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Biomedical subjects

I F Brockington

Publications and source records attributed to I F Brockington.

At least 19 recordsLinked to original sources
PubMed2006

Severe disorders of the mother-infant relationship: definitions and frequency.

We assessed the frequency of severe disorders of the mother-infant relationship in over 200 mothers referred to services in Birmingham and Christchurch, all of whom were interviewed using the Birmingham Interview for Maternal Mental Health. 10.6% had established rejection and 14.6% threatened rejection of their infants. 28.6% had various degrees of pathological anger, which was severe in 8.3%. Rejection was strongly associated with unwanted pregnancy and lack of interaction with the foetus.

Acute Disease↗
PubMed2006

Anxiety, obsessions and morbid preoccupations in pregnancy and the puerperium.

129 mothers referred to specialist psychiatric services in Birmingham and Christchurch were interviewed with the Birmingham Interview. Anxiety disorders were more frequent than depression during pregnancy, and equally frequent after delivery. The focus of pre- and post-partum anxiety may be important for psychological treatment. At a severe level, the most common prepartum theme was fear of foetal death; this was associated with a history of reproductive losses or infertility. After delivery the commonest themes were the pathological fear of cot death and fear of the criticism of mothering skills (which was a clue to a disordered mother-infant relationship). Clinicians should be vigilant for obsessional disorders, querulant (complaining) disorders, post-traumatic stress disorder, conjugal jealousy and dysmorphophobic states, which are all quite common. Patients with "postpartum depression" usually had at least one other (co-morbid) disorder, and 27% had two or more. These findings emphasize the diversity of postpartum psychiatric illness.

Adolescent↗
PubMed2006

The Postpartum Bonding Questionnaire: a validation.

This is a validation of a self-rating questionnaire designed to detect disorders of the mother-infant relationship. 125 subjects filled in the questionnaire, and were also interviewed using the 5(th) Edition of the Birmingham Interview for Maternal Mental Health. On the basis of these interviews and the case records, we made consensus diagnoses of various forms and degrees of mother infant relationship disorder, according to criteria published in this paper. We calculated specificity, sensitivity and positive predictive value of the four scale scores generated by the questionnaire. Scale 1 (a general factor) had a sensitivity of 0.82 for all mother-infant relationship disorders. Scale 2 (rejection and pathological anger) had a sensitivity of 0.88 for rejection of the infant, but only 0.67 for severe anger. The performance of scale 3 (infant-focused anxiety) was unsatisfactory. Scale 4 (incipient abuse) selected only a few mothers, but was of some value in identifying those at high risk of child abuse. Revision of the thresholds can improve sensitivity, especially of scale 2, where a cut-off point of 12 = normal, 13 = high better identifies mothers with threatened rejection. These new cut-off points would need validation in another sample.

Adolescent↗
PubMed1999

[Postpartum dysphoric syndrome. Psychopathology, diagnosis and etiology].

About half of newly delivered mothers suffer a transient phase of emotional lability or sadness a few days after parturition around the 2nd and 5th day after delivery. The transitory psychopathology of the postpartum blues is similar to premenstrual tension, whose main symptom is irritability. The essence of the postpartum blues is not depression, but a sudden, fleeting and unexpected mood change with anxiousness, low spirits, tearfulness, confusion, poor concentration and forgetfulness. The aetiology of this disorder is unknown. It is well known that oestrogens and progesterone modify catecholamine concentration and the density of adrenergic, noradrenergic und dopaminergic receptors in the limbic structures of the central nervous system. But most of the neurochemical studies have not distinguished between postpartum blues and other forms of depression found in women and occurring postpartum. Those research groups who defined a group with a dysphoric peak in the early puerperium could not find a significant correlation between sex hormone levels, neurobiochemical data, and postpartum mood changes.

Depression, Postpartum↗
PubMed1998

Pathological fear of cot death.

Cot death (sudden infant death syndrome) is one of the most common causes of death in the first year of life. Four cases with a pathological fear of cot death are presented. All the patients were depressed and in 2 cases the fear of cot death had an obsessional quality. In all cases there were complications during pregnancy (miscarriage, threatened abortion, recurrent vomiting in last trimester). In 1 case, the patient knew 3 mothers who had suffered cot deaths; in another, the infant was gravely ill in the neonatal period. Pathological fear of cot death can be recognised by the presence of two central features - overvigilance and excessive nocturnal checking of the baby's breathing. Therapeutic interventions are discussed.

Adult↗
PubMed1997

Fetal abuse.

