Predictors of mother-infant interaction quality in women at risk of postpartum psychosis: The role of emotion recognition.

Background: Limited research exists on mother-infant interaction in women at-risk-of postpartum psychosis (PP). This study aimed to investigate potential predictors of mother-infant interaction quality in women at-risk-of-PP during the first postnatal year. Potential predictors investigated were: maternal ability to recognize emotions, childhood maltreatment, parenting stress, and infant social-interactive behaviour at birth.
Methods: 98 women (and their offspring) were included, 40 at-risk-of-PP because of a diagnosis of Bipolar Disorder, Schizoaffective Disorder or previous PP, and 58 with no current/previous mental illness or family history of PP. Mother-infant interaction was assessed using the CARE-Index at 8 weeks and 12 months postpartum. Maternal ability to recognize emotions was assessed with the VERT-K, maternal experience of childhood maltreatment with the CECA-Q, maternal parenting stress with the PSI-SF and infant social-interactive behaviour with the NBAS.
Results: Women at-risk-of-PP were less able to recognize fear than healthy controls and this predicted the quality of the mother-infant interaction at 8 weeks' and 12 months' post partum, over and above the effect of maternal Group (respectively, β = 0.33, p = .015; β = 0.40, p = .006). Infant social-interactive behaviour at birth was a significant predictor for mother-infant interaction at 12 months (β = 0.32, p = .031), although this did not differ significantly between the groups.
Limitations: A relatively small sample size precluded a more in-depth investigation of indirect pathways and other potential predictors.
Conclusions: These results are important as they suggest that preventive interventions targeting emotion recognition may be implemented in women at-risk-of-PP, with the aim of improving mother-infant interaction and potentially also the infant long-term development.
Competing Interests: Declaration of competing interest PD has received speaker's fees from Lundbeck and Janssen. CMP has received research funding from Johnson & Johnson for research on depression and inflammation and is funded by the Wellcome Trust strategy award to the Neuroimmunology of Mood Disorders and Alzheimer's Disease (NIMA) Consortium (104025), which is also funded by Janssen, GlaxoSmithKline, Lundbeck and Pfizer. LMH has received funding from the NIHR and the Nuffield Foundation for Research Programmes on maternal mental disorders. MAM has received research funding from Takeda Pharmaceuticals, Lundbeck, Johnson & Johnson and support in kind from AstraZeneca and has acted as a consultant for Lundbeck and Takeda. However, this paper is independent from this funding; there are no further declarations of interest.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)