Gilden Janneke, Molenaar Nina M, Smit Anne K, Hoogendijk Witte J G, Rommel Anna-Sophie, Kamperman Astrid M, Bergink Veerle
Department of Psychiatry, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
J Clin Med. 2020 Jul 19;9(7):2291. doi: 10.3390/jcm9072291.
Mother-to-infant bonding is important for long-term child development. The aim of this study was to investigate bonding in women admitted to a Mother and Baby Unit with postpartum depression (PD, = 64) and postpartum psychosis (PP, = 91). Participants completed the Postpartum Bonding Questionnaire (PBQ), the Edinburgh Postnatal Depression Scale (EPDS) and the Young Mania Rating Scale (YMRS) weekly during admission. At admission, 57.1% of women with PD had impaired bonding, compared to only 17.6% of women with PP (-value < 0.001). At discharge, only 18.2% of women with PD and 5.9% of women with PP still experienced impaired bonding (-value = 0.02). There was a strong association between decrease of depressive and manic symptoms and improved bonding over an eight-week admission period. In a small group of women (5.7%) impaired bonding persisted despite being in remission of their psychiatric disorder. The results from our study show that impaired bonding is a more present and evidently severe problem in postpartum depression but not so much in postpartum psychosis. Treatment of depressive symptoms will improve bonding in almost all women, but clinicians should assess if impaired bonding is still present after remission because for a small group special care and treatment focused on bonding might be required.
母婴联结对儿童的长期发展至关重要。本研究旨在调查入住母婴病房的产后抑郁症（PD，n = 64）和产后精神病（PP，n = 91）女性的母婴联结情况。参与者在住院期间每周完成产后联结问卷（PBQ）、爱丁堡产后抑郁量表（EPDS）和杨氏躁狂评定量表（YMRS）。入院时，57.1%的产后抑郁症女性存在联结障碍，相比之下，产后精神病女性中只有17.6%存在联结障碍（p值<0.001）。出院时，只有18.2%的产后抑郁症女性和5.9%的产后精神病女性仍存在联结障碍（p值 = 0.02）。在为期八周的住院期间，抑郁和躁狂症状的减轻与联结改善之间存在密切关联。在一小部分女性（5.7%）中，尽管精神障碍已缓解，但联结障碍仍然存在。我们的研究结果表明，联结障碍在产后抑郁症中是一个更普遍且明显更严重的问题，但在产后精神病中并非如此。治疗抑郁症状几乎可以改善所有女性的联结情况，但临床医生应评估在症状缓解后联结障碍是否仍然存在，因为对于一小部分女性可能需要针对联结进行特殊护理和治疗。
