Evaluating change in and predictors of depressive symptoms and parenting skills at a psychiatric mother-baby unit - a retrospective analysis of routine data

Background The postpartum period is a particularly vulnerable time in the lives of parents, leading to adverse mental health outcomes for them and, as a result, their children. Relative to demand, there is a pronounced lack of inpatient treatment options for mother-baby-dyads in Germany and beyond, creating a need for additional mother-baby units and the assessment of their effectiveness. The present study is a retrospective evaluation based on routine data from the mother-baby unit at the Charité- Universitätsmedizin Berlin, Germany, examining symptom and parenting skills change and outcome predictors. Methods Data were extracted from electronic health records for all patients treated in the unit between October 2021 and June 2025, resulting in a sample of N = 156 women (mean age (years) = 31.10; SD = 6.39) after applying analysis inclusion criteria. Using the Montgomery Åsberg Depression Rating Scale for rater-based depressive symptoms and a custom scale assessing perceived parenting skills, symptom change was examined using unconditional linear mixed models, while descriptive linear mixed models were employed to identify moderators of treatment outcomes. Results For both outcomes, there was a significant fixed effect for time, indicating that participants showed above-chance improvements in depressive symptoms and parenting skills across the treatment period. While there were no significant predictors for post-treatment parenting skills beyond the baseline value, several diagnostic categories (PTSD, personality disorders, anxiety/OCD) were associated with a higher MÅDRS value at discharge, while educational and occupational status predicted a lower value. Limitations Interpretations of the present results are limited by a lack of a control group and post-treatment assessments. Moreover, the main outcome (MÅDRS) only partially captures transdiagnostic symptoms and is not specifically designed to represent depression during the post-partum period. Conclusions The present study indicates the effectiveness of the Charité mother-baby unit using routine, real-world data. This adds to a hitherto small evidence base on the effectiveness of MBUs in Germany and beyond, both in terms of symptom reduction and parenting skills improvement across the diagnostic spectrum. Overall, the findings highlight the importance of holistic treatment approaches in the postpartum period for the mental health of both parents and their children.