Psychological Medicine



Original Article

What predicts poor mother–infant interaction in schizophrenia?


MING WAI WAN a1c1, MARGARET P. SALMON a2, DENISE M. RIORDAN a3, LOUIS APPLEBY a1, ROGER WEBB a1 and KATHRYN M. ABEL a1
a1 Centre for Women's Mental Health Research, Division of Psychiatry, Williamson Building, University of Manchester, Manchester, UK
a2 School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
a3 Fleming Nuffield Unit, Newcastle, Northumberland and North Tyneside NHS Trust, Jesmond, Newcastle upon Tyne, UK

Article author query
wan mw   [PubMed][Google Scholar] 
salmon mp   [PubMed][Google Scholar] 
riordan dm   [PubMed][Google Scholar] 
appleby l   [PubMed][Google Scholar] 
webb r   [PubMed][Google Scholar] 
abel km   [PubMed][Google Scholar] 

Abstract

Background. Poor clinician-rated parenting outcome and observed interactive deficits in mothers with schizophrenia admitted to a psychiatric mother and baby unit (MBU) reflect continuing concerns over the parenting capacity of this group. However, little is known about whether interaction deficits are accounted for by severity of illness or adverse social circumstances typically experienced by these mothers.

Method. Thirty-eight women with severe perinatal illness (schizophrenia n=13; affective disorders n=25) and their infants were observed in play interaction a week prior to MBU discharge. Clinical and sociodemographic data were also obtained.

Results. Mothers with schizophrenia and their infants were rated to have poorer interactive behaviour than the affective disorders group. Infant avoidance of the mother was associated with a lack of maternal sensitivity and responsiveness. The deficits in mother–infant interaction found in the schizophrenia group could not be accounted for by our measures of illness severity or factors relating to adverse social circumstances.

Conclusions. The results replicate and extend previous findings showing poor interactive behaviours in mothers with schizophrenia, their infants, and in the dyad, in a range of areas following clinical recovery. The findings suggest that factors other than illness duration, dose of medication, marital status and occupational status are explanatory for the interactive deficits associated with maternal schizophrenia. Parenting interventions that aim to improve maternal sensitivity need to be developed specifically for this group.


Correspondence:
c1 Centre for Women's Mental Health Research, Division of Psychiatry, Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. (Email: m.w.wan@manchester.ac.uk)


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