Mental disorders in pregnancy and postpartum period are common worldwide, if not treated sufficiently they might negatively affect not alone the mother (and father) but also the child and the whole family in the long term. Even today, only a minority of for example postnatally depressed mothers are diagnosed and treated, even less the postnatally depressed fathers. Specialized parent-children outpatient clinics, day clinics and inpatient wards are still sparse, at least in Germany. The German-speaking section of the International Marcé Society was founded 20 years ago and the International Marcé-Society 40 years ago to facilitate research in peripartum psychiatry, to improve patient-centered care of individuals with peripartal mental disorders and to raise awareness in the public and work on anti-stigma campaigns. In this symposium we will highlight was has been done in the past 20 and 40 years respectively, from the international and national perspectives as well give an outlook how result from newer studies like Scandinavian registry studies and bonding studies from Croatia might bring further advances in the field.
10:00 Uhr
20th anniversary of the German speaking Marcé-Society: what has changed?
Luc Turmes, Herten (Germany)
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Luc Turmes, Herten (Germany)
20th anniversary of the German speaking Marcé-Society: what has changed?
Luc Turmes
Im Vorfeld des 1st World Congress on Women’s Mental Health im März 2001 in Berlin wurde am 08. Dezember 2000 die deutsche Sektion der internationalen Marcé-Society gegründet. Gründungsmitglieder waren Prof. Dr. Anton Bergant - Innsbruck, Dr. Niels Bergemann – Heidelberg, Dr. Pascale Britsch – Berlin, Dr. Christiane Hornstein – Wiesloch, Dr. Anette Kersting – Münster, Dr. Claudia Klier – Wien und PD Dr. Mario Lanczik – Bozen.
Im Symposium werden im Rückblick die wesentlichen Meilensteine und Erfolge der deutschsprachigen Marcé-Gesellschaft der letzten 20 Jahre dargestellt und im Ausblick die zukünftigen Projekte beschrieben.
10:15 Uhr
The psychiatry of childbearing: German Gems
Ian Brockington, Birmingham (United Kingdom)
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Ian Brockington, Birmingham (United Kingdom)
Writers in the German language have made many of the most important contributions to our knowledge of the psychiatry of motherhood. Starting in the 18th century, they drew attention to the frequency of neonaticide (Hoffmann, 1721) and its pathology (Büttner, 1781 and many others). In 1797, Osiander described puerperal mania. In the first half of the 19th century there were pioneering descriptions of several complications of parturition, including parturient rage (Kluge, 1833) and postpartum stupor (Tott, 1844). Almost all the major studies of eclamptic psychosis were German (Kutzinski, 1909; Kleinknecht, 1914; Sioli, 1921). The same is true of menstrual psychosis (v. Krafft-Ebing, 1901). Theses of the highest quality on puerperal psychosis continued between the wars (Daseking, 1931; Beckmann, 1939) and after them (Bonse, 1989). German psychiatrists also drew attention to mothers’ emotional rejection of the infant (Oppenheim, 1919; Luft, 1964). German contributions rival and even exceed the French in this area of psychiatry.
10:30 Uhr
Mother’s and father’s mental health and contextual factors: implications for parent-infant bonding
Sandra Nakić Radoš, Zagreb (Croatia)
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Sandra Nakić Radoš, Zagreb (Croatia)
Literature about various determinants of bonding is still scarce. Bonding was examined within Belsky’s (1984) framework where parental mental health, child characteristics and context have potential effects on bonding. Our project aimed to examine mental health and contextual determinants of parent-infant bonding. Mothers (N=1258) and fathers (N=247) filled in questionnaires in several online studies in the first postpartum year.
In mothers (Sample 1), postpartum depression (PPD), anxiety symptoms, and infant temperament (difficult and unpredictable) were related to poorer bonding. Also, the relationship between maternal childbirth satisfaction and bonding via posttraumatic stress disorder (PTSD) following childbirth and PPD symptoms was examined. This revealed that childbirth satisfaction had a direct effect on bonding and an indirect effect through a serial mediation by PTSD and PPD symptoms. However, PTSD symptoms did not have a direct effect on bonding.
Furthermore, we examined the psychometric properties of the new instrument for measuring PTSD in mothers (Sample 2) and confirmed the existence of two specific factors: Birth-related symptoms and General symptoms. This instrument was applied to re-examine the interplay between PTSD and PPD symptoms with bonding. It was established that Birth-related PTSD symptoms did not have an effect on PPD or bonding, while General PTSD symptoms had a direct effect on bonding.
In fathers (Sample 3), the contextual factors of job characteristics (inflexible working hours, overtime work) have shown as related to the higher levels of conflict of work and family role, which in turn were related to poorer father-infant bonding.
Insights from the complex relationships between parental mental health, infant temperament, and contextual factors should direct future preventive programs with a focus on optimal parent-infant bonding and healthy parenting.