A randomised trial of an early parenting intervention to reduce maternal mood disorder and infant behavior disturbance

在澳大利亚，每年有超过242，000名妇女分娩，其中高达20%的妇女在婴儿出生后的第一年经历了严重的心理压力。严重的疲劳、忧虑和抑郁会妨碍母亲自信心的发展。如果婴儿睡不好或喂养不容易或长时间哭泣，母亲会感到无效和无助。在婴儿生命的早期给予帮助对于避免母亲和孩子长期的情绪和行为问题很重要。在全国范围内，卫生和社会政策的重点是帮助家庭，包括那些父母有精神健康问题和早期养育问题的家庭以及有发育困难风险的儿童。澳大利亚的寄宿式早期养育服务是独一无二的，为有困难的母亲和行为不稳定的婴儿提供短暂的治疗。对父母进行婴儿护理方面的教育，并向他们提供情感支持和帮助，以适应养育子女的要求。在CIA和CIB过去的研究中，女性在完成这种治疗后和六个月后，情绪困扰，产妇信心和婴儿体重都有显着改善。教育和情感支持被评为可接受和非常有效。该项目是一项随机对照试验，将评估是否短暂入院的住宅早期育儿服务有轻度至中度产妇心理健康问题和婴儿行为障碍的可持续利益。患有可诊断的精神健康状况和据报告有不稳定婴儿行为的四个月大婴儿的母亲将被随机分配到早期育儿服务的住院治疗计划或常规护理。在治疗后一个月和婴儿一岁时，将对母亲和婴儿进行标准化的心理测量。一个有效的和可接受的干预措施将提供一个重要的替代现有的治疗产后心理障碍。

Over 242,000 women give birth annually in Australia and up to 20% experience significant psychological distress in the baby's first year. Severe fatigue, worrying and depression interfere with the development of maternal confidence. If a baby does not sleep well or feed easily or cries for prolonged periods, mothers can feel ineffective and helpless. Assistance early in the baby's life is important to avoid long-term emotional and behavioral problems for mother and child. Nationally, health and social policy focuses on assisting families including those with parental mental health and early parenting problems and children at risk of developmental difficulties. Australia's residential early parenting services are unique, offering brief treatment to mothers with difficulties and infants with unsettled behaviour. Parents are educated in infant care and provided with emotional support and assistance to adjust to the demands of parenting. In past studies by CIA and CIB women reported marked improvements in emotional distress, maternal confidence and infant manageability after completing this treatment and six months later. The education and emotional support were rated as acceptable and very effective. This project is a randomized controlled trial that will evaluate whether brief admission to a residential early parenting service has sustainable benefits for mild to moderate maternal mental health problems and for infant behaviour disturbance. Mothers with a diagnosable mental health condition and with four-month-old infants reported to have unsettled infant behaviour will be randomly assigned to a residential treatment program at an early parenting service or to routine care. Mothers and infants will be assessed with standardized psychological measures one month after treatment and when the baby is one year old. An effective and acceptable intervention will provide an important alternative to available treatments for postnatal psychological disturbance.