Mother–infant interaction in women with depression in pregnancy and in women with a history of depression: the Psychiatry Research and Motherhood – Depression (PRAM-D) study
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Alessandra Biaggi
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Aoife Bairead
Minds In Mind, Ireland
Andrea Du Preez
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and The Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Katie Hazelgrove
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Freddie Waites
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Susan Conroy
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Paola Dazzan
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Sarah Osborne
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Susan Pawlby
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Vaheshta Sethna
Sackler Institute for Translational Neurodevelopment, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Carmine M. Pariante
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Background Little is known about the effects of depression before birth on the quality of the mother–infant interaction. Aims To understand whether depression, either in pregnancy or in lifetime before pregnancy, disrupts postnatal mother–infant interactions. Method We recruited 131 pregnant women (51 healthy, 52 with major depressive disorder (MDD) in pregnancy, 28 with a history of MDD but healthy pregnancy), at 25 weeks’ gestation. MDD was confirmed with the Structured Clinical Interview for DSM-IV Disorders. Neonatal behaviour was assessed at 6 days with the Neonatal Behavioural Assessment Scale, and mother–infant interaction was assessed at 8 weeks and 12 months with the Crittenden CARE-Index. Results At 8 weeks and 12 months, dyads in the depression and history-only groups displayed a reduced quality of interaction compared with healthy dyads. Specifically, at 8 weeks, 62% in the depression group and 56% in the history-only group scored in the lowest category of dyadic synchrony (suggesting therapeutic interventions are needed), compared with 37% in the healthy group (P = 0.041); 48% and 32%, respectively, scored the same at 12 months, compared with 14% in the healthy group (P = 0.003). At 6 days, neonates in the depression and history-only groups exhibited decreased social-interactive behaviour, which, together with maternal socioeconomic difficulties, was also predictive of interaction quality, whereas postnatal depression was not. Conclusions Both antenatal depression and a lifetime history of depression are associated with a decreased quality of mother–infant interaction, irrespective of postnatal depression. Clinicians should be aware of this, as pregnancy provides an opportunity for identification and intervention to support the developing relationship.
