Hospitalization-Based Treatment for Postpartum Depressed Mothers and Their Babies: Rationale, Principles, and Preliminary Follow-Up Data
Abstract
This paper describes the rationale and treatment principles of a mother-infant unit for severely depressed mothers and their infants in Flanders (Belgium). The unit integrates systemic, psychodynamic, and cognitive behavioral treatment approaches, and aims at improvements on three levels: (1) improving mood and interpersonal relationships in depressed mothers, (2) fostering a positive mother infant relationship, and (3) establishing a supportive environment outside the treatment setting for both mother and infant. In addition, we present preliminary data of a 3.5-year naturalistic follow-up study of postpartum depressed mothers (n = 41) admitted at this mother-infant unit between April 2003 and April 2005. Results showed that at 3.5-year follow-up a considerable subgroup of mothers (61%) were functioning relatively well, as indicated by low levels of depressive symptoms, anxiety and anger, negative affect, and relatively high levels of positive affect. Yet, in line with other studies, a relatively large subgroup of mothers (39%) continued to suffer from (severe) depression during follow-up. Using a Life History Calendar method, it was found that, compared to currently nondepressed mothers, mothers who were depressed at follow-up did not have more depressive episodes but had longer depressive episodes, received more psychotherapy after hospitalization, and experienced more negative life events during the 3.5-year follow-up period. Implications of these findings for future research and intervention strategies in postpartum depression are discussed.
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Compared to nondepressed women, women who were diagnosed with depression in the first weeks after childbirth continued to suffer from depression at 1 year after childbirth.
“Compared to nondepressed women, women who were diagnosed with depression in the first weeks after childbirth continued to suffer from depression at 1 year after childbirth.36,37,66”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Postpartum depression is associated with more financial problems.
“Studies also showed that PPD was associated with greater perceived stress,66 more negative life events (indicating greater distress and discontinuity), more financial problems, and more illness among close relatives.37”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Postpartum depression is associated with more negative life events.
“Studies also showed that PPD was associated with greater perceived stress,66 more negative life events (indicating greater distress and discontinuity), more financial problems, and more illness among close relatives.37”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Postpartum depression is associated with more illness among close relatives.
“Studies also showed that PPD was associated with greater perceived stress,66 more negative life events (indicating greater distress and discontinuity), more financial problems, and more illness among close relatives.37”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Currently depressed mothers reported significantly more negative life events, indicating greater distress and discontinuity.
“Currently depressed mothers reported significantly more negative life events, indicating greater distress and discontinuity.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Mothers who were depressed at follow-up (3.5 years) experienced more negative life events during the follow-up period than currently nondepressed mothers.
“Another study used a life history calendar method and found that compared to currently nondepressed mothers, mothers who were depressed at follow-up (3.5 years) did not have more depressive episodes; however, they had longer depressive episodes, received more psychotherapy after hospitalization, and experienced more negative life events during the follow-up period.37”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Mothers who were depressed at follow-up (3.5 years) had longer depressive episodes than currently nondepressed mothers.
“Another study used a life history calendar method and found that compared to currently nondepressed mothers, mothers who were depressed at follow-up (3.5 years) did not have more depressive episodes; however, they had longer depressive episodes, received more psychotherapy after hospitalization, and experienced more negative life events during the follow-up period.37”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Women with high depression scores had significantly higher levels of anger, lower scores for anger control, and lower levels of positive affect than mothers with low depression scores.
“In addition, women with high depression scores had significantly higher levels of anger, lower scores for anger control, and lower levels of positive affect than mothers with low depression scores.37”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Currently depressed mothers reported more financial problems (69% vs 31%, p < 0.05) and more illness among close relatives (100% vs 46%, p < 0.05).
“More specifically, currently depressed mothers reported more financial problems (69% vs 31%, p < 0.05) and more illness among close relatives (100% vs 46%, p < 0.05).”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Compared to currently nondepressed mothers, mothers who were depressed at follow-up (3.5 years) did not have more depressive episodes.
