Mother-Infant Psychoanalysis Project of Stockholm (MIPPS)

Karolinska Institute

Status: Completed

Conditions: Mother-infant Relational Disturbances

Treatments: Other: Treatment as Usual at Child Health Centre; Other: Mother-Infant Psychoanalytic treatment (MIP)

Study type: Interventional

Funder types: Other

Identifiers

NCT00923559

MIPPS-01

Details and patient eligibility

About

Mother-infant relationship disturbances broadly comprise three areas; maternal distress, infant functional problems, and relationship difficulties. Given the high frequency of such disturbances and the relative paucity of randomized treatment studies, substantial systematic investigation is needed. This project is a randomized controlled study comparing mother-infant psychoanalytic treatment with treatment as usual in cases where mothers and/or health visitors demanded expert help.

Full description

DESIGN

Eighty dyads with infants below 1½ years of age were interviewed and then randomly assigned to MIP or TAU. An end-point interview followed after ½ year, evaluating the intervention effects.

The MIP treatments were performed by IPA psychoanalysts at the Infant Reception Service of the Swedish Psychoanalytic Society. TAU implied contact with a nurse at a Child Health Centre, as part of regular Swedish health care of infants and mothers. Additional treatments within the TAU framework suggested at the initiative by the health visitor or the mother were registered at the end-point interview.

INSTRUMENTS

Mother-report questionnaires; the Ages and Stages Questionnaire:Social-Emotional (ASQ:SE; Squires et al., 2002), the Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987), the General Severity Index of the Symptom Check List-90 (Derogatis, 1994)and the Swedish Parental Questionnaire (SPSQ; Östberg et al., 1997).

Time frame: All four instruments were measured at intake interviews and six months later.

Independently rated video-taped mother-infant interactions: the Emotional Availability Scale (EAS; Biringen, 1998).

Relationship assessment: the Parent-Infant Relationship Global Assessment Scale (PIR-GAS; ZERO-TO-THREE, 2005).

Enrollment: 80 patients

Sex: All

Ages: Under 18 months old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The mother expressed significant concerns about one or more of the following domains: herself as a mother, her infant's well-being, or the mother-baby relationship (this was operationalized as a score < 80 ("perturbed relation") on the PIR-GAS or, alternatively, > 2.5 on the SPSQ).
• Infant of any gender, age below 18 months.
• Duration of worries exceeding two weeks.
• Domicile in Stockholm.
• Reasonable mastery of Swedish.

Exclusion criteria

• Maternal psychosis.
• Substance dependence according to DSM-IV, to an extent precluding collaboration.

No mothers met these criteria.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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80 participants in 2 patient groups

Mother-Infant Psychoanalytic treatment;MIP

Experimental group

Description:

MIP intervention

Treatment:

Other: Mother-Infant Psychoanalytic treatment (MIP)

TAU at Child Health Centres

Active Comparator group

Description:

Regular nurse visits at Child Health Centres according to Swedish infant health care.

Treatment:

Other: Treatment as Usual at Child Health Centre