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Inpatient mother-and-child postpartum psychiatric care: Factors associated with improvement in maternal mental health

Published online by Cambridge University Press:  16 April 2020

N.M.-C. Glangeaud-Freudenthal ,
A.-L. Sutter ,
A.-C. Thieulin ,
V. Dagens-Lafont ,
M.-A. Zimmermann ,
A. Debourg ,
B. Massari ,
O. Cazas ,
R. Cammas  and
C. Rainelli
...Show all authors
N.M.-C. Glangeaud-Freudenthal*
Affiliation:
Inserm, UMRS 953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, 16, avenue Paul-Vaillant-Couturier, 94807Villejuif cedex, France UMR S 953, UMPC University Paris 6, 75005Paris, France
A.-L. Sutter
Affiliation:
Pôle universitaire de psychiatrie adulte, réseau de psychiatrie périnatale, centre hospitalier Charles-Perrens, Bordeaux, France EA 4139, université Victor-Segalen Bordeaux 2, 121, rue de la Béchade, 33076Bordeaux cedex, France
A.-C. Thieulin
Affiliation:
Inserm, UMRS 953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, 16, avenue Paul-Vaillant-Couturier, 94807Villejuif cedex, France UMR S 953, UMPC University Paris 6, 75005Paris, France
V. Dagens-Lafont
Affiliation:
Centre hospitalier Théophile-Roussel, 1, rue Philippe-Mithouard, BP 71, 78063Montesson, France
M.-A. Zimmermann
Affiliation:
Hôpital civil, clinique psychiatrique, CHU, 1, place de l’Hôpital, BP 426, 67092Strasbourg cedex, France
A. Debourg
Affiliation:
Service de soins en périnatalité, hôpital du Vésinet, 72, avenue de la Princesse, 78110Le Vesinet, France
B. Massari
Affiliation:
Unité médico-psychologique pour la mère et l’enfant, CHIC, 40, avenue de Verdun, 94010Creteil cedex, France
O. Cazas
Affiliation:
Service universitaire de psychiatrie, hôpital Paul-Brousse, 12, avenue Paul-Vaillant-Couturier, 94804Villejuif cedex, France
R. Cammas
Affiliation:
Unité d’hospitalisation mère-bébé “La Pomme”, 4, rue Charles-Lauth 75018Paris, France
C. Rainelli
Affiliation:
Unité mère-bébé, pavillon Bergouignan, centre hospitalier Esquirol, 15, rue du Dr-Marcland, 87025Limoges cedex, France
F. Poinso
Affiliation:
Unité d’hospitalisation parents-enfants, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13274Marseille cedex 09, France
M. Maron
Affiliation:
Service hospitalo-universitaire de psychiatrie, hôpital Fontan, CHRU de Lille, 6, rue Émile-Verhaeghe, 59037Lille cedex, France
S. Nezelof
Affiliation:
Service de psychiatrie infantojuvénile, CHU de Besançon, 2, place Saint-Jacques, 25000 Besançon, France
P.-Y. Ancel
Affiliation:
Inserm, UMRS 953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, 16, avenue Paul-Vaillant-Couturier, 94807Villejuif cedex, France UMR S 953, UMPC University Paris 6, 75005Paris, France
B. Khoshnood
Affiliation:
Inserm, UMRS 953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, 16, avenue Paul-Vaillant-Couturier, 94807Villejuif cedex, France UMR S 953, UMPC University Paris 6, 75005Paris, France
*
* Corresponding author. Tel.: +35312791700; fax: +35312791799. E-mail address: nine.glangeaud@inserm.fr (N.M.-C. Glangeaud-Freudenthal).
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Abstract

Purpose

This study assessed the underexplored factors associated with significant improvement in mothers’ mental health during postpartum inpatient psychiatric care.

