Introduction
Methods
Inclusion and exclusion criteria
Search strategy
Risk of bias
Methods for selecting study participants | Methods for measuring exposure and outcome variables | Design-specific sources of bias (excluding confounding) loss to follow-up | Design-specific sources of bias (excluding confounding) blinding of outcomes | Methods to control confounding | Statistical methods (excluding control of confounding) | |
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Low | High | High | Unclear | Low | High | |
Unclear | High | High | Unclear | Low | High | |
High | Low | High | Low | Low | Low | |
High | Low | N/A | Low | High | High | |
Boston Cohort [40] | High | Low | N/A | Low | High | Low |
Bethlem Cohort [41] | High | High | High | High | High | Low |
Austin Cohort [21] | High | High | Low | High | High | High |
Manchester Cohort 1993-1995 [42] | High | High | N/A | High | High | High |
Manchester Cohort 1993–1995 and 1996-2000 [43] | High | Low | N/A | Low | Low | Low |
High | Low | N/A | Low | Unclear | Low | |
London Cohort I (Pawlby) [46] | High | Low | High | Low | High | Low |
London Cohort II (Kenny) [47] | High | Low | Low | Low | High | Low |
Results
What are the characteristics of the studies investigating the early caregiver–infant relationship?
Cohort, collection period | Reference study | Design and sample characteristics | Maternal diagnosis and subgroups (mean age) | Infant age*, gender: male (%) | Domains covered | |||||
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Maternal behaviour | Infant behaviour | Mutual interaction | Mother correlates | Infant correlates | ||||||
Design |
N, consent rate, attrition | |||||||||
Lund Cohort 1973–1977 | [23] Study description, no interactive data presented | Longitudi-nal 0–6 year | 192, consent rate index: 93 % control 98 % | 104 matched controls 88 psychosis (28.7 years) Hereof 17 schz project criteria +RDC | 0–6 years Schz: 11(65 %) Psychosis: 50 (57 %) Control: 48 (46 %) | |||||
[24] | 124 | 51 psychosis, hereof 11 schz 73 matched controls | 3 days 58 (47 %) |
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| Diagnosis | |||
[25] | 3 weeks: 102 6 weeks: 129 | 42 psychosis, hereof 11 schz 60 matched controls 51 psychosis, hereof 14 schz 78 matched controls | 3 and 6 weeks gender: NI |
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| Diagnosis | |||
[26] | 3½ month:128 6 months: 131 | 48 psychosis, hereof 11 schz 80 controls 52 psychosis 14 schz 79 controls | 3½ and 6 month gender: NI |
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| Diagnosis | |||
[27] | 126 | 46 psychosis, hereof 10 schz 80 controls | 1 year gender: NI |
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| Diagnosis | Attachment | ||
[28] | 126 | 46 psychosis, hereof 10 schz 80 controls | 1 year 61 (48 %) |
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| Diagnosis Psychiatric condition | Attachment | ||||
[29] | 126 | 46 psychosis 80 controls | 1 year gender: NI |
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| Diagnosis | Attachment | ||
[30] | 126 | 46 psychosis, hereof 10 schz 80 controls | 1 year 61 (48 %) |
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| Psychiatric condition | Gender | ||||
[31] | Subsample: 126 | 46 psychosis, hereof 10 schz 80 controls | 1 year male: 61 (48 %) |
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| Diagnosis | |||||
[32] | 126 | 46 psychosis 80 controls | 1 year gender: NI |
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| Fear of strangers | |||
[33] | NI | 88 psychosis hereof 17 with post-partum psychosis | Diagnosis Post-partum Psychosis | Fear of stranger Attachment | ||||||
[34] | 161 attrition: psych 27 % control 6 % | 88 psychosis, hereof 12 schz 104 controls | 1 year (attachment) 6 years (psychopathology) gender: NI |
