A longitudinal study of psychiatric symptoms in primiparous women: relation to personality disorders and sociodemographic factors

Sorjonen

2015

Infant Ment. Health J.

An earlier randomized controlled trial (RCT) compared 80 mother-infant dyads in a Stockholm sample. One had received mother-infant psychoanalytic treatment [mother-infant psychoanalytic therapies (MIP) group], and the other received Child Health Center care (CHCC group). Effects were found on mother-reported depression and expert-rated mother-infant relationship qualities and maternal sensitivity. When the children were 412 years, the dyads were followed up with assessments of the children's attachment representations, social and emotional development, and global functioning, and the mothers' psychological well-being and representations of the child as well as the mother-child interactions. We gathered data from 66 cases approximately 312 years' posttreatment. All scores involving the mothers had now approached community levels. We found effects on maternal depression in favor of MIP, but no other between-group differences. The MIP treatments seemed to have helped the mothers to recover more quickly on personal well-being, to become more sensitive to their babies' suffering, and to better support and appreciate their children throughout infancy and toddlerhood. If so, this would explain why the MIP children had a better global functioning and were more often "OK" and less often "Troubled" at 412 years.

Section: Discussionmentioning

confidence: 99%

A Long-Term Follow-Up Study of a Randomized Controlled Trial of Mother-Infant Psychoanalytic Treatment: Outcomes on Mothers and Interactions

Sorjonen

2015

Infant Ment. Health J.

Arch Womens Ment Health

“…Specifically, our results are similar to Vesga-Lopez’s findings for any mood disorder and for any anxiety disorder (prevalence 8.5% and 12.2%, respectively). A history of mental health problems has been found to greatly increase the risk for poor antepartum mental health (Bilszta et al 2008; Borjesson et al 2005; Buesching et al 1986; Marcus et al 2003; Mora et al 2009; Rich-Edwards et al 2006; Seguin et al 1995) and confound associations between other risk factors and poor mental health during pregnancy. Importantly, our study highlights the strong association between a history of mental health problems and antepartum mental health problems.…”

Section: Discussionmentioning

confidence: 99%

“…While these studies may have limited generalizability to the entire population (Bolton et al 1998), they provide a valuable enumeration of evidence regarding which pregnant women are more likely to experience poor mental health. One of the most salient risk factors for poor antepartum mental health is having a prior history of such problems (Bilszta et al 2008; Borjesson et al 2005; Buesching et al 1986; Marcus et al 2003; Mora et al 2009; Lancaster et al 2010; Rich-Edwards et al 2006). Women who are younger (Borjesson et al 2005; Kearns et al 1997; Paarlberg et al 1996), African-American (Jesse and Swanson 2007; Orr et al 2006), in poor physical health (Marcus et al 2003), unemployed (Bolton et al 1998; Borjesson et al 2005; Marcus et al 2003), or having their first baby (Kearns et al 1997; Records and Rice 2007) may also be at greater a risk.…”

Section: Introductionmentioning

confidence: 99%

“…One of the most salient risk factors for poor antepartum mental health is having a prior history of such problems (Bilszta et al 2008; Borjesson et al 2005; Buesching et al 1986; Marcus et al 2003; Mora et al 2009; Lancaster et al 2010; Rich-Edwards et al 2006). Women who are younger (Borjesson et al 2005; Kearns et al 1997; Paarlberg et al 1996), African-American (Jesse and Swanson 2007; Orr et al 2006), in poor physical health (Marcus et al 2003), unemployed (Bolton et al 1998; Borjesson et al 2005; Marcus et al 2003), or having their first baby (Kearns et al 1997; Records and Rice 2007) may also be at greater a risk. In addition, women with limited or no social support (Demyttenaere et al 1995; Jesse and Swanson 2007; Kearns et al 1997; Lancaster et al 2010; Lee et al 2007; Leigh and Milgrom 2008; Rudnicki et al 2001; Seguin et al 1995; Westdahl et al 2007), low socioeconomic status (Bolton et al 1998; Holzman et al 2006; Kearns et al 1997; Marcus et al 2003), public insurance (Canady et al 2008; Jesse 2003; Jesse et al 2005; Kermode et al 2000; Lancaster et al 2010), poor coping skills or sense of control (Bernazzani et al 1997; Da Costa et al 2000; Demyttenaere et al 1995; Rudnicki et al 2001), low self-esteem (Jesse and Swanson 2007; Jesse et al 2005; Lee et al 2007; Leigh and Milgrom 2008; Ritter et al 2000), chronic stress (Jesse and Swanson 2007; Monk et al 2008; Mora et al 2009; Paarlberg et al 1996; Seguin et al 1995), alcohol or substance abuse problems (Marcus et al 2003; Mora et al 2009; Pajulo et al 2001), or a history of childhood or adult abuse (Benedict et al 1999; Holzman et al 2006; Jesse and Swanson 2007; Lancaster et al 2010; Leigh and Milgrom 2008; Nayak and Al-Yattama 1999) are more susceptible to having antepartum mental health problems.…”

