Prevalence and predictors of parenting outcomes in a cohort of mothers with schizophrenia admitted for joint mother and baby psychiatric care in England.
OBJECTIVE
Most women with schizophrenia have children. Schizophrenia has been identified as an independent predictor of poor parenting outcome following joint mother and baby psychiatric admission. We aimed to describe the characteristics of these women postnatally and to estimate the prevalence of, and identify independent predictors of, parenting outcomes.


METHODS
Clinical and psychosocial data from consecutive joint psychiatric admissions of mothers and infants between September 1996 and September 2002 were collected. Diagnoses were based on ICD-10 criteria (N = 239 schizophrenia; N = 693 affective disorders). The prevalence of each parenting outcome at discharge, assessed according to social services intervention and staff-rated measures of parenting ability, was estimated. Factors associated with poor parenting outcomes and independent predictors were identified using "modified" Poisson regression, and prevalence of these parenting outcomes was estimated in subgroups of mothers stratified by combinations of protective/risk factors.


RESULTS
Mothers with schizophrenia were characterized as having more complex clinical and psychosocial problems and were considerably more likely to experience all types of poor parenting outcomes, compared to mothers with affective disorders. Mothers with schizophrenia reporting supportive marital and other relationships, those whose partners were well, and those of higher social class showed the best parenting outcomes.


CONCLUSIONS
Mothers with schizophrenia who experience better parenting outcomes may be protected by certain factors. Successful parenting is related, partly, to stability within the family and access to financial and social resources. The nature of the relationship between identified predictors and parenting outcomes in this group is unclear but may suggest that parenting outcome varies with clinical outcome in schizophrenia. Future research and service development should focus on potential protective factors that may encourage successful parenting outcomes in this vulnerable group.
Abel
Kathryn M
KM
Centre for Women's Mental Health Research, Manchester University, UK. kathryn.m.abel@manchester.ac.uk
Webb
Roger T
RT
Salmon
Margaret P
MP
Wan
Ming W
MW
Appleby
Louis
L
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000175:diagnosis / Q000523:psychology; D016241:Child of Impaired Parents / Q000523:psychology*; D004739:England / Q000453:epidemiology; D005192:Family Health; D005195:Family Relations; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007224:Infant Care / Q000592:standards; D007231:Infant, Newborn; D017063:Outcome Assessment, Health Care; D016487:Parenting / Q000523:psychology*; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012923:Social Class; D012944:Social Support; D012947:Social Work / Q000706:statistics & numerical data