CRIS blog: Mother’s improved clinical outcomes are correlated with improvements in mother-infant interactions in a mother-and-baby inpatient unit

Alastair Macdonald is Emeritus Professor of Clinical Outcomes Research at the Institute of Psychiatry, Psychology and Neuroscience at King's College London.

Lucy Stephenson is Clinical Research Associate, Mental Health and Justice Project at the Institute of Psychiatry, Psychology and Neuroscience at King's College London.

Psychiatric Mother and Baby Inpatient Units (MBUs) are preferred by patients and clinicians. MBUs provide specialist in-patient care for mothers who experience severe mental illness (SMI) without separation from their baby. There are only 17 such units in the UK, although more are now planned.  Such investment needs to be justified by measurement of outcomes - for mothers and infants. 

We set out to describe maternal clinical outcomes, mother-infant interaction outcomes and their relationship in patients admitted to one MBU over 32 months in South London. 

The unit provided an individualised treatment programme from the multidisciplinary team, including nursery nurses. Care plans involve antenatal and postnatal care for the mother and the baby, management of maternal SMI, monitoring of physical health, appropriate pharmacological interventions suitable for pregnant women and breastfeeding mothers, developmental assessment of babies, intensive mental health nursing, occupational therapy and support for developing independent living skills, and assessment of and assistance with social needs.

We used routinely-collected Health of the Nation Outcome Scales (HoNOS) gathered from Clinical Record Interactive Search (CRIS) data, Brief Psychiatric Rating Scale (BPRS) scores for the mother together with Crittenden CARE-Index (CCI) mother-infant interaction scores rated independently from videos collected at admission and discharge.

There were significant improvements in Brief Psychiatric Rating Scale, Health of the Nation Outcome Scales and Crittenden CARE-Index scores across diagnostic groups.  Although maternal BPRS scores and mother-infant interaction scores were unrelated, improvement in maternal HoNOS scores was associated with improved maternal sensitivity and reduction in maternal unresponsiveness and infant passiveness.

Read the BJPsych Open paper online at:

Further CRIS blogs are available online. 

Tags: Informatics - Clinical and population informatics - Psychosis & neuropsychiatry - CRIS - Publications -

By NIHR Maudsley BRC at 3 Sep 2018, 10:54 AM

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