Section: Introductionmentioning

confidence: 99%

“…In order to understand the factors associated with poor mental health during pregnancy, a more narrow definition is important. The only other population-based studies to date are from Sweden (Borjesson et al 2005; Larsson et al 2004; Rubertsson et al 2003). However, significant differences in the socio-environmental stresses and health care resources experienced by pregnant women in the USA may preclude the generalization of Swedish reports to USA populations.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The prevalence and determinants of antepartum mental health problems among women in the USA: a nationally representative population-based study

Witt

DeLeire

Hagen

et al. 2010

Mental health problems disproportionately affect women, particularly during childbearing years. We sought to estimate the prevalence of antepartum mental health problems and determine potential risk factors in a representative USA population. We examined data on 3,051 pregnant women from 11 panels of the 1996–2006 Medical Expenditure Panel Survey. Poor antepartum mental health was defined by self report of mental health conditions or symptoms or a mental health rating of “fair” or “poor.” Multivariate regression analyses modeled the odds of poor antepartum mental health; 7.8% of women reported poor antepartum mental health. A history of mental health problems increased the odds of poor antepartum mental health by a factor of 8.45 (95% CI, 6.01–11.88). Multivariate analyses were stratified by history of mental health problems. Significant factors among both groups included never being married and self-reported fair/poor health status. This study identifies key risk factors associated with antepartum mental health problems in a nationally representative sample of pregnant women. Women with low social support, in poor health, or with a history of poor mental health are at an increased risk of having antepartum mental health problems. Understanding these risk factors is critical to improve the long-term health of women and their children.

A randomized controlled trial of mother–infant psychoanalytic treatment: I. Outcomes on self‐report questionnaires and external ratings

Infant Mental Health Journal

Sandell

2011

Mother-infant relationship disturbances occur in three domains: maternal distress, infant functional problems, and relationship difficulties. They constitute common clinical problems. In Sweden, they are usually handled by nurses as part of public Child Health Centre care. Severe cases are referred to child psychiatry services. This randomized controlled trial compared two groups of mother-infant dyads in a Stockholm sample. One received only Child Health Centre care (the "CHCC" group) while the other received mother-infant psychoanalytic treatment plus CHCC (the "MIP" group). Eighty dyads of mothers and infants under 1½ years of age where the mothers had serious concerns about themselves in their role as mothers, their infants' well-being, or the mother-baby relationship were randomly selected for either the MIP or the CHCC group. The primary outcomes were mother-reported depression, mother-reported infant functional problems, and interviewer-based relationship assessments, all at 6 months after joining the project. Secondary outcomes were mother-reported stress and general psychic distress, externally rated video-recorded interactions, and the consumption of healthcare at the CHC, again all after 6 months. Intent-to-treat analyses of Treatment × Time effects significantly favored MIP treatment for maternal depression, mother-infant relationships, and maternal sensitivity. Effects were nearly significant on maternal stress, but nonsignificant on mother-reported infant functional problems, general psychic distress, maternal interactive structuring and nonintrusiveness, infant responsiveness and involvement, and healthcare consumption. MIP treatment improved mother-infant relationships and maternal sensitivity and depression, all of which are known to influence child development. If effects persist and are reproduced, MIP treatment holds promise for more widespread use.