Mother–infant interaction in schizophrenia: transmitting risk or resilience? A systematic review of the literature

Abstract

PurposeThe parent–infant relationship is an important context for identifying very early risk and resilience factors and targets for the development of preventative interventions. The aim of this study was to systematically review studies investigating the early caregiver–infant relationship and attachment in offspring of parents with schizophrenia.MethodsWe searched computerized databases for relevant articles investigating the relationship between early caregiver–infant relationship and outcomes for offspring of a caregiver with a diagnosis of schizophrenia. Studies were assessed for risk of bias.ResultsWe identified 27 studies derived from 10 cohorts, comprising 208 women diagnosed with schizophrenia, 71 with other psychoses, 203 women with depression, 59 women with mania/bipolar disorder, 40 with personality disorder, 8 with unspecified mental disorders and 119 non-psychiatric controls. There was some evidence to support disturbances in maternal behaviour amongst those with a diagnosis of schizophrenia and there was more limited evidence of disturbances in infant behaviour and mutuality of interaction.ConclusionsFurther research should investigate both sources of resilience and risk in the development of offspring of parents with a diagnosis of schizophrenia and psychosis. Given the lack of specificity observed in this review, these studies should also include maternal affective disorders including depressive and bipolar disorders.Electronic supplementary materialThe online version of this article (doi:10.1007/s00127-015-1127-x) contains supplementary material, which is available to authorized users.

Investigation of associations between attachment, parenting and schizotypy during the postnatal period

“…For instance, a systematic review by Davidsen et al (2015) concluded that mothers with schizophrenia differed in their maternal behaviour compared to controls, for example in reduced contact with their child and increased tension. They noted that most studies regarding the effects of mothers with psychosis take place within the first 12 months after the birth of their child.…”

Autism: a transdiagnostic, dimensional, construct of reasoning?

“…In addition to the option of transmission directly via a genetic pathway, environmental factors may be involved. Despite evidence that parental psychopathology is linked to an increased risk of adult psychopathology, some children do not develop psychopathology (Davidsen et al ., ). There is limited evidence on the relationship among maternal mental illness including schizophrenia, the mother–infant relationship and infant development.…”

Maternal Traits Associated with Poor Mother-Infant Attachment and Poor Mental Health of the Child Later in Life

“…Gratz et al suggested that parental mental health generally influences the child's functional and emotional development. In a separate study, children of mothers with borderline personality disorder were shown to have a particularly high risk of experiencing emotional dysfunction and emotional regulation difficulties [13]. Postpartum depression, for example, has long been seen as an independent risk factor for poor attachment in infancy and poor outcomes in general for both mothers and their children [1,14,15].…”