[Psychotic women and motherhood: what risks for the child?]

Desire for child in psychotic patients: what risks for the child? Here are two very different questions. When mentally ill patients express the desire to have a child, professionals are apprehensive regarding the child's future and express eugenics temptation. Nevertheless, it is a topical question as neuroleptic drugs efficiency as well as mental health policy encourage them to live as close to normality as possible. Therefore, they have sexual relations, they have children. Since 1975, children born from psychotic mothers have been considered by the World Health Organisation (WHO) to be at high risk. This means they justify close support measures and prevention. The child runs 3 risks: a risk to develop a mental illness partly hereditary, a risk regarding his or her development, risks related to suffering, as these children are confronted with the illness of their parents. The major role played by environmental factors guide prevention behaviours; in particular towards parents-to-be psychotic adult patients and during the pregnancy, a privileged moment for preventive strategies consistent with the Perinatal Plan 2005-2007. A clinical label will provide an example of the difficulty to establish a mother-child link observed with a psychotic woman, because the imaginary child overrides the real baby. To conclude the emphasis should be put on multidisciplinary and evolutionary strategies. These imply some optimism.