The possible occurrence of fetal abuse in expectant mothers has received little attention in either clinical practice or in research. Five cases with reported fetal abuse are presented. Each case suffered from depression and four of the five women had unplanned pregnancies and had considered a termination of pregnancy. Other possible factors associated with fetal abuse included: denial of the pregnancy, ambivalence towards the pregnancy, previous postpartum depression, and relationship difficulties. Enquiry of possible fetal abuse in pregnant women should be made, particularly if a depressive illness is demonstrated. The relationship between fetal abuse and subsequent child abuse remains unclear.

Adult↗
PubMed1996

Maternal obsessions of child sexual abuse.

Very few cases exist in the literature of maternal obsessional thoughts of child sexual abuse. Two such cases are described of mothers who experienced obsessional thoughts in the puerperium which concerned sexually abusing their own children. Obsessional thoughts of a sexual nature have been shown to occur commonly--in over 25% of those diagnosed with obsessive-compulsive neuroses. These obsessional thoughts concern actions which are usually identified as going against the sufferer's own value systems or involving sexual perversions. Obsessional thoughts of sexually abusing family members are rarely documented; there are no reports of obsessional thoughts experienced by a mother in the puerperium concerning sexual abuse of her own children. We report two cases of mothers suffering from obsessions of this nature at The Mother and Baby Unit (MBU), Queen Elizabeth Psychiatric Hospital, Birmingham.

Adult↗
PubMed1995

Dopamine supersensitivity and hormonal status in puerperal psychosis.

BACKGROUND: We examine the dopamine receptor supersensitivity hypothesis of puerperal psychosis, and explore puerperal changes in the functional sensitivity of this receptor system. METHOD: Dopamine receptor sensitivity was estimated using growth hormone (GH) response to apomorphine challenge following delivery in 37 control women, and 11 deliveries in 10 women at 'high risk' of puerperal psychosis (previous history of puerperal affective or non-puerperal manic psychosis). Tests were on days 4 or 5, 11 or 12 and at six weeks postpartum. RESULTS: Three women developing puerperal psychosis had subsensitive GH responsiveness on day 4. GH response to 67 challenge tests (in control and 'high risk' women) increased between days 4 or 5 and six weeks postpartum (P < 0.05). GH response at six weeks correlated with free thyroxine levels (P < 0.01). CONCLUSIONS: These three cases do not support the stated hypothesis. Hypothalamic dopamine receptor sensitivity increases during the puerperium; thyroxine might influence this.

Adult↗
PubMed1995

Post-traumatic stress disorder (PTSD) after childbirth.

BACKGROUND: There has been discussion about the possible occurrence of post-traumatic stress disorder (PTSD) in mothers after difficult childbirth. METHOD: Four cases with a symptom profile suggestive of PTSD commencing within 48 hours of childbirth are presented. RESULTS: The PTSD was in each case associated with the delivery. In each case, there was an associated depressive illness. All four had persistent disorders, and two had difficulties with mother/infant attachment. CONCLUSION: As confirmed by other reports, the prevalence of PTSD associated with childbirth is a matter of concern.

Adult↗
PubMed1994

Clinical clues to the aetiology of puerperal psychosis.

Recent case reports of postpartum psychosis are reviewed, which suggest hypotheses for the aetiology of this disease. The main themes are: The relationship to manic depression. Premenstrual relapse. Prepartum onset. Onset after miscarriage or evacuation of a trophoblastic tumour. Onset after bromocriptine treatment. Attempts to treat this and related psychoses by progesterone. Apomorphine growth hormone challenge tests.

Female↗
PubMed1993

The community's tolerance of the mentally ill.

A survey of attitudes to mental illness was conducted in a quota sample of about 2000 subjects in Malvern and Bromsgrove. Factor analysis showed three main components - benevolence, authoritarianism, and fear of the mentally ill. Residents of Bromsgrove, which is served by a traditional mental hospital, were slightly more tolerant than those living in Malvern, which has a community-based service, and has seen the closure of two mental hospitals in its vicinity during the last 10 years. The main demographic determinants of tolerance are age, education, occupation, and acquaintance with the mentally ill.

Adolescent↗
PubMed1993

A comparison of responses to the mentally ill in two communities.

Vignettes representing mentally ill people were presented to about 2000 randomly selected residents in Bromsgrove, served by a mental hospital, and Malvern, served by a community-based psychiatric service. They were asked about the likely cause of the condition, what action they would take, and what agencies were most likely to help. In Malvern, residents seemed more enterprising in involving various agencies and more tolerant. It is possible to derive simple 'action scores' as an indicator of such tolerance. Although there were significant demographic differences between subgroups, overall identification of vignette subjects as mentally ill was surprisingly low, and so was knowledge both of community psychiatric nurses as an agency, and of the location of dispersed treatment facilities in both areas.

Adolescent↗