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

2010 ◽  
Vol 40 (11) ◽  
pp. 1861-1869 ◽  
Author(s):  
S. Pawlby ◽  
C. Fernyhough ◽  
E. Meins ◽  
C. M. Pariante ◽  
G. Seneviratne ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Mood Disorders ◽  
Mental States ◽  
Depressive Mood ◽  
Healthy Controls ◽  
Schizophrenia Group ◽  
Depressed Group ◽  
Mother And Baby Unit

BackgroundPrevious 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.MethodIn-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).ResultsCompared 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.ConclusionsThe 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.

scholarly journals The SOFIA pilot trial: a cluster-randomized trial of coordinated, co-produced care to reduce mortality and improve quality of life in people with severe mental illness in the general practice setting

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
M. P. Rozing ◽  
A. Jønsson ◽  
R. Køster-Rasmussen ◽  
T. D. Due ◽  
J. Brodersen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Illness ◽  
General Practice ◽  
Severe Mental Illness ◽  
General Practitioners ◽  
Pilot Trial ◽  
Care Program ◽  
Coordinated Care ◽  
Educational Training

Abstract Background People with severe mental illness (SMI) have an increased risk of premature mortality, predominantly due to somatic health conditions. Evidence indicates that primary and tertiary prevention and improved treatment of somatic conditions in patients with SMI could reduce this excess mortality. This paper reports a protocol designed to evaluate the feasibility of a coordinated co-produced care program (SOFIA model, a Danish acronym for Severe Mental Illness and Physical Health in General Practice) in the general practice setting to reduce mortality and improve quality of life in patients with severe mental illness. Methods The SOFIA pilot trial is designed as a cluster randomized controlled trial targeting general practices in two regions in Denmark. We aim to include 12 practices, each of which is instructed to recruit up to 15 community-dwelling patients aged 18 and older with SMI. Practices will be randomized by a computer in a ratio of 2:1 to deliver a coordinated care program or usual care during a 6-month study period. A randomized algorithm is used to perform randomization. The coordinated care program includes educational training of general practitioners and their clinical staff educational training of general practitioners and their clinical staff, which covers clinical and diagnostic management and focus on patient-centered care of this patient group, after which general practitioners will provide a prolonged consultation focusing on individual needs and preferences of the patient with SMI and a follow-up plan if indicated. The outcomes will be parameters of the feasibility of the intervention and trial methods and will be assessed quantitatively and qualitatively. Assessments of the outcome parameters will be administered at baseline, throughout, and at end of the study period. Discussion If necessary the intervention will be revised based on results from this study. If delivery of the intervention, either in its current form or after revision, is considered feasible, a future, definitive trial to determine the effectiveness of the intervention in reducing mortality and improving quality of life in patients with SMI can take place. Successful implementation of the intervention would imply preliminary promise for addressing health inequities in patients with SMI. Trial registration The trial was registered in Clinical Trials as of November 5, 2020, with registration number NCT04618250. Protocol version: January 22, 2021; original version

Maternal Psychopathology and Prediction of Outcome Based on Mother-Infant Interaction Ratings (BMIS)

1996 ◽  
Vol 169 (5) ◽  
pp. 655-661 ◽  
Author(s):  
A. E. Hipwell ◽  
R. Kumar
Keyword(s):  
Mental Illness ◽  
Prediction Of Outcome ◽  
Maternal Psychopathology ◽  
Maternal Parenting ◽  
Mother And Baby Unit ◽  
Different Types ◽  
Schizophrenic Group ◽  
Eventual Outcome ◽  
Parenting Behaviour

BackgroundVery little is known about the adequacy and safety of maternal parenting behaviour in the context of severe postpartum psychiatric illness, about specific difficulties in relation to different types of mental illness, or about the potential for improvement over the course of an episode of illness. The Bethlem Mother–Infant Interaction Scale (BMIS) was thus developed as an aid to assessment on a specialist psychiatric Mother and Baby Unit.MethodNurses' ratings of the quality of mother–infant interaction using the BMIS were collected throughout the consecutive admissions of 78 in-patient pairs. The ratings from three points during the admissions were examined according to the mothers' RDC diagnoses and also according to the eventual outcome of the admission.ResultsThe nature of the mother's illness was associated with the quality of her infant care-taking using the BMIS ratings. The nurses' ratings during the second week of admission together with maternal psychiatric diagnosis, were strongly predictive of the eventual outcome of the admission. The majority of women who were separated from their infants on discharge or who required formal supervision belonged to the schizophrenic group.ConclusionsThe results suggest that the BMIS can be used in this in-patient setting to aid clinical decisions about the safety of parenting by individual mothers with severe mental illness in the postpartum period.

scholarly journals Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model

2020 ◽  
Vol 29 (8) ◽  
pp. 2073-2087 ◽  
Author(s):  
Anne Berghöfer ◽  
Luise Martin ◽  
Sabrina Hense ◽  
Stefan Weinmann ◽  
Stephanie Roll
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Care Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Care Model

scholarly journals Self-management interventions for people with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 214 (5) ◽  
pp. 260-268 ◽  
Author(s):  
Melanie Lean ◽  
Miriam Fornells-Ambrojo ◽  
Alyssa Milton ◽  
Brynmor Lloyd-Evans ◽  
Bronwyn Harrison-Stewart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Health Problems ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

scholarly journals Cognitive Reserve Assessment Scale in Health (CRASH): Its Validity and Reliability

2019 ◽  
Vol 8 (5) ◽  
pp. 586 ◽  
Author(s):  
Silvia Amoretti ◽  
Bibiana Cabrera ◽  
Carla Torrent ◽  
Caterina del Mar Bonnín ◽  
Gisela Mezquida ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Internal Consistency ◽  
Psychosocial Functioning ◽  
Affective Disorders ◽  
Convergent Validity ◽  
Cognitive Reserve ◽  
Psychotic Disorders ◽  
Assessment Scale ◽  
Healthy Controls

(1) Background: The cognitive reserve (CR) concept has not been precisely defined in severe mental disorders and has been estimated using heterogeneous methods. This study aims to investigate and develop the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH), an instrument designed to measure CR in people with severe mental illness; (2) Methods: 100 patients with severe mental illness (non-affective psychoses and affective disorders) and 66 healthy controls were included. The internal consistency and convergent validity of CRASH were assessed. Spearman’s correlations coefficients were also performed to examine the relationship between CRASH and neuropsychological tests, psychosocial functioning, and clinical course; (3) Results: The internal consistency was high (Cronbach’s alpha coefficient = 0.903). The CRASH global score had a large positive correlation with the Cognitive reserve questionnaire total score (r = 0.838, p < 0.001), demonstrating good convergent validity. The correlation coefficients between the CRASH total scores and clinical, functional, and neuropsychological performance were different between groups. In order to provide clinical interpretation, severity classification based on diagnosis (non-affective psychotic disorders, affective disorders, and healthy controls) have been created; (4) Conclusions: CRASH is the first CR measure developed specifically for patients with severe mental illness, facilitating reliable and valid measurement of this construct. The scale may aid in the stratification of patients and the implementation of personalized interventions.

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