infant intervention model. A sample of 129 pregnant women was recruited in Geneva (Switzerland) and screened for depressive symptoms with two instruments: the 'Edinburgh postnatal depression scale' (EPDS) and the 'Dépistage anténatal de la dépression postnatale'. A group of 40 women presenting depressive symptoms (treatment group) participated in a four-session intervention called 'Psychotherapy centred on parenthood (PCP)'. It consists in two antenatal and two postnatal sessions and is focussed on changing problematic representations of parenthood. This treatment group was compared to a control group of 88 women without depressive symptoms and following the usual obstetrical care. The main outcome measure was EPDS at 3 and 6 months after delivery. The 'Global assessment functioning scale' was administered at the end of each therapeutic session. The 'Parent-infant relationship global assessment scale' was administered at the two postnatal sessions in order to explore if PCP was also effective in preventing the potential negative effects of depression on mother-infant relationship. Results show that in the treatment group (N = 31), EPDS scores dropped from 12.8 to 4.8; none of these women met the EPDS cut-off score of 12 at 3 and 6 months postpartum. Mother-infant relationship was well adapted for all 31 dyads at the end of the intervention. These results suggest that PCP is a promising intervention for treating perinatal depression and helping mothers engaging in parenting.

The authors begin by pointing out that Freud always considered parent-child relations in terms of the child's psychic development and took little account of the parents' experience of the relationship and its psychic effects on them. They recall Freud's distinction between the anaclitic and narcissistic modes of relationship and show how these are unconsciously embodied and enacted in varying proportions in the cases observed in their own clinical practice of therapeutic consultations with parents and young children. After a review of the relevant psychoanalytic literature, the authors present their concept of the narcissistic scenarios of parenthood, which include parental projection on to the child, parental counter-identification, a specific aim and a relational dynamic that is acted out. Depending on the individual situation, the effects may help to structure the developing psyche or, if the narcissistic element is excessive, they may be pathological. The authors consider the literature on the application of psychoanalysis to therapeutic interventions with parents and children, stressing the technical importance of establishing a therapeutic focus. These ideas are illustrated by a detailed case history showing the interaction between a mother and a 4-year-old girl and how it was modified by a short therapy. The differences between interpretation in this situation and in the classical psychoanalytic setting are explained, and the paper ends with some comments on the transmission of psychic elements from generation to generation.