Methods

This study analyzed clinical improvement in a prospective cohort of 869 women jointly admitted with their infant to 13 psychiatric Mother-Baby Units (MBUs) in France between 2001 and 2007. Predictive variables tested were: maternal mental illness (ICD-10), sociodemographic characteristics, mental illness and childhood abuse history, acute or chronic disorder, pregnancy and birth data, characteristics and mental health of the mother's partner, and MBU characteristics.

Results

Two thirds of the women improved significantly by discharge. Admission for 25% was for a first acute episode very early after childbirth. Independent factors associated with marked improvement at discharge were bipolar or depressive disorder, a first acute episode or relapse of such an episode. Schizophrenia, a personality disorder, and poor social integration (as measured by occupational status) were all related to poor clinical outcomes.

Discussion

Most women improved significantly while under care in MBUs. Our results emphasize the importance of the type of disease but also its chronicity and the social integration when providing postpartum psychiatric care.

Keywords

Affective disordersSchizophrenia and psychosisPersonality disordersPsychiatry in EuropeEpidemiologySocial and cross culturalPostpartum disordersMother-baby unit
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 4 , May 2011 , pp. 215 - 223
Copyright
Copyright © Elsevier Masson SAS 2011

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References

Abel, KM, Webb, RT, Salmon, MP, Wan, MW, Appleby, LPrevalence and predictors of parenting outcomes in a cohort of mothers with schizophrenia admitted for joint mother and baby psychiatric care in England. J Clin Psychiatry 2005;66(6):781–789.CrossRefGoogle Scholar
Andrade, LH, Viana, MC, Tofoli, LF, Wang, YPInfluence of psychiatric morbidity and sociodemographic determinants on use of service in a catchment area in the city of Sao Paulo. Braz Soc Psychiatry Psychiatr Epidemiol 2008;43(1):45–53.CrossRefGoogle Scholar
Bell, AJ, Land, NM, Milne, S, Hassanyeh, FLong-term of post-partum psychiatric illness requiring admission. J Affect Disord 1994; 31: 67–70.CrossRefGoogle ScholarPubMed
Buist, A, Minto, B, Szego, K, Samhuel, M, Shawyer, L, O’Connor, LMother-baby psychiatric units in Australia – the Victorian experience. Arch Womens Ment Health 2004;7(1):81–87.CrossRefGoogle ScholarPubMed
Cazas, O, Glangeaud-Freudenthal, NMThe history of mother-baby units (MBUs) in France and Belgium and of the French version of the Marce checklist. Arch Womens Ment Health 2004;7(1):53–58.CrossRefGoogle ScholarPubMed
Chaudron, LH, Pies, RWThe relationship between postpartum psychosis and bipolar disorder: a review. J Clin Psychiatry 2003;64(11):1284–1292.CrossRefGoogle ScholarPubMed
Deater-Deckard, K, Pickering, K, Dunn, JF, Golding, JFamily structure and depressive symptoms in men preceding and following the birth of a child. Am J Psychiatr 1998; 155: 818–823.Google ScholarPubMed
Dollberg, D, Feldman, R, Keren, MMaternal representations, infant psychiatric status, and mother-child relationship in clinic-referred and non-referred infants. Eur Child Adolesc Psychiatry 2010;19(1):25–36.CrossRefGoogle ScholarPubMed
Eklund, M, Hansson, LSocial network among people with persistent mental illness: associations with sociodemographic, clinical and health-related factors. Int J Soc Psychiatry 2007;53(4):293–305.CrossRefGoogle ScholarPubMed
