Abstract Body

The perinatal period represents an at-risk period for mental health consequences, which has been overlooked for long time. Perinatal mental health problems constitute a relevant threat for long-term mental health, not only for the direct impact on the affected women, but also for the considerable foetal/infant morbidity and mortality.

Perinatal mental disorders are associated with negative outcomes in the newborn, including an increased risk of premature delivery and infant mortality, as well as a higher prevalence of mental disorders in the offspring (e.g., attention deficit or anxiety disorders). Depressive disorders represent the most common disorder during the perinatal period. For the adequate, appropriate and complete management of women with perinatal depression, there is the need for integrated interventions, following a comprehensive global assessment of women’s mental health. In particular, the management of depression during perinatal period requires special attention, even considering the problems and limitations in prescribing pharmacological drugs. In this context, psychoeducational interventions are effective in reducing affective symptoms and the levels of stress, with low costs for the mental health department.

Abstract Body

The first years of life represent a crucial period for psycho-affective development - the critical first 1000 days - because the events that happen to infants and babies during this period have psychosocial as well as epigenetic repercussions, with potential consequences throughout life and even for generations to come.

The interactive circle that will develop between the skills (and/or vulnerabilities) of infants and parents and the interactive features arising from each triad, must be supported by perinatal mental health policies, of which the joint care of parents and infants in perinatal psychiatry is a pivotal element. It is necessary to develop care pathways, with systems integrated into "usual" care that take into account families from the prenatal or even pre-conceptual period to the postnatal period,
Joint care must also be scalable and thus encompass everything from parent-child psychotherapy to joint mother-baby hospitalisation.

This intervention will present and discuss an example of a graduated, integrated and coordinated system of care, and will open up the perspective that perinatal clinicians must bear in mind that joint care is above all "a way of doing things", based on the notions of multidisciplinarity and prevention.

Abstract Body

Parental mental health problems have been found to have a significant impact on a range of aspects of parental caregiving during the postnatal period, with significant implications in terms of key aspects of the child’s development. Video feedback is a generic term that refers to the use of videotaped interactions of the parent and child to promote parental sensitivity, and a recent meta‐analysis of 20 studies (1757 parent‐child dyads) found that video feedback can improve parental sensitivity compared with a control or no intervention up to six months' follow‐up. This paper will examine the ways in which video feedback might contribute to the ability of parents with mental health problems to provide the type of caregiving that will promote the development of a secure attachment in the infant.

Abstract Body

In perinatal clinical practice (PCP), the focus of care has shifted from the mother and then the baby-mother dyad to the emphasis on the role of fathers. Individual and therapeutic interventions are multimodal, and in almost all cases interdisciplinary cooperation is assumed. The preferred therapeutic methods for perinatal mental disorders are psychological and psychotherapeutic interventions. Through the life-course model, the central, therapeutic-conceptual role of the family can be understood, which - in clinical practice - reflects the need for “think-family” in psychiatric care.

Hence there is a growing need for evidence-based family-interventions.

Parental mental health disorders may have an impact on family functioning and partner relationship, as well as parent-child interactions, the quality of attachment and relationship with the child.

Even though we have an increasing number of evidence regarding the aims and effectiveness of family interventions, additional evidence is needed to determine what interventions and modalities are effective in the perinatal period. And we also need information when these interventions are contraindicated and regarding their risk.

It is conceivable that there is not much difference between the efficacy of family intervention methods used in other indications and the perinatal application of the same methods.

We have gathered evidence primarily on perinatal depression, which opens the path of family interventions in other disorders.

When thinking in the family as a general framework, it should be filled with evidence-based quantitative and qualitative anchors.

The conceptual framework can be based on systems- and network theory.

The presentation is illustrated with clinical vignettes.