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Inpatient mother-and-child postpartum psychiatric care: Factors associated with improvement in maternal mental health

Published online by Cambridge University Press:  16 April 2020

N.M.-C. Glangeaud-Freudenthal ,
A.-L. Sutter ,
A.-C. Thieulin ,
V. Dagens-Lafont ,
M.-A. Zimmermann ,
A. Debourg ,
B. Massari ,
O. Cazas ,
R. Cammas  and
C. Rainelli
...Show all authors
N.M.-C. Glangeaud-Freudenthal*
Affiliation:
Inserm, UMRS 953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, 16, avenue Paul-Vaillant-Couturier, 94807Villejuif cedex, France UMR S 953, UMPC University Paris 6, 75005Paris, France
A.-L. Sutter
Affiliation:
Pôle universitaire de psychiatrie adulte, réseau de psychiatrie périnatale, centre hospitalier Charles-Perrens, Bordeaux, France EA 4139, université Victor-Segalen Bordeaux 2, 121, rue de la Béchade, 33076Bordeaux cedex, France
A.-C. Thieulin
Affiliation:
Inserm, UMRS 953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, 16, avenue Paul-Vaillant-Couturier, 94807Villejuif cedex, France UMR S 953, UMPC University Paris 6, 75005Paris, France
V. Dagens-Lafont
Affiliation:
Centre hospitalier Théophile-Roussel, 1, rue Philippe-Mithouard, BP 71, 78063Montesson, France
M.-A. Zimmermann
Affiliation:
Hôpital civil, clinique psychiatrique, CHU, 1, place de l’Hôpital, BP 426, 67092Strasbourg cedex, France
A. Debourg
Affiliation:
Service de soins en périnatalité, hôpital du Vésinet, 72, avenue de la Princesse, 78110Le Vesinet, France
B. Massari
Affiliation:
Unité médico-psychologique pour la mère et l’enfant, CHIC, 40, avenue de Verdun, 94010Creteil cedex, France
O. Cazas
Affiliation:
Service universitaire de psychiatrie, hôpital Paul-Brousse, 12, avenue Paul-Vaillant-Couturier, 94804Villejuif cedex, France
R. Cammas
Affiliation:
Unité d’hospitalisation mère-bébé “La Pomme”, 4, rue Charles-Lauth 75018Paris, France
C. Rainelli
Affiliation:
Unité mère-bébé, pavillon Bergouignan, centre hospitalier Esquirol, 15, rue du Dr-Marcland, 87025Limoges cedex, France
F. Poinso
Affiliation:
Unité d’hospitalisation parents-enfants, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13274Marseille cedex 09, France
M. Maron
Affiliation:
Service hospitalo-universitaire de psychiatrie, hôpital Fontan, CHRU de Lille, 6, rue Émile-Verhaeghe, 59037Lille cedex, France
S. Nezelof
Affiliation:
Service de psychiatrie infantojuvénile, CHU de Besançon, 2, place Saint-Jacques, 25000 Besançon, France
P.-Y. Ancel
Affiliation:
Inserm, UMRS 953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, 16, avenue Paul-Vaillant-Couturier, 94807Villejuif cedex, France UMR S 953, UMPC University Paris 6, 75005Paris, France
B. Khoshnood
Affiliation:
Inserm, UMRS 953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, 16, avenue Paul-Vaillant-Couturier, 94807Villejuif cedex, France UMR S 953, UMPC University Paris 6, 75005Paris, France
*
* Corresponding author. Tel.: +35312791700; fax: +35312791799. E-mail address: [email protected] (N.M.-C. Glangeaud-Freudenthal).
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Abstract

Purpose

This study assessed the underexplored factors associated with significant improvement in mothers’ mental health during postpartum inpatient psychiatric care.

Methods

This study analyzed clinical improvement in a prospective cohort of 869 women jointly admitted with their infant to 13 psychiatric Mother-Baby Units (MBUs) in France between 2001 and 2007. Predictive variables tested were: maternal mental illness (ICD-10), sociodemographic characteristics, mental illness and childhood abuse history, acute or chronic disorder, pregnancy and birth data, characteristics and mental health of the mother's partner, and MBU characteristics.

Results

Two thirds of the women improved significantly by discharge. Admission for 25% was for a first acute episode very early after childbirth. Independent factors associated with marked improvement at discharge were bipolar or depressive disorder, a first acute episode or relapse of such an episode. Schizophrenia, a personality disorder, and poor social integration (as measured by occupational status) were all related to poor clinical outcomes.

Discussion

Most women improved significantly while under care in MBUs. Our results emphasize the importance of the type of disease but also its chronicity and the social integration when providing postpartum psychiatric care.

Keywords

Affective disordersSchizophrenia and psychosisPersonality disordersPsychiatry in EuropeEpidemiologySocial and cross culturalPostpartum disordersMother-baby unit
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 4 , May 2011 , pp. 215 - 223
Copyright
Copyright © Elsevier Masson SAS 2011

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