title: Substance abusing mothers in residential treatment with their babies: postnatal psychiatric symptomatology and its association with mother-child relationship and later need for child protection actions.
abstract: BACKGROUND
  A residential treatment model has been developed in Finland, which is specifically designed for substance abusing pregnant and parenting women, and has its focus on supporting both maternal abstinence from substances and mother-baby relationship.
  
  
  OBJECTIVE
  Among mother-baby pairs in this residential treatment, to explore amount and type of maternal postnatal psychiatric symptoms, relationship with the baby, and their association with later need for child substitution care placements.
  
  
  METHODS
  Participants were 34 mother-baby pairs from three units during pre- to postnatal period. Methods included self-report questionnaires for substance abuse and background data (pregnancy and perinatal period), experienced difficulties with the baby (1 month postnatally); maternal psychiatric symptoms (Brief Symptom Inventory, Edinburgh Pre-postnatal Depression Screen, Inventory of Interpersonal Problems; (pregnancy and 3 months) postnatally; videotaped mother-child interaction measure (Care Index for infants and toddlers) and standardized test of child development (Bayley Scales of Infant Development) (4 months postnatally); questionnaire for follow-up information (2 years of child's age).
  
  
  RESULTS
  Mothers showed high levels of different types of psychiatric symptomatology. Maternal interaction with the baby was on average weak, as 53% were within the high-risk range regarding sensitivity. Experiencing more difficulties in early care-giving of the baby was associated with higher amount of postnatal psychiatric symptomatology. Specific psychiatric symptoms were associated with later need for child substitution care.
  
  
  CONCLUSIONS
  In designing treatment and follow-up of these mother-baby pairs, careful attention should be paid to pre- and perinatal identification and type of maternal psychiatric symptoms, and mothers' expressions of subjectively experienced difficulties in early care-giving of the baby.
authors.affiliation: University of Turku, Department of Child Psychiatry, Kiinamyllynkatu 4-8, 20521 Turku, Finland. marjukka.pajulo@utu.fi
authors.forename: Marjukka
authors.initials: M
authors.lastname: Pajulo
authors.forename: Nina
authors.initials: N
authors.lastname: Pyykkönen
authors.forename: Mirjam
authors.initials: M
authors.lastname: Kalland
authors.forename: Jari
authors.initials: J
authors.lastname: Sinkkonen
authors.forename: Hans
authors.initials: H
authors.lastname: Helenius
authors.forename: Raija-Leena
authors.initials: RL
authors.lastname: Punamäki
mesh_terms: D002657:Child Development; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D005387:Finland; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008427:Maternal Health Services; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D008609:Mental Status Schedule; D009034:Mother-Child Relations; D011247:Pregnancy; D011644:Puerperal Disorders / Q000175:diagnosis / Q000523:psychology; D012114:Residential Treatment; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy