Karitane, PO Box 241, Villawood, NSW 2163, Australia.
Aust N Z J Psychiatry. 2010 Mar;44(3):280-9. doi: 10.3109/00048670903487225.
Residential mother-infant intervention programmes for unsettled infant behaviour have been shown to be associated with positive child and maternal outcomes. Despite evidence of elevated rates of maternal psychopathology among residential unit populations, little is known about whether psychological disorders interfere with the effectiveness of such interventions.
Two cohorts (n = 104 and 147, respectively) were recruited from a residential mother-infant intervention programme for unsettled infant behaviour. In study 1, mothers completed self-report questionnaires measuring depression, anxiety and parenting stress at three time points (admission, 1 month after discharge and 3 months after discharge). In study 2, mothers were interviewed using a structured clinical interview for depressive and anxiety disorders. In both studies, nurses recorded infant behaviours over the duration of the 5 day admission using 24 h behaviour charts.
Study 1 showed the intervention to be associated with significant improvements in child behaviours and in levels of maternal depression, anxiety and parenting stress. These improvements were evident for women who scored above the Edinburgh Postnatal Depression Scale threshold for major depression during the admission, as well as for women in the normal range. Study 2 confirmed that the intervention was associated with significant improvements in infant behaviours. Infants of mothers with a depressive or anxiety disorder were less unsettled on admission, but improvements over the course of the admission were comparable for infants of women who had, or had not, experienced an anxiety or depressive disorder during the admission.
These results show positive infant and maternal outcomes associated with a residential mother-infant intervention for unsettled infant behaviour, regardless of the women's psychiatric status on admission. This suggests that women with depression or anxiety disorders who also report unsettled infant behaviour, will benefit from referral to residential programmes.
针对婴儿行为不安的住院母婴干预计划已被证明与儿童和产妇的积极结果相关。尽管在住院单元人群中存在较高的产妇精神病理学发生率的证据，但对于心理障碍是否会干扰此类干预措施的有效性知之甚少。
从一个针对婴儿行为不安的住院母婴干预计划中分别招募了两个队列（分别为 104 人和 147 人）。在研究 1 中，母亲在三个时间点（入院时、出院后 1 个月和出院后 3 个月）完成了自我报告问卷，以评估抑郁、焦虑和育儿压力。在研究 2 中，母亲通过结构化临床访谈进行了抑郁和焦虑障碍的访谈。在这两项研究中，护士使用 24 小时行为图表在住院期间记录婴儿的行为。
研究 1 表明该干预措施与儿童行为的显著改善以及母亲抑郁、焦虑和育儿压力水平的显著降低有关。对于在入院期间出现明显产后抑郁的母亲，以及在正常范围内的母亲，这些改善都是明显的。研究 2 证实干预措施与婴儿行为的显著改善有关。患有抑郁或焦虑障碍的母亲的婴儿在入院时不那么不安，但在入院期间，婴儿的改善情况与入院期间经历过焦虑或抑郁障碍的母亲的婴儿相当。
这些结果表明，针对婴儿行为不安的住院母婴干预计划与积极的母婴结果相关，而不论母亲入院时的精神状态如何。这表明，同时报告婴儿行为不安且患有抑郁或焦虑障碍的女性，将受益于转诊到住院项目。
