Mood Disorders Unit, Department and Institute of Psychiatry, Clinical Hospital, School of Medicine, University of Sao Paulo, Brazil.
J Affect Disord. 2012 Dec 20;143(1-3):172-8. doi: 10.1016/j.jad.2012.05.050. Epub 2012 Aug 9.
Bipolar disorder (BD) is a highly incapacitating disease typically associated with high rates of familial dysfunction. Despite recent literature suggesting that maternal care is an important environmental factor in the development of behavioral disorders, it is unclear how much maternal care is dysfunctional in BD subjects.
The objective of this study was to characterize maternal care in DSM-IV/SCID diagnosed BD type I subjects compared to healthy controls with (PD) and without (NPD) other psychiatric diagnoses.
Thirty-four BD mothers and 106 controls underwent an interview about family planning and maternal care, obstetrical complications, and mother-child interactions. K-SADS-PL questions about violence exposure were used to ascertain domestic violence and physical/sexual abuse.
BD mothers were less likely to have stable unions (45.5%; p<0.01) or to live with the biological father of their children (33.3%; p<0.01), but had higher educational level and higher rates of social security use/retirement. They also had fewer children and used less contraceptive methods than controls. Children of BD women had higher rates of neonatal anoxia, and reported more physical abuse (16.1%; p=0.02) than offspring of NPD mothers. Due to BD mothers' symptoms, 33.3% of offspring suffered physical and/or psychological abuse.
Post hoc analysis, and the use of questions as a surrogate of symptoms as opposed to validated instruments.
This is one of few reports confirming that maternal care given by BD women is dysfunctional. BD psychopathology can lead to poor maternal care and both should be considered important environmental risk factors in BD, suggesting that BD psychoeducation should include maternal care orientation.
双相情感障碍（BD）是一种高度致残的疾病，通常与家庭功能障碍的高发生率有关。尽管最近的文献表明，母性关怀是行为障碍发展的一个重要环境因素，但BD 患者的母性关怀有多少是功能失调的还不清楚。
本研究的目的是比较 DSM-IV/SCID 诊断的 BD 型 I 患者与有（PD）和无（NPD）其他精神诊断的健康对照者的母性关怀特征。
34 名 BD 母亲和 106 名对照者接受了关于家庭计划和母性关怀、产科并发症和母婴互动的访谈。K-SADS-PL 关于暴力暴露的问题用于确定家庭暴力和身体/性虐待。
BD 母亲更不可能有稳定的婚姻（45.5%；p<0.01）或与孩子的生父一起生活（33.3%；p<0.01），但她们的教育程度更高，社会安全使用/退休的比例更高。她们的孩子也更少，使用的避孕方法也比对照组少。BD 女性的孩子有更高的新生儿缺氧率，并报告了更多的身体虐待（16.1%；p=0.02），比 NPD 母亲的孩子多。由于 BD 母亲的症状，33.3%的子女遭受身体和/或心理虐待。
事后分析，以及使用问题作为症状的替代物，而不是使用经过验证的工具。
这是少数几个证实 BD 女性提供的母性关怀是功能失调的报告之一。BD 精神病理学可导致母性关怀不良，两者都应被视为 BD 的重要环境风险因素，这表明 BD 心理教育应包括母性关怀指导。
