Maternal psychopathology and outcomes of a residential mother-infant intervention for unsettled infant behaviour

Objective: Residential mother-infant intervention programmes for unsettled infant behaviour have been shown to be associated with positive child and maternal outcomes. Despite evidence of elevated rates of maternal psychopathology among residential unit populations, little is known about whether psychological disorders interfere with the effectiveness of such interventions. Method: Two cohorts (n = 104 and 147, respectively) were recruited from a residential mother-infant intervention programme for unsettled infant behaviour. In study 1, mothers completed self-report questionnaires measuring depression, anxiety and parenting stress at three time points (admission, 1 month after discharge and 3 months after discharge). In study 2, mothers were interviewed using a structured clinical interview for depressive and anxiety disorders. In both studies, nurses recorded infant behaviours over the duration of the 5 day admission using 24 h behaviour charts. Results: Study 1 showed the intervention to be associated with significant improvements in child behaviours and in levels of maternal depression, anxiety and parenting stress. These improvements were evident for women who scored above the Edinburgh Postnatal Depression Scale threshold for major depression during the admission, as well as for women in the normal range. Study 2 confirmed that the intervention was associated with significant improvements in infant behaviours. Infants of mothers with a depressive or anxiety disorder were less unsettled on admission, but improvements over the course of the admission were comparable for infants of women who had, or had not, experienced an anxiety or depressive disorder during the admission. Conclusions: These results show positive infant and maternal outcomes associated with a residential mother-infant intervention for unsettled infant behaviour, regardless of the women's psychiatric status on admission. This suggests that women with depression or anxiety disorders who also report unsettled infant behaviour, will benefit from referral to residential programmes.