Prevention of mothers' mental illness deterioration: can their attitudes toward self-care and childcare prevent mental deterioration?

BACKGROUND Women with severe mental illness experience many kinds of problems during childcare and have a high risk of relapse. Previous studies have not revealed methods for preventing deterioration of mothers' illness. In this study, we retrospectively investigated mothers with severe mental illness, and we attempted to identify characteristics of mothers whose condition did not deteriorate and who did not require hospitalization during childcare. METHODS Data were collected from a self-administered questionnaire filled out by female outpatients who had experienced childcare and were diagnosed with schizophrenia, schizoaffective disorder, bipolar affective disorder or depression with psychotic symptoms. The questionnaire asked about attitudes toward childcare during the first three years following the first childbirth. It was composed of six sections on A) living situation, B) psychiatric medication, C) sleep, D) subjective symptoms of deterioration, E) resting time, and F) advice for other mothers with mental illness. The subjects were split into two groups: those that were admitted to a hospital within three years following the first childbirth (hospital group, n=16) and those that were not hospitalized (non-hospital group, n=19). RESULTS The two groups showed no significant differences in their responses to the questions in sections A-E of the questionnaire. In section F, the non-hospital group wrote significantly more comments than the hospital group. The non-hospital group described concrete ways for taking care of their mental health, while the hospital group did not. DISCUSSION Our results suggest that whether or not mothers need admission during childcare depends on their assertiveness and ability to communicate.