{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:40:16Z","timestamp":1789170016141,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Early parenting services in Australia offer brief structured residential programs to address moderate to severe non\u2010psychotic mental health problems among women and unsettled infant\/toddler behaviours. The aims were to (1) estimate the immediate and medium\u2010term impact of a five\u2010night psychoeducational residential early parenting program on postpartum depressive symptoms and (2) identify the factors associated with improvement or worsening of postpartum depressive symptoms after completing the program and six weeks post\u2010discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Audit of routinely collected medical record data from pre\u2010admission, pre\u2010discharge and post\u2010discharge assessments of a consecutive cohort of women admitted, with their infants\/toddlers in a 15\u2010month period to Masada Private Hospital Early Parenting Centre. Data included structured questions assessing: demographic characteristics, access to family and social support, past and current mental health problems, reproductive and obstetric health, chronic health conditions, breastfeeding problems, coincidental major life events, health risk behaviours and infant\/toddler feeding, sleeping and crying behaviours. Standardised instruments included the Partner Interaction after Birth Scale (PIBS), the MacLean Screening Instrument for Borderline Personality Disorder (MSI\u2010BPD), Modified Fatigue Assessment Scale (FAS) and selected items from the Karitane Parenting Confidence Scale. The primary outcomes were Edinburgh Postnatal Depression Scale scores at pre\u2010discharge and follow up assessments. Data were analysed using multinomial logistic regression models in which individual and psychosocial characteristics at pre\u2010admission were included as predictors of the likelihood of the changes of the outcomes from pre\u2010admission to pre\u2010discharge and follow up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Complete data from 1220 of 1290 (95%) eligible women were available to assess pre\u2010admission to pre\u2010discharge and from 559 (45.8%) to assess pre\u2010discharge to six\u2010week follow\u2010up changes. The mean pre\u2010admission EPDS score was 11.7 (95% CI: 11.5; 12.0), pre\u2010discharge it was 7.1 (95% CI: 6.9; 7.4) and at six\u2010week follow up it was 5.7 (95% CI: 5.3; 6.1). We found that almost all women experienced a clinically meaningful and rapid improvement in depressive symptoms of at least this magnitude (reduction in mean EPDS scores of 4.6 points from pre\u2010admission to pre\u2010discharge (five nights) and a further reduction of 1.2 points pre\u2010discharge to follow up) (six weeks) and we identified an interpretable set of risk factors for symptoms that did not improve or worsened. The adverse outcomes were associated with having symptoms of borderline personality disorder, a partner experienced as lacking kindness and care, coincidental adverse events and having a child younger than six months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Residential early parenting programs, which take a psycho\u2010educational approach to strengthening caregiving skills, maximising agency, and reducing helplessness, have a rapid beneficial effect on women's postpartum depressive symptoms. These programs provide a valuable and effective component of comprehensive mental health services. Long\u2010term dialectical behaviour therapy is indicated for women with borderline personality disorder traits for whom early parenting programs alone are insufficient to improve depressive symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.13668","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T22:33:48Z","timestamp":1708986828000},"page":"458-473","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of a private sector residential early parenting program on clinically significant postnatal depressive symptoms experienced by women: Audit of routinely collected data"],"prefix":"10.1111","volume":"150","author":[{"given":"Jane","family":"Fisher","sequence":"first","affiliation":[{"name":"Global and Women's Health, Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Stanzel","sequence":"additional","affiliation":[{"name":"Global and Women's Health, Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hau","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Global and Women's Health, Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patsy","family":"Thean","sequence":"additional","affiliation":[{"name":"Early Parenting Centre, Masada Private Hospital  St Kilda East Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"French","sequence":"additional","affiliation":[{"name":"Ramsay Hospital Research Foundation, Ramsay Health Care  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Popplestone","sequence":"additional","affiliation":[{"name":"Global and Women's Health, Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thach","family":"Tran","sequence":"additional","affiliation":[{"name":"Global and Women's Health, Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.05.003"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737\u2010009\u20100048\u20107"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2013.03.006"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.05.010"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016\u20101870"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205243"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2020.102906"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.950004"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.23.1.56"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.134.4.382"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15182"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2006.099812"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12752"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NMC.0000351704.35761.f1"},{"key":"e_1_2_13_16_1","unstructured":"FisherJ RoweH HiscockH et al.Understanding and Responding to Unsettled Infant Behaviour: a Discussion Paper for the Australian Research Alliance for Children and Youth (ARACY).2011b."},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-6405.2010.00653.x"},{"key":"e_1_2_13_18_1","unstructured":"Hevey J 1920\u20132020 A colourful tribute to Tweddle Child and Family Health Service. 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