Narayan Shweta, Kishore M Thomas, Satyanarayana Veena, Bhaskarapillai Binukumar, Desai Geetha, Chandra Prabha
Dept. of Clinical Psychology, NIMHANS, Bangalore, Karnataka, India.
Dept. of Biostatistics, NIMHANS, Bangalore, Karnataka, India.
Indian J Psychol Med. 2023 May;45(3):250-256. doi: 10.1177/02537176231164732. Epub 2023 Apr 17.
Maternal mental health has specific implications for bonding and infants' mental health. However, most of the evidence comes from mothers who are either symptomatic or did not have adequate mental health support. In this context, our objective was to explore if symptom status in mothers and bonding share any significant association with the infants' development and quality of life (QOL), in case of mothers with severe mental illnesses in remission.
The study included 41 mother-infant dyads from the outpatient perinatal psychiatry services and the mother-baby unit of the current study center. Symptom status, self-reported bonding, mother-infant interactions, and infants' development and QOL were assessed with Clinical Global Impressions, Postpartum Bonding Questionnaire, Pediatric Infant-Parent Exam, Developmental Assessment Scales for Indian Infants, and Pediatric Quality of Life Scale, respectively.
Most mothers had a complete recovery or minimal symptoms. Nine (22%) infants had a significant developmental delay. Atypical play-based interactions were observed in nine (22%) mothers. Self-reported bonding and bonding as evinced over play-based interactions did not significantly correlate with the QOL or development of the infants. Mothers who have recovered and are functioning well reported good bonding with their infants, though objective assessment revealed specific difficulties. Symptom severity correlated with poor physical QOL in infants.
The association between mothers' bonding and infants' mental health is domain-specific and differential than linear and robust. Infants of mothers with severe mental illnesses postpartum should be routinely monitored for mother-infant bonding, development, and quality of life.
母亲的心理健康对母婴联结及婴儿心理健康具有特定影响。然而，大多数证据来自有症状或未获得充分心理健康支持的母亲。在此背景下，我们的目标是探讨在病情缓解的重症母亲中，母亲的症状状态和母婴联结与婴儿发育及生活质量（QOL）之间是否存在显著关联。
本研究纳入了来自当前研究中心门诊围产期精神病服务部门和母婴病房的41对母婴。分别使用临床总体印象量表、产后联结问卷、儿科婴儿 - 父母检查量表、印度婴儿发育评估量表和儿科生活质量量表评估症状状态、自我报告的联结情况、母婴互动以及婴儿的发育和生活质量。
大多数母亲已完全康复或症状轻微。9名（22%）婴儿存在明显发育迟缓。9名（22%）母亲存在基于游戏互动的非典型情况。自我报告的联结以及基于游戏互动所表现出的联结与婴儿的生活质量或发育无显著相关性。已康复且功能良好的母亲报告称与婴儿联结良好，尽管客观评估显示存在特定困难。症状严重程度与婴儿较差的身体生活质量相关。
母亲的联结与婴儿心理健康之间的关联具有领域特异性，并非线性且稳固的。产后患有重症精神疾病的母亲的婴儿应常规监测母婴联结、发育及生活质量。
