Enhancing Mother Infant Interactions through Video Feedback Enabled Interventions in Women with Schizophrenia: A Single Subject Research Design Study

In India, marital rates of persons with schizophrenia are high compared to western countries.[1] Most women with schizophrenia do become mothers and raise their own children.[2,3] Parenting difficulties in women with psychosis are common and could be due to social cognitive impairments, [4,5] specific positive symptoms [6,7] the presence of social stressors (e.g.chronic social adversity, stigma [8] or a lack of protective factors (e.g.low social and partner support; eroded empowerment).[9,10] However, the demands of parenting while managing a mental illness can be challenging.[11][12][13][14][15][16][17] Empirical studies suggest that mothers with schizophrenia are particularly vulnerable to difficulties with parenting [2] and interacting sensitively with their infants, [9,[18][19][20] leading to risk of infants developing insecure attachment, [21,22] or being removed to care [2,23] and less infant focused speech.[24] Nearly a third of parents with psychotic disordersBackground: It has been shown that mother infant interactions are often impaired in mothers with schizophrenia.Contributory factors include psychotic symptoms, negative symptoms and surrogate parenting by others.Aim: This study describes the effectiveness of video feedback in enhancing mother-infant interaction in mothers with schizophrenia who have impaired interaction with their infant.Materials and Methods: Two women with schizophrenia who were admitted for persistent psychotic symptoms and poor mothering skills, participated in the intervention.Pre intervention parenting assessment was done using video recording of mother infant interaction.Six sessions of mothering intervention were provided using video feedback and a repeat recording was done.Pre-and post-intervention videos were subsequently rated in a blind fashion by an independent expert in perinatal psychiatry using the pediatric infant parent exam (PIPE) scale.Results: Pre and post intervention comparison of PIPE scores indicating significant improvement in several areas of mothering.Conclusions: Video feedback is a simple and inexpensive tool which can be used for improving mothering skills among mothers with postpartum psychosis or schizophrenia even in low resource settings.