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

澳大利亚每年有超过24.2万名妇女分娩，高达20%的人在婴儿出生的第一年就经历了严重的心理痛苦。严重的疲惫、担忧和抑郁干扰了母亲信心的发展。如果婴儿睡不好觉，不容易进食，或者长时间哭泣，母亲可能会感到无能为力和无助。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感和行为问题很重要。在全国范围内，卫生和社会政策的重点是帮助家庭，包括那些有父母心理健康和早期育儿问题的家庭以及有发育困难风险的儿童。澳大利亚的家庭早期育儿服务是独一无二的，为有困难的母亲和行为不稳定的婴儿提供短暂的治疗。父母接受婴儿护理方面的教育，并获得情感支持和帮助，以适应养育子女的要求。在CIA和CIB过去的研究中，女性报告称，在完成这项治疗后和六个月后，女性在情绪困扰、母亲自信和婴儿可管理性方面有了显著改善。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，将评估家庭早期育儿服务的短暂入院是否对轻度至中度的母亲心理健康问题和婴儿行为障碍具有可持续的好处。有可诊断的精神健康状况的母亲和据报告有婴儿行为不稳定的四个月大的婴儿将被随机分配到早期育儿服务机构的住宿治疗计划或常规护理。母亲和婴儿将在治疗后一个月和婴儿一岁时接受标准化心理测量。有效和可接受的干预措施将为现有的产后心理障碍治疗提供一个重要的替代方案。

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.