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Roche-ster Cohort 1970–1976 | [35] Study description, no interactive data presented | 184 attrition 0 to 4 months: 22 %. 4 months to 4 years: 19 % | Matched sample: 29 schz 58 depr 40 Pers. Disorder 57 No mental disorder DSM II criteria | 0, 4, 12, 30 and 48 months gender: NI | Diagnosis Severity and chronicity of illness Social status | Mental and psychomotor development | ||||
[36] | 0–30 months longitudinal study | 184 attrition: whole group: 31 % Schz group: 35 % | Matched sample (24.4 years): 29 schz 58 depr 40 Pers. Disorder 57 No mental disorder DSM II criteria | 4 and 12 months gender: NI |
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Incl attachment | Diagnosis Illness Severity and chronicity Social status | Mental and psychomotor development | ||
Emory Cohorts | [20] | Longitudinal | 153 attrition 29 % | 115 index hereof 71 schz 36 depr 8 unspec 38 control DSM III criteria | 0–5 year mean: 2 years gender: NI |
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| Diagnosis | IQ Social behaviour Psychiatric outcome |
[37] | 101 | 53 schz 25 depr 23 matched control | 3 month to 5 years mean 2 years gender: 50/50 |
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| Diagnosis | IQ Social behaviour | ||
Pitts-burgh Cohort | [38] Study description, no interactive data presented | Cross sectional | 21 | 9 schz 12 controls | 3 months |
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| Diagnosis Level of anxiety, depression and anger Nurturant care | IQ Neurological and physiological examination |
[39] | Cross-sectional | 18 | 9 schz (21 years) 9 controls (22 years) | Mean 14.2 months gender: NI |
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| Diagnosis Education Care | Mental and psychomotor development | |
Boston Cohort | [40] | Cross-sectional | 45 | 15 schz 15 depr 15 controls DSMIII criteria | Mean 12.5 months gender: NI |
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| Diagnosis | |||
Beth-lem Cohort | [41] | Pre-post. assessment | 78 | 15 schz (26.8 years) 28 depr (29.7 years) 35 bipolar/manic (28.2 years) RDC | Mean age: schz: 5.1, depr: 6.9, bipolar: 4.3, 3 weeks male: schz: 7 (41 %) depr: 17 (60 %) bipolar:18 (51 %) |
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| Diagnosis | |||
Austin Cohort | [21] | Pre-post assessment | 15 | 15 schz (28.6 years). DSM-IV criteria | 1–44 weeks mean: 16.9 weeks male: 8 (53) |
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| Severity of illness | |
Man-chester 1993–95 Cohort | [42] | Cross sec-tional | 48 admitted 32 eligible 5 refused to be videotaped 26 included | 8 schz (31.5 years) 12 depr 6 bipolar (25.7 years) RDC = research diagnostic criteria | App. 4 months 13 (50 %) |
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| Diagnosis | |
Man-chester 1993–95 + 1996–2000 Cohort | [43] | Cross sec-tional replication study | 55 included 38 used for analysis (>4 months old from 1993 cohort excluded) | 13 Schz 14 bipolar 11 depr ICD-10 diagnostic criteria | 4 months gender: NI |
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| Diagnosis | |
Man-chester 1996–2000 | [44] | 45 | 14 schz 31 affective (28 years) DSM-IV criteria | 4–60 weeks, mean: 15 weeks 20 (44 %) |
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| Diagnosis | |||
[45] | 51 | 14 schz Comparison group: 8 bipolar, 25 depr., 2 OCD, 1 anxiety (28 years) ICD-10 criteria | 7–60 weeks, mean: 16 weeks 25 (50 %) |
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| Diagnosis | |||||
London Cohort | [46] | Pre-post assessment | 139 49 control 82 + 8 eligible in-patients | 49 controls Of 42 remaining in-patients: 15 schz (34.6 years) 23 depr (32.2 years) 12 mania (29.0 years) DSM-IV criteria | 0-52 weeks mean age: At admission: 10.6 weeks At discharge: 19.1 weeks |
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| Diagnosis | ||
[47] | Pre-post assessment | 49 | 8 schz 23 depr 18 mania | 1–53 weeks (admission) 5–61 weeks (discharge) mean age: At admission:12.4 At discharge: 20.6 |
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| Diagnosis |