early intervention to protect the mother-child relationship after postpartum depression

Conditions: Post Partum Depression

Summary: postpartum depression (ppd) may impair the mother-infant relationship and lead to both short and long-term suboptimal development of the baby. this study aims to evaluate the effectiveness of a targeted intervention (hugs: happiness understanding giving and sharing) for enhancing the mother-infant relationship.

post-partum depression (ppd) is the most common psychological pathology following childbirth and affects 12% of women in france. this pathology may impair the mother-infant relationship and lead to suboptimal development of the baby in the short and long-term. the prevalence of early interaction disorders is estimated at 73% among women suffering from ppd. although treatments for pdd are effective, the mother-infant interaction remains impaired, as well as the short, medium and long-term development of the child. it is therefore essential to develop at a very early stage an intervention specifically targeting the mother-infant interaction, and to integrate this care into the general care given to mothers suffering from ppd. a short cognitive-behavioural therapy intervention focused on improving the quality of the mother-infant relationship (the hugs program: happiness, understanding, giving and sharing) has been created and validated by prof. jeannette milgrom's australian team. the objective of our study is to evaluate the effectiveness of the hugs programme compared to a playtime control group using a randomised controlled trial in a population of women suffering from ppd and being cared for in 7 french maternity hospitals. the comparison will be made 6 months after intervention initiation using "factor 1: mother positive affective involvement and verbalization" of the pcera (parent-child early relational assessment) mother-child interaction evaluation scale.

Eligibility criteria:
inclusion criteria regarding the mother: * person affiliated or beneficiary of a social security plan; * free, informed and written consent signed by the participant and the investigator (at the latest on the day of inclusion and before any examination required by the research); * woman who gave birth in one of the maternity hospitals participating in the study; * diagnosis of postpartum depression made by the perinatal psychiatry team according to the clinical criteria of the dsm-5; * time to onset of depressive symptoms within the first 12 months after childbirth; * treatment for postpartum depression that started at least 8 weeks ago with improved mood as assessed by the psychiatrist. inclusion criteria for the baby: * baby aged less than 1 year at inclusion; * twins will be able to participate in the study and benefit from the interventions; non-inclusion criteria concerning the mother: * uncontrolled substance use disorder; * presence of suicidal ideas at inclusion; * manic episode of a bipolar disease * psychiatric pathology decompensated upon inclusion and corresponding to the following list: schizophrenic disorder, schizoaffective disorder, mood disorders with psychotic symptoms; * non french speaker. non-inclusion criteria for the baby: - baby hospitalized or having sustained medical care upon inclusion in the context of a somatic pathology.

Keywords: mother-baby interaction group therapy cognitive behavioral therapy mother-infant relationship