Weidner Kerstin, Junge-Hoffmeister Juliane, Coenen Anne, Croy Ilona, Bittner Antje
Klinik und Poliklinik für Psychotherapie und Psychosomatik, Universitätsklinikum C.G. Carus an der Technischen Universität Dresden.
Psychother Psychosom Med Psychol. 2021 Jul;71(7):274-283. doi: 10.1055/a-1283-6422. Epub 2021 Jan 13.
Women with postpartum mental disorders often have a delayed bonding to their child with negative consequences for the child's development. In several countries it has been demonstrated that a specific mother-child treatment has positive effects on maternal psychopathology and mother-child bonding. Data for German-speaking countries are rare, partly due to the lack of adequately financed mother-baby units. The objectives of this study were to characterize the patients and to evaluate the treatment in a psychosomatic-psychotherapeutic mother-child day clinic.
A total of 270 patients were examined at admission and discharge from the mother-child day clinic. The evaluation included main and secondary diagnoses according to ICD-10, duration of treatment, medication, information on the child, and psychometric questionnaires on maternal psychopathology, mother-child bonding, and parental sense of competence.
Of the women examined, 75% had more than one, on average 2.3 mental diagnoses. The most frequent main diagnoses were affective disorders (38.5%), neurotic, stress and somatoform disorders (30.7%) and personality and behavioral disorders (20.4%). About 56% reported impaired mother-child bonding. The average duration of therapy was 32 treatment days. Between admission and discharge, a highly significant improvement in symptoms was observed with a high effect size [F=288.557 (df=1), p<0.001, Eta²=0.549]. At discharge, 86.6% of patients showed no signs of mother-child bonding disorder.
The results indicate high potential effects of an interaction-centered treatment on maternal mental health and mother-child bonding.
The joint treatment of mother and child should be a fixed and financed component of the mental health system in order to prevent chronification and negative developmental consequences for the child.
患有产后精神障碍的女性往往与孩子的情感联结延迟，这会对孩子的发育产生负面影响。在一些国家，已经证明一种特定的母婴治疗方法对母亲的精神病理学和母婴情感联结有积极影响。德语国家的相关数据很少，部分原因是缺乏资金充足的母婴病房。本研究的目的是对患者进行特征描述，并评估在一家身心治疗性母婴日间诊所的治疗效果。
共有270名患者在母婴日间诊所入院和出院时接受了检查。评估包括根据国际疾病分类第10版（ICD - 10）的主要和次要诊断、治疗持续时间、用药情况、孩子的信息，以及关于母亲精神病理学、母婴情感联结和父母胜任感的心理测量问卷。
在接受检查的女性中，75%有不止一种精神诊断，平均为2.3种。最常见的主要诊断是情感障碍（38.5%）、神经症、应激和躯体形式障碍（30.7%）以及人格和行为障碍（20.4%）。约56%的人报告母婴情感联结受损。平均治疗持续时间为32个治疗日。入院和出院之间，症状有高度显著的改善，效应量很高[F = 288.557（自由度 = 1），p < 0.001，Eta² = 0.549]。出院时，86.6%的患者没有母婴情感联结障碍的迹象。
结果表明以互动为中心的治疗对母亲心理健康和母婴情感联结具有很高的潜在效果。
母婴联合治疗应成为心理健康系统中一个固定且有资金支持的组成部分，以防止病情慢性化并避免对孩子产生负面发育后果。
