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Postpartum psychiatric disorder: who should be admitted and to which hospital?
1School of Psychiatry, University of New South Wales, Kensington, New South Wales, Australia.
Objective:
To review the question of whether an infant should be admitted to psychiatric services when a severe psychiatric disorder necessitates admission of the mother.
Method:
All available literature on mother-infant joint admission was reviewed and arguments for and against are summarised.
Results:
Early reports favoured joint admission, then opinions changed, possibly for economic reasons. Recent thinking encompasses research data on (i) longer-term adverse effects of postnatal depression on the children, and (ii) the finding of psychological and psychiatric morbidity in many of the fathers. Joint admission to designated special units is valuable, but such facilities are only cost-efficient and effective if established as part of an appropriate broader plan for managing postpartum, psychiatric disorder.
Conclusions:
(1) Further research is needed to answer this question definitively. (2) Services at primary and secondary level require expansion. (3) All services should target the whole family.