Treatment of women with postpartum mental disorders in a day clinic mother-baby unit and the effect on child behavioural problems - A 1-year follow-up.

BACKGROUND

Postpartum mental disorders are highly prevalent with substantial impact on mother-child bonding and child development. While short-term benefits of an interaction-focused mother-baby treatment for maternal mental health are documented, little is known about the stability of these effects and their influence on child behavioural development.

METHOD: This prospective study included 348 women with postpartum mental disorders who received dyadic treatment at a specialized mother-baby day clinic. Maternal symptoms of depression (EPDS), anxiety (STAI-T), overall psychological distress (BSI-GSI) as well as parenting sense of competence (PSOC) were assessed at admission, discharge, and 1-year follow-up, along with diagnostic classification at admission. At 1-year follow-up, mothers (n = 164) completed the Child Behaviour Checklist (CBCL) to measure child behavioural problems.

RESULTS

Maternal psychopathology and PSOC improved significantly from admission to discharge, with clinically meaningful effects. No additional improvements emerged from discharge to 1-year follow-up, except for a tentative reduction in anxiety symptoms. All outcome measures and outcome trajectories regarding anxiety symptoms and overall psychological distress varied by primary clinical diagnosis. Greater maternal symptom improvement from admission to 1-year follow-up was associated with fewer child behavioural problems. However, this effect was not found for symptom changes from admission to discharge when controlling for maternal symptoms at 1-year follow-up.

CONCLUSIONS

Interaction-focused treatment in a mother-baby day clinic may be associated with clinically meaningful improvements in maternal mental health outcomes up to 1-year follow-up. These long-term improvements may also relate to less child behavioural problems. However, the absence of a waiting list control group warrants cautious interpretation of findings.