“Another study used a life history calendar method and found that compared to currently nondepressed mothers, mothers who were depressed at follow-up (3.5 years) did not have more depressive episodes; however, they had longer depressive episodes, received more psychotherapy after hospitalization, and experienced more negative life events during the follow-up period.37”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Mothers who were depressed at follow-up (3.5 years) received more psychotherapy after hospitalization than currently nondepressed mothers.
“Another study used a life history calendar method and found that compared to currently nondepressed mothers, mothers who were depressed at follow-up (3.5 years) did not have more depressive episodes; however, they had longer depressive episodes, received more psychotherapy after hospitalization, and experienced more negative life events during the follow-up period.37”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Depressed mothers had significantly elevated levels of state and trait anxiety at 1 year and 3.5 years after childbirth compared with nondepressed mothers.
“One study showed that depressed mothers had significantly elevated levels of state and trait anxiety at 1 year and 3.5 years after childbirth compared with nondepressed mothers.37”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Postpartum depression is associated with more relationship difficulties.
“PPD was associated with more relationship difficulties37 and therefore with lower social function.85”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Depressed mothers reported more relationship difficulties, including romantic break-ups, than nondepressed mothers, but the difference was not significant.
“Depressed mothers also reported having more relationship difficulties, including romantic break-ups, than nondepressed mothers; however, this difference was not significant.37”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Women with depressive symptoms showed less closeness, warmth, and sensitivity and a significantly lower level of mutual attunement and experienced more difficulties in their relationships with their child during the first year than women without depressive symptoms.
“women with depressive symptoms showed less closeness,44 warmth,44,52 and sensitivity44,52 and a significantly lower level of mutual attunement (with regard to emotional availability)37 and experienced more difficulties in their relationships with their child44 during the first year than women without depressive symptoms.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Depressed mothers seemed to experience more difficulties in their social relationships (including relationships with their partners) and to feel that they received lower quality social support than nondepressed mothers.
“Depressed mothers also seemed to experience more difficulties in their social relationships (including relationships with their partners)37,44 and to feel that they received lower quality social support85 than nondepressed mothers.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
Difficulties in mother-to-infant bonding could reduce the quality of parenting practices and could affect the rates of abusive behavior.
“In addition, difficulties in mother-to-infant bonding could reduce the quality of parenting practices37,53,130,137,145,146 and could affect the rates of abusive behavior.144”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [37]
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- Authors
- Vliegen, N., Casalin, S., Luyten, P., Docx, R., Lenaerts, M., Tang, E., & Kempke, S.
- Affiliations
- KU Leuven (BE)
- University College London (GB)
- Venue
- Psychiatry: Interpersonal and Biological Processes
- Publisher
- Guilford Publications
- Published
- 2013-06
- Volume
- 76
- Issue
- 2
- Pages
- 150-168
- ISSN
- 0033-2747 (ISSN-L)
- OpenAlex
- W2146177186
- Cited by
- 56
- References
- 83
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 6 · 2023: 13 · 2022: 5 · 2021: 9 · 2020: 4 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 4 · 2014: 1
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- postpartum depression, inpatient care, mother-infant relationship, systemic therapy, psychodynamic psychotherapy, cognitive behavioral therapy, long-term follow-up, depressive episodes, life events, negative affect, positive affect, maternal mental health
- MeSH terms
- Adult, Affect, Belgium, Child Development, Chronic Disease, Emotions, Female, Follow-Up Studies, Health Facility Environment, Hospital Units, Hospitalization, Hospitals, Psychiatric, Humans, Infant, Mother-Child Relations, Mothers, Patient Care Team, Professional-Patient Relations, Psychiatric Status Rating Scales, Psychotherapy, Severity of Illness Index, Social Support, Cluster Analysis, Disease Progression, Spouses, Depression, Postpartum
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