Severe puerperal mental illness and disturbances of maternal behaviour

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Abstract
The development and preliminary evaluation is described of a rating scale to measure disturbances of maternal behaviour in 26 women who were hospitalised with severe puerperal mental illness. Serial ratings were made about once weekly by nurses and the scores were compared with parallel clinical ratings that were independently made by a psychiatrist. Associations between aspects of psychopathology and disturbances of maternal behaviour are described and the value of serial measures is illustrated by means of 5 case vignettes. In the great majority of cases, improvements of mothers' interactions with their infants closely followed clinical recovery and there did not seem to be any gross residual areas of dysfunction. Multiparae were less affected than primiparae and there seemed to be very few women in whom severe disturbances of maternal behaviour were not obviously secondary to puerperal illness.