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Predictors of parenting outcome in women with psychotic disorders discharged from mother and baby units

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Howard LM, Thornicroft G, Salmon M, Appleby L. Predictors of parenting outcome in women with psychotic disorders discharged from mother and baby units.

Acta Psychiatr Scand 2004: 1–9. © Blackwell Munksgaard 2004. Objective: 

To compare the social and clinical characteristics of mothers with psychotic disorders with parenting difficulties, with mothers with no significant parenting problems. Method: 

Descriptive and case–control study. Results: 

Over half of the women with psychotic disorders admitted to psychiatric mother and baby units had a good outcome at the time of discharge – 70% did not need social services supervision, and had no significant parenting problem as judged by clinical staff. Diagnosis was independently associated with all measures of poor parenting; compared with a diagnosis of psychotic depression, a diagnosis of schizophrenia was highly significantly associated with social services supervision [adjusted odds ratio (OR) 25.7; 95% CI 5.97, 111.05], and staff rated problems with emotional responsiveness (adjusted OR 3.39;95% CI 1.42, 8.08), practical baby care (adjusted OR 6.07; 95% CI 2.12, 17.39), and perceived risk of harm to baby (adjusted OR 7.81; 95% CI. 2, 30.53). Low social class and psychiatric illness in the partner were also significantly associated with poor parenting outcomes, including social services supervision (adjusted OR 3.88; 95% CI 2.07, 7.25 and 4.23; 95% CI 2.1, 8.55, respectively). Conclusions: 

Although these associations do not demonstrate causality, these findings suggest preventative interventions targeting socio-economic difficulties, early treatment of psychosis, and detection and treatment of psychiatric problems in the partner may be helpful in improving parenting outcomes in these vulnerable families.

Keywords: mother and baby unit; parenting; schizophrenia

Document Type: Research Article


Affiliations: 1: Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London 2: School of Psychiatry and Behavioural Sciences, The University of Manchester, Manchester, UK

Publication date: November 1, 2004


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