We discuss clinical issues associated with parenting in mothers with severe mental illness, in particular the safety of parenting and risk to infants. We also examine some of the implications for a young child of having as primary carer a mother who suffers from a chronic and severe mental illness. Types of clinical presentation, and assessment and management are described, with illustrative case examples.
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References
1.
Apfel, R.J. & Handel, M.H. (1993) Madness and Loss of Motherhood: Sexuality, Reproduction, and Long-term Mental Illness. Washington DC: American Psychiatric Association.
2.
Appleby, L. & Dickens, C. (1993) Mothering skills of women with mental illness. British Medical Journal, 306, 348-349.
3.
Appleby, L., Fox, H., Shaw, M. & Kumar, R. (1989) The psychiatrist in the obstetric unit. Establishing a liaison service. British Journal of Psychiatry, 154, 510-515.
4.
Cantwell, D.P. & Baker, L. (1987) Parental mental illness and psychiatric disorders in 'at risk' children. Journal ofClinical Psychiatry, 45, 503-507.
5.
D'Orban, P.T. (1979) Women who kill their children. British Journal of Psychiatry, 134, 560-571.
6.
Gopfert, M., Webster, J., Pollard, J. & Nelki, J.S. (1996) The assessment and prediction of parenting: a community approach. In: M. Gopfert, J. Webster & M.V. Seeman (Eds) Parental Psychiatric Disorder. Cambridge: Cambridge University Press.
7.
Grunbaum, L. & Gammeltoft, M. (1993) Young children of schizophrenic mothers: difficulties of intervention. American Journal of Orthopsychiatry, 63, 16-27.
8.
Grunebaum, H.U., Cohler, B.J., Kauffman, C. & Gallant, D. (1978) Children of depressed and schizophrenic mothers. Child Psychiatry andHuman Development, 8, 219-229.
9.
Hilgard, J.R. & Newman, M.F. (1959) Anniversaries in mental illness. Psychiatry, 22, 113-121.
10.
Kumar, R. & Hipwell, A. (1994) Implications for the infant of maternal puerperal psychiatric disorders. In: M. Rutter, E. Taylor & L. Hersov (Eds). Child and Adolescent Psychiatry (3rd ed.). Oxford: B lackwells Scientific Publications.
11.
Kumar, R. & Hipwell, A. (1996) Development of a clinical rating scale to assess mother-infant interaction in a psychiatric mother and baby unit. British Journal of Psychiatry, 169, 18-26.
12.
Kumar, R., Marks, M., Platz, C. & Yoshida, K. (1995) Clinical survey of a psychiatric mother and baby unit: characteristics of 100 consecutive admissions. Journal of Affective Disorders, 33, 11-22.
13.
Marks, M.N. & Kumar, R. (1993) Infanticide in England and Wales. Medicine, Science and the Law, 33, 329-339.
14.
McNeil, T.F., Kaij, L. & Malmquist-Larsson, A. (1984) Women with nonorganic psychosis: mental disturbance during pregnancy. Acta Psychiatrica Scandinavica, 70, 127-139.
15.
Naslund, B., Persson-Blennow, I., McNeil, T. & Kaij, L. (1984) Offspring of women with nonorganic psychosis: infant attachment to the mother at one year of age. Acta Psychiatrica Scandinavica, 69, 231-241.
16.
Nicholson, J., Geller, J.L., Fisher, W.H. & Dion, G.L. (1993) State policies and programs that address the need of mentally ill mothers in the public sector. Hospital and Community Psychiatry, 44, 484-489.
17.
Oliver, J.E. (1991) Child protection by child and family guidance workers . Psychiatric Bulletin, 15, 197-199.
18.
Pancheri, P., Romiti, R., Marconi, P.L. & Valigi, R. (1990) Reproductivity in schizophrenia and mood disorders: a retrospective study. New Trends in Experimental andClinical Psychiatry, 6, 29-44.
19.
Ramsay, R. & Kumar, C. (1993) Assessment of risk to infants of severely mentally ill mothers. Marcé Society Annual Meeting, November 1993. Eindhoven, The Netherlands.
20.
Ramsay, R. & Kumar, C. (1996) Ethical dilemmas in perinatal psychiatry. Psychiatric Bulletin, 20, 90-92.
21.
Randolph, B., Larson, G.L., Sweeney, S., Hough, E.E. & Arorian, K. (1990) Hospitalised pregnant psychotic women: characteristics and treatment issues. Hospital and Community Psychiatry, 41, 159-162.
22.
Rutter, M. (1996) Children of Sick Parents: an Environmental and Psychiatric Study. Institute of Psychiatry Maudsley Monographs no. 16. London: Oxford University Press.
23.
Rutter, M. & Quinton, D. (1984) Parental psychiatric disorder: effects on children . Psychological Medicine, 14, 853-80.
24.
Rynearson, E.K. (1982) Relinquishment and its maternal complications: a preliminary study. American Journal of Psychiatry,139, 338-340.
25.
Test, M.A., Burke, S.S. & Wallisch, L.S. (1990) Gender differences of young adults with schizophrenic disorders in community care. Schizophrenia Bulletin, 16, 331-344.
26.
Watt, N., Anthony, J., Wynne, L. & Rolf, J. (1984) Children at Risk of Schizophrenia. New York: Cambridge University Press.
27.
Webster, J. (1992) Split in two: experiences of the children of schizophrenic mothers. British Journal of Social Work, 22, 309-329.
28.
White, C.L., Nicholson, J., Fisher, W.H. & Geller, J.L. (1995) Mothers with severe mental illness caring for children . Journal of Nervous and Mental Disease, 183, 398-403.
29.
Wolkind, S. & Rushton, A. (1994) Residential and foster family care. In: M. Rutter, E. Taylor & L. Hersov (Eds) Child and Adolescent Psychiatry (3rd ed.). Oxford: Blackwells Scientific Publications.