Garfield, P, Kent, A, Paykel, ES, Creighton, FJ, Jacobson, ROutcome of postpartum disorders: a 10 year follow-up of hospital admissions. Acta Psychiatr Scand 2004;109(6):434–439.CrossRefGoogle ScholarPubMed
Glangeaud-Freudenthal, N.M.-C., Sutter, A.-L., Thieulin, A.-C., Chardeau, P, Zimmermann, M.-A., Debourg, A, et al.Qui sont les femmes et les bébés hospitalisés à plein temps dans les unités mère-bébé (UMB) en France ? Données nationales, 2001–2007, du groupe de recherche UMB-SMF. In: Poinso, F, Glangeaud-Freudenthal, N.M.-C.Orages à l’aube de la vie : liens précoces, pathologies puerpérales et développement des nourrissons 2009 Érés Paris19–27.Google Scholar
Glangeaud-Freudenthal, NMMother-baby psychiatric units (MBUs): national data collection in France and in Belgium (1999–2000). Arch Womens Ment Health 2004;7(1):59–64.CrossRefGoogle ScholarPubMed
Grube, MInpatient treatment of women with postpartum psychiatric disorders – the role of the male partners. Arch Womens Ment Health 2005; 8: 163–170.CrossRefGoogle ScholarPubMed
Harlow, BL, Vitonis, AF, Sparen, P, Cnattingius, S, Joffe, H, Hultman, CMIncidence of hospitalization for postpartum psychotic and bipolar episodes in women with and without prior prepregnancy or prenatal psychiatric hospitalizations. Arch Gen Psychiatry 2007;64(1):42–48.CrossRefGoogle ScholarPubMed
Harvey, I, Mac Grath, GPsychiatric morbidity in spouses of women admitted to a mother and baby unit. Br J Psychiatry 1988; 152: 506–510.CrossRefGoogle ScholarPubMed
Howard, L, Shah, N, Salmon, M, Appleby, LPredictors of social services supervision of babies of mothers with mental illness after admission to a psychiatric mother and baby unit. Soc Psychiatry Psychiatr Epidemiol 2003;38(8):450–455.CrossRefGoogle ScholarPubMed
Howard, M, Battle, CL, Pearlstein, T, Rosene-Montella, KA psychiatric mother-baby day hospital for pregnant and postpartum women. Arch Womens Ment Health 2006;9(4):213–218.CrossRefGoogle ScholarPubMed
Joy, C, Saylan, MMother and baby units for schizophrenia. Cochrane Database Syst Rev 2007;24(1):CD006333Google Scholar
Kumar, R, Marks, M, Platz, C, Yoshida, KClinical survey of a psychiatric mother and baby unit: characteristics of 100 consecutive admissions. J Affect Disord 1995; 33: 11–22.CrossRefGoogle ScholarPubMed
Lovestone, S, Kumar, RPostnatal psychiatric illness: the impact on partners. Br J Psychiatry 1993; 163: 210–216.CrossRefGoogle ScholarPubMed
Main, TFMothers with children in a psychiatric hospital. Lancet 1958;2(7051):845–847.CrossRefGoogle ScholarPubMed
Marks, M, Wieck, A, Checkley, S, Kumar, CHow does marriage protect women with histories of affective disorder from post-partum relapse? Br J Med Psychol 1996; 69: 329–342.CrossRefGoogle ScholarPubMed
Marmorstein, NR, Malone, SM, Iacono, WGPsychiatric disorders among offspring of depressed mothers: associations with paternal psychopathology. Am J Psychiatry 2004;161(9):1588–1594.CrossRefGoogle ScholarPubMed
Merikangas, KRAssortative mating for psychiatric disorders and psychological traits. Arch Gen Psychiatry 1982; 39: 1173–1180.CrossRefGoogle ScholarPubMed
Munk-Olsen, T, Laursen, TM, Pedersen, CB, Mors, O, Mortensen, PBFamily and partner psychopathology and the risk of postpartum mental disorders. J Clin Psychiatry 2007;68(12):1947–1953.CrossRefGoogle ScholarPubMed
