Abstract
PurposeThe postnatal period is a vulnerable time for parents and children but epidemiological and health care utilisation data for Germany on parental mental health during early childhood is scarce. This protocol describes the rationale, aim and study design of a population-based cohort study to assess the occurrence and determinants of psychosocial stress and mental health disorders, as well as the use and cost of health care and social services in early childhood.MethodsAs part of the collaborative SKKIPPI project, we will contact a random sample of 30,000 infants listed in the residents’ registration offices of three German towns and we expect to include 6,000 mother–child pairs. Both parents are invited to fill out an online screening questionnaire. Mothers with indications of psychosocial stress will be interviewed to assess mental health disorders, regulatory problems of their children, as well as health care and social services utilisation, with a follow-up assessment after 6 months.ResultsAfter description of sociodemographic and health data, we will analyse occurrences, patterns, and potential determinants (maternal age, social status, household factors, migration status etc.) of psychosocial stress and mental health disorders in the mothers and their children in early childhood.ConclusionsOur study will identify potential risk and protective factors for postnatal mental health and health care utilization of psychosocially burdened families. This will help to improve prevention and treatment strategies to strengthen the parent–child relationship, to reduce persisting vulnerability of children, and to improve health care and social services.Trial registrationThe study has been registered in the German Clinical Trial Registry on February 8th 2019 (DRKS-ID: DRKS00016653).
Highlights
Psychosocial stress in parents with young children is a burden for their own mental health but may negatively affect the children’s short and long-term mental well-being [1]
Epidemiological studies on maternal mental health disorders in the postnatal period have been almost exclusively focused on postnatal depression and anxiety disorders [2–4]
One of the few studies in this field reported that 10.4% of the parents with at least one child at home belonged to an average parental burnout category and 2.1% of the parents to a high parental burnout category, but the sample included parents with children of all ages [13]
Summary
Psychosocial stress in parents with young children is a burden for their own mental health but may negatively affect the children’s short and long-term mental well-being [1]. The few German studies assessing prevalence data on postnatal maternal mental health disorders revealed estimates between 3 and 6% for postnatal depression and around 11% for postnatal anxiety [6–8]. Ongoing research is focusing especially on postnatal depression or anxiety disorders, but there are less studies assessing prevalence data of other postnatal mental health problems like obsessive–compulsive disorders [9, 10] or parental burnout, a concept that has only recently been suggested and investigated [11, 12]. In Germany (like in other countries), there are out- and inpatient health care structures specialized in offering treatment for perinatal mental health disorders, for example motherbaby-units within psychiatric hospitals [44, 45] or specialized psychotherapeutic outpatient clinics [46, 47], offering parent–child psychotherapy Another example are early support programs beginning directly after birth in the maternity ward, like the Babylotse Plus program for psychosocially burdened mothers and their infants [48]. A study from UK calculated total lifetime costs of perinatal depression to be £ 75,728 per woman with this disorder, most of it related to adverse impacts on the child [53]
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