Reebye Pratibha N, Ng Tammy W C, Misri Shaila, Stikarovska Irena
Infant Psychiatry Clinic, Department of Psychiatry, University of British Columbia Vancouver, BC, Canada.
Front Psychiatry. 2012 Feb 28;3:11. doi: 10.3389/fpsyt.2012.00011. eCollection 2012.
This study explored the affect expression and self-regulation capacities of 8-month-old infants exposed in utero to psychotropic medications. This was a continuation of our previous study conducted on the same cohort when the infants were 3 months old. Psychotropics implicated included selective serotonin reuptake inhibitors (SSRIs), and a benzodiazepine derivative anxiolytic (clonazepam). The three comparison groups were: control (n = 23; infants not exposed to psychotropics in utero), SSRI-alone (n = 22; infants exposed to SSRIs only and having mothers who had a primary diagnosis of depressive disorder without having comorbid anxiety disorder), and SSRI+ group (n = 15; infants gestationally exposed to SSRIs and clonazepam and having mothers that had both clinical depression and anxiety disorder). Using the Parent-Child Early Relational Assessment Scale, infants were assessed in a dyadic context during free play and a structured task. There were significant differences in psychotropic exposed and non-exposed dyads regarding infant negative affect management. There were significant associations between the SSRI+ group of mothers and infant negative affect. This group of mothers also showed significant associations with infants' averting and avoiding behaviors in both play situations. The SSRI-alone group was similar to the control group and showed variable associations with infant's positive, negative, and sober moods unlike the SSRI+ group. There were no differences in infants' capacity for self-regulation in psychotropic exposed and non-exposed groups. Increased awareness of these vulnerable subgroups (SSRI-alone and SSRI+) is needed, in order to safeguard these dyads through better support systems and improved management.
本研究探讨了子宫内暴露于精神药物的8个月大婴儿的情感表达和自我调节能力。这是我们之前对同一队列婴儿在3个月大时进行的研究的延续。涉及的精神药物包括选择性5-羟色胺再摄取抑制剂(SSRI)和一种苯二氮卓类衍生物抗焦虑药(氯硝西泮)。三个比较组分别为:对照组(n = 23;子宫内未暴露于精神药物的婴儿)、仅暴露于SSRI组(n = 22;仅暴露于SSRI且母亲初步诊断为抑郁症而无共病焦虑症的婴儿)和SSRI+组(n = 15;孕期暴露于SSRI和氯硝西泮且母亲患有临床抑郁症和焦虑症的婴儿)。使用亲子早期关系评估量表,在自由玩耍和结构化任务期间,在二元情境中对婴儿进行评估。在婴儿负面影响管理方面,暴露于精神药物和未暴露于精神药物的二元组之间存在显著差异。SSRI+组母亲与婴儿负面影响之间存在显著关联。在两种玩耍情境中,这组母亲与婴儿的回避行为也存在显著关联。仅暴露于SSRI组与对照组相似,与婴儿的积极、消极和冷静情绪的关联各不相同,这与SSRI+组不同。在暴露于精神药物和未暴露于精神药物的组中,婴儿的自我调节能力没有差异。需要提高对这些脆弱亚组(仅暴露于SSRI组和SSRI+组)的认识,以便通过更好的支持系统和改进的管理来保护这些二元组。