Infant Mental Health

This research project includes two studies: the first is about the effectiveness of Parenthood-Centred-Psychotherapy on perinatal maternal anxious-depressive symptoms and child development, and the second focuses on grief in infertility.
First: Untreated depressive and anxiety symptoms during pregnancy can lead to recurrent or chronic maternal depression, with negative consequences for child development and the mother-infant bond. The hypothesis is that parenthood-centred psychotherapy, using a psychoanalytical application manualised by the Geneva School, reduces anxiety and depression symptoms and promotes the mother-child bond. Methods this study was conducted between 2015-2023 in a Primary Health Care Centre in Barcelona in 160 women with prepartum anxiety and/or depressive symptoms, focusing on outcomes for the mother, the child and the parent–child bond. Pregnant women (EPDS ≥ 9 and/or STAI ≥ 40) were assigned by recruitment order to either a treatment group receiving six individual psychotherapy sessions (three during pregnancy and three in the first six postpartum months) or a control group receiving standard perinatal primary care. Maternal depression (EPDS) and anxiety (STAI) were assessed at baseline (pregnancy) and when the child was 2, 6 and 18 months old. All assessments were conducted by independent raters, who remained blinded at the final 18-months post-partum, along with evaluation of the parent–infant relationship (PIR-GAS) and child development (ASQ-3). Results supported the hypothesis where the treatment group showed a significant reduction in depressive symptoms (p = 0.011) and state anxiety (p= 0.015), compared with the control group, with between-group differences increasing over the follow-up period (p= 0.001 for combined depressive–anxiety symptoms). At 18 months, infants in the treatment group scored better in three of the five ASQ-3 developmental domains. PIR-GAS scores were significantly higher in the treatment group (p= 0.001). Discussion In line with a recent metanalysis, psychoanalytic application prevent the adverse effects of maternal depression and anxiety in adolescence and adulthood. Parenthood Centred Psychotherapy achieves significant improvements not only in maternal depressive and anxiety symptoms but also in infant developmental outcomes and the quality of the mother-infant relationship. These findings suggest this may act as a developmental protective factor and foster a secure and responsive relational environment in early life. Clinicians and policy-makers may benefit from the implementation of such applications in standard primary care.

Second: The diagnosis of infertility generates a significant psychological impact on the couples who experience it. The loss of fertility triggers a psychological mourning process that affects self-esteem and identity.
The aim of this study is the follow-up of couples 25 years after conceiving children with artificial insemination of donor semen, to explore from a mixed methods approach the relationship between the mode of elaboration of infertility grief, the communication strategies of the genetic origins of babies and the filiation experience.
Method: The macrostages of the process are QUAL-QUANT-QUAL to integrate qualitative and quantitative elements. The indirect observational methodology has been used, based on in-depth interviews with infertile couples. The observational design is N/F/M: nomothetic (10 couples), incomplete intersessional follow-up (two time points) and incomplete intrasessional follow-up (single in-depth interview), and multidimensional. There are 5 dimensions proposed based on the theoretical psychoanalytic framework and the answers obtained, which are displayed in sub-dimensions up to the fourth level, and based on each of them a system of categories is developed. The observational instrument is ad hoc, and allows to systematize the transcriptions of the answers, obtaining matrixes of codes (249). After a process of transformation of the data, the quality control of the data is found, and a lag sequential analysis is carried out with the GSEQ5 software, with the aim of detecting regularities in the existence of behavioural patterns.
Results: The total number of behaviour patterns was 55. Since the purpose of the study was to know the potential existence of multiple cases from the results of the lag sequential analysis and considering the similarities between the patterns obtained, 5 multiple cases have been detected that show that there is a connection between the conducts of the mode of elaboration of infertility grief and the communication of genetic origins and filiation experience.
Discussion: Qualitative and quantitative elements have been integrated, which is innovative in this substantive area. Likewise, the rigor of a mixed methods approach has facilitated the identification of nuanced aspects in grief coping analysis, which holds relevance for the psychological support of couples undergoing assisted reproduction.