Psychological Medicine

Original Articles

Mind-mindedness and maternal responsiveness in infant–mother interactions in mothers with severe mental illness

S. Pawlbya1 c1, C. Fernyhougha2, E. Meinsa2, C. M. Pariantea1, G. Seneviratnea1 and R. P. Bentalla3

a1 Section of Perinatal Psychiatry and Stress, Psychiatry and Immunology, Institute of Psychiatry, King's College London, London, UK

a2 Psychology Department, Durham University, Durham, UK

a3 School of Psychology, University of Bangor, Wales, UK


Background Previous cross-diagnosis studies of interaction between mothers with severe mental illness and their babies have concluded that mothers with schizophrenia have deficits in interaction, but these studies have not included healthy controls.

Method In-patients on a mother and baby unit, with diagnoses of schizophrenia (n=15), depressive mood disorders with or without psychosis (n=23), or mood disorders where mania was the predominant feature, with or without psychosis (n=12), were observed interacting with their infants on admission and discharge. Mothers' mind-mindedness and other measures of the quality of maternal and infant behaviour were coded. Findings from this sample were compared with those from healthy mothers and their infants (n=49).

Results Compared with healthy controls, on admission depressed mothers were marginally less likely to comment appropriately on their infants' mental states. Both the depressed and mania groups were more likely to touch their babies and engage in attention-seeking behaviours. Interactional behaviours of mothers in the schizophrenia group were not markedly different from healthy controls. On discharge there were fewer differences between the clinical and healthy groups, although the depressed group continued to engage in more attention-seeking and touching behaviour and the mania group continued to touch their infants more. Only mothers in the schizophrenia group showed changes in interactional behaviours between admission and discharge, talking more to their infants.

Conclusions The findings challenge previous conclusions that mothers with schizophrenia have deficits in their interactions with their babies, and demonstrate that mothers with severe mental illness are able to respond appropriately to their infants' cues.

(Received November 21 2008)

(Revised December 10 2009)

(Accepted December 14 2009)

(Online publication January 27 2010)