Post‐discharge outcomes for mothers and the mother–infant relationship following admission to a psychiatric Mother–Baby Unit

ABSTRACT Mother–Baby Unit research has focussed on maternal psychopathology over the course of an admission. Less is known about the baby's well‐being, the shared relationship, or the mother's recovery. In an initial sample of 45 women, we describe discharge and post‐discharge outcomes for...

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Veröffentlicht in:Infant mental health journal 2020-11, Vol.41 (6), p.770-782
Hauptverfasser: Wright, Tanya, Stevens, Suzanne, Reed, Peter W., Wouldes, Trecia A.
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Sprache:eng
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Zusammenfassung:ABSTRACT Mother–Baby Unit research has focussed on maternal psychopathology over the course of an admission. Less is known about the baby's well‐being, the shared relationship, or the mother's recovery. In an initial sample of 45 women, we describe discharge and post‐discharge outcomes for maternal psychopathology (using maternal report and the Global Assessment of Function, GAF) and the mother–infant relationship (using the Child and Adult Relational Experimental Index, CARE Index). Three months post‐discharge, one third of women described themselves as “completely recovered,” one third were experiencing significant deterioration and 17% were readmitted to inpatient care. Poorer GAF scores were associated with a clinical diagnosis of comorbid personality disorder, antenatal presence of the index illness, partner illicit substance use, maternal perception of her bond, infant social withdrawal, and child protection concern. Post‐discharge, the mother–infant relationship results were concerning. Only 17% were regarded as adequate. Improvement was observed across this period in 56% but relational deterioration occurred for 35%. Maternal and relational outcomes were weakly correlated at discharge (r² = 0.29, p = 0.07) but this was lost post‐discharge (r² = 0.03, p = 0.89). The shared relationship and infant mental health should both be targets for intervention; both during MBU admission, and post‐discharge. RESUMEN La investigación sobre la Unidad de Madres y Bebés se han enfocado en la sicopatología materna a lo largo del curso de una admisión. Se conoce menos del bienestar del bebé, la relación entre ellos o la presente recuperación de la madre. En un grupo muestra inicial de 45 mueres, describimos resultados posteriores a cuando se les dio de alta en cuanto a la sicopatología materna (usando el reporte materno y la Evaluación Global de la Función, GAF) y la relación infante‐madre (usando el Índice de Relación Experimental entre Niño y Adulto, Índice CARE). Tres meses después de que se les dio de alta, un tercio de las mujeres se describió a sí mismas como “completamente recuperadas,” un tercio de ellas estaba experimentando un deterioro significativo y 17% fueron readmitidas bajo el cuidado de paciente interno. Los más pobres puntajes de GAF se asociaron con un diagnóstico clínico de trastornos de personalidad comórbidos, presencia antenatal de la enfermedad en el índice, uso ilícito de sustancias por parte de la pareja, percepción maternal de su unión afec
ISSN:0163-9641
1097-0355
DOI:10.1002/imhj.21870