Short-term outcome of mothers with severe mental illness admitted to a mother baby unit

Abstract

Background: Mother baby psychiatry units (MBUs) are the expected standard of inpatient care internationally for postpartum mothers with severe mental illness (SMI) and favorable outcomes for mother infant dyads have been reported from these services. However, there are very few such units in low- and middle-income countries. The current study aimed to assess the short-term outcome of mothers in SMI admitted to an MBU in India. Materials and Methods: Mother infant dyads admitted over a year in the MBU were assessed in detail at admission, discharge, and at 3 months. Tools used included the Brief Psychiatric Rating Scale (BPRS), Young's Mania Rating Scale, Edinburgh Postnatal Depression Scale, and Clinical Global Impression. Mother infant interaction was assessed using the NIMHANS maternal behavior scale. Results: The mean age of the 43 mothers admitted in this period was 27.3 ± 6.2 years. For 27 (62.8%) mothers, this was a first episode of psychosis. Affective disorders and acute psychotic disorders were the most common diagnoses. The average duration of stay in the MBU was 25 days. While all mothers showed significant improvement at discharge, mothers with a first episode in the postpartum had higher BPRS scores (Ws = 309.5, P = 0.02) as compared to the others. At 3 months following discharge, all mothers sustained the improvement achieved. Discussion: Mothers with SMI admitted to an MBU showed significant clinical and dyadic improvement at discharge which was sustained at 3 months. However, the lack of a control group limits the generalizability of the current findings. Conclusion: The study highlighted a favorable short-term outcome among mothers with SMI admitted to a MBU facility.