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Master Thesis

Étude des facteurs de risque maternels de séparation mère-enfant à l’issu d’une hospitalisation conjointe en Unité Mère-Enfant en psychiatrie Adulte

Abstract : Background: Mother-Baby Units (MBUs) allow perinatal health professionals to focus on the dyad, treating mothers with psychiatric disorders while providing a safe environment for the child. Some situations require a clear separation between the mother and the child. The main risk factors of separation found in the literature include the mother’s diagnosis of schizophrenia and personality disorders; low socio-economic status; poor relationship with the friends, family and/or partner; and neonatal complications. The current study aims to examine these risk factors at a local population level as the approach to perinatal psychiatry care and policy regarding child protection vary between different MBUs. Aim: The aim of the present study was to investigate the mothers’ socio-demographic, psychiatric and obstetrical characteristics, as well as their children’s neonatal characteristics at the end of the hospitalisation in MBU. Method: Data was collected retrospectively from female patients’ medical files hospitalised full-time in postpartum between 1 January 2009 and 31 December 2013 in the MBU of the ‘Pôle Universitaire de Psychiatrie Adulte’ at the Centre Hospitalier Charles Perrens in Bordeaux. The independent variables were the mother’s and infant’s socio-demographic characteristics; psychiatric history and social environment data; pregnancy and infant’s neonatal characteristics; and history of placement of the child’s siblings. The dependant variable was the medical request for the child placement at discharge (‘demande d’Ordonnance Provisoire de Placement de l’enfant’). Multivariate logistic regression analyses were conducted to investigate the independent effect of socio-demographic and psychiatric factors, as well as mothers’ obstetrical and their infants’ neonatal characteristics on the child’s placement request at discharge. Results: One hundred and forty-six dyads were included in the study; 25% of the dyads were separated at discharge. Early age of first hospitalisation, mother’s diagnosis of psychotic disorders, personality and/or addictive disorders and history of placement of the child’s siblings are independently related to the dyad separation at discharge from MBU. Conclusions: Results from the present study propose the duration and chronicity of maternal psychiatric disorders as risk factors for mother-baby separation at discharge from MBU. A better understanding of these factors could allow perinatal health professionals to improve their recognition of high separation-risk situations and an upstream work with judicial, administrative and child protection services.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01215448
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, October 14, 2015 - 11:26:58 AM
Last modification on : Wednesday, August 23, 2017 - 4:30:18 PM
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Alice Benacchio. Étude des facteurs de risque maternels de séparation mère-enfant à l’issu d’une hospitalisation conjointe en Unité Mère-Enfant en psychiatrie Adulte. Médecine humaine et pathologie. 2015. ⟨dumas-01215448⟩

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