Neil, S, Sanderson, H, Wieck, AA satisfaction survey of women admitted to a psychiatric mother and baby unit in the northwest of England. Arch Womens Ment Health 2006;9(2):109–112.CrossRefGoogle ScholarPubMed
Nezelof, S, Cazas, O, Sutter-Dallay, AL, Glangeaud-Freudenthal, M.-C.L’hospitalisation conjointe mère-bébé en psychiatrie [Joint admission to psychiatric mother-baby unit]. Ann Med Psychol 2005; 163: 529–534.Google Scholar
Oates, MPsychiatric services for women following childbirth. Int Rev Psychiatry 1996; 8: 87–98.CrossRefGoogle Scholar
Peduzzi, P, Concato, J, Kemper, E, Holford, TR, Feinstein, ARA simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 1996;49(12):1373–1379.CrossRefGoogle ScholarPubMed
Poinso F, Glangeaud-Freudenthal MC (Eds.). Orages à l’aube de la vie : liens précoces, pathologies puerpérales et développement des nourrissons. Paris: Érés ed.; 2009.Google Scholar
Porter, CLPredicting preschoolers’ social-cognitive play behavior: attachment, peers, temperament, and physiological regulation. Psychol Rep 2009;104(2):517–528.CrossRefGoogle ScholarPubMed
Pritchard, DB, Harris, BAspects of perinatal psychiatric illness. Br J Psychiatry 1996; 169: 555–562.CrossRefGoogle ScholarPubMed
Ramchandani, P, Stein, A, Evans, J, O’Connor, TGALSPAC study team Paternal depression in the postnatal period and child development: a prospective population study. Lancet 2005;365(9478):2201–2205.CrossRefGoogle ScholarPubMed
Salmon, M, Abel, K, Cordingley, L, Friedman, T, Appleby, LClinical and parenting skills outcomes following joint mother-baby psychiatric admission. Aust N Z J Psychiatry 2003;37(5):556–562.CrossRefGoogle ScholarPubMed
Salmon, MP, Abel, K, Webb, R, Warbuton, AL, Appleby, LA national audit of joint mother and baby admissions to UK psychiatric hospitals: an overview of findings. Arch Womens Ment Health 2004; 7: 65–70.CrossRefGoogle Scholar
Salmon, MP, Appleby, APredictors of clinical outcome, other outcomes and risk of harm to babies using data from the national audit of mother and baby admissions to psychiatric hospitals. Arch Womens Ment Health 2000;3():107Google Scholar
Schumacher, M, Zubaran, C, White, GBringing birth-related paternal depression to the fore. Women Birth 2008;21(2):65–70.CrossRefGoogle ScholarPubMed
Semprevivo, DM, McGrath, JA select psychiatric mother and baby unit in Britain: implications for care in the United States. NAACOGS Clin Issu Perinat Womens Health Nurs 1990;1(3):402–409.Google ScholarPubMed
Sharma, VManagement of bipolar II disorder during pregnancy and the postpartum period – Motherisk update 2008. Can J Clin Pharmacol 2009;16(1):e33–e41.Google ScholarPubMed
Sneddon, J, Kerry, RJ, Bant, WPThe psychiatric mother and baby unit. A three-year study. Practitioner 1981;225(1359):1295–1300.Google ScholarPubMed
Spinelli, MGPostpartum psychosis: detection of risk and management. Am J Psychiatry 2009;166(4):405–408.CrossRefGoogle ScholarPubMed
Steiner, MPostpartum psychiatric disorders. Can J Psychiatry 1990; 35: 89–95.CrossRefGoogle ScholarPubMed
Stewart, DEPsychiatric admission of mentally. III. Mothers with their infants. Can J Psychiatry 1989;34(1):34–38.CrossRefGoogle Scholar
Vittinghoff, E, McCulloch, CERelaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol 16562007 Mar 15 710–718.CrossRefGoogle Scholar
Wisner, KL, Jennings, KD, Conley, BClinical dilemmas due to the lack of inpatient mother-baby units. Int J Psychiatry Med 1996;26(4):479–493.CrossRefGoogle ScholarPubMed
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