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Letters to the Editor   |    
An Early Study of an Intervention With Children of Psychotic Mothers
Henry Grunebaum, M.D.; Bertram J. Cohler, Ph.D.
Am J Psychiatry 2011;168:1222-1223. doi:10.1176/appi.ajp.2011.11071016
View Author and Article Information
Cambridge, Mass.
Chicago

The authors report no financial relationships with commercial interests.

Accepted for publication in August 2011.

Accepted August , 2011.

Copyright © American Psychiatric Association

To the Editor: It may interest readers of the article by Wickramaratne et al. (1) on the children of depressed mothers that a study of a similar population with similar goals was conducted four decades ago. The Intensive Nursing Aftercare Project (2), in which we participated, recruited 50 psychotic mothers with children age 5 or younger who were matched with neighborhood comparison subjects. Based on a random selection, half of the psychotic mothers were offered a weekly 1-hour visit by specially trained psychiatric nurses, and the other half were offered a monthly brief visit. The children were evaluated as they entered the study and 2 years later at the end if the intervention.

We found that there was very little difference between the weekly (intensive) treatment group and the monthly (minimal) treatment group, but there were several problems with the study. First, the treatment that the mothers received was highly psychoanalytically influenced, and medication for depression was not adequate at that time. Second, diagnosis of the mothers' mental illness was clinical and not up to current standards. Finally, a major ethical problem arose when the monthly treatment group required help, and we felt obligated to offer it.

The random treatment group assignment is a study design that was advanced for its time. In addition, other findings included the attentional difficulties of the children of mothers with schizophrenia (3) and the fact that some of these children functioned at an unusually high level (4). We also found that the children of depressed mothers performed less well on careful assessments of development than the children of mothers with schizophrenia, who could more easily separate themselves from their mother's distress (3).

Wickramaratne  P;  Gameroff  MJ;  Pilowsky  DJ;  Hughes  CW;  Garber  J;  Malloy  E;  King  C;  Cerda  G;  Sood  AB;  Alpert  JE;  Trivedi  MH;  Fava  M;  Rush  AJ;  Wisniewski  S;  Weissman  MM:  Children of depressed mothers 1 year after remission of maternal depression: findings from the STAR*D-Child study.  Am J Psychiatry 2011; 168:593–602
[CrossRef] | [PubMed]
 
Cohler  B;  Grunebaum  H:  Children of parents hospitalized for mental illness, II: the evaluation of an intervention program for mentally ill mothers of young children.  J Child Contemp Soc 1983; 15:57–66
[CrossRef]
 
Cohler  BJ;  Grunebaum  HU;  Weiss  JL;  Gamer  E;  Gallant  DH:  Disturbance of attention among schizophrenic, depressed, and well mothers and their young children.  J Child Psychol Psychiatry 1977; 18:115–135
[CrossRef] | [PubMed]
 
Kauffman  C;  Grunebaum  H;  Cohler  B;  Gamer  E:  Superkids: competent children of psychotic mothers.  Am J Psychiatry 1979; 136:1398–1402
[PubMed]
 
References Container
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References

Wickramaratne  P;  Gameroff  MJ;  Pilowsky  DJ;  Hughes  CW;  Garber  J;  Malloy  E;  King  C;  Cerda  G;  Sood  AB;  Alpert  JE;  Trivedi  MH;  Fava  M;  Rush  AJ;  Wisniewski  S;  Weissman  MM:  Children of depressed mothers 1 year after remission of maternal depression: findings from the STAR*D-Child study.  Am J Psychiatry 2011; 168:593–602
[CrossRef] | [PubMed]
 
Cohler  B;  Grunebaum  H:  Children of parents hospitalized for mental illness, II: the evaluation of an intervention program for mentally ill mothers of young children.  J Child Contemp Soc 1983; 15:57–66
[CrossRef]
 
Cohler  BJ;  Grunebaum  HU;  Weiss  JL;  Gamer  E;  Gallant  DH:  Disturbance of attention among schizophrenic, depressed, and well mothers and their young children.  J Child Psychol Psychiatry 1977; 18:115–135
[CrossRef] | [PubMed]
 
Kauffman  C;  Grunebaum  H;  Cohler  B;  Gamer  E:  Superkids: competent children of psychotic mothers.  Am J Psychiatry 1979; 136:1398–1402
[PubMed]
 
References Container
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