Mère souffrant de trouble de personnalité limite : quels soins spécifiques en période périnatale ? Une revue de la littérature
Bibliographic record
Abstract
Borderline personality disorder (BPD) is a common and severe disorder characterized by unstability of self-image, unstable affect, and unstable interpersonal relationships. Women with BPD would give birth as much as other women, but according to several studies, BPD mothers have a reduced sensitivity to their babies and a poor interpretation of their emotions; this would interfere in mother-baby interaction and in psycho-affective development of the baby, with the risk to develop psychiatric pathologies in adulthood. In this context several professionals have developed different interventions for mothers suffering from BPD. Objectives The main objective of this literature review is to list the interventions developed for BPD mothers during the perinatal period (from pregnancy to the 18 months of infant). The secondary objective is to assess the effectiveness of some of these interventions. Method We have screened five databases: PUBMED/MEDLINE, EMBASE, CINAHL, EBM REVIEWS and PSYCINFO, gray literature, recommendations of some countries, Google.ca website and OpenGray. We used keywords to screen the articles: Borderline personality disorder; Mothers, Women, Woman, Maternal, Perinatal, Perinatology, Postnatal, Postpartum, Pregnant, Pregnancy(ies), Infant(s), Infancy, Baby(ies), Newborn(s), Offspring(s), Young child, Young children. To be included, an article had to be written in English or French and published between 1980 and 2020 (a bibliographic watch was then carried out until December 2021); it had to deal with preventive and/or therapeutic intervention(s) targeting mothers suffering from BPD in the perinatal period. Results The search have generated 493 articles and 20 articles were selected. We have identified two main types of interventions: some are centered on the mother-baby dyad, others are centered only on the mother. Among them, there are therapies established for BPD patients in the general population, or specific mother-baby psychotherapies. Interventions are multidisciplinary, intervene early and intensively. Four articles have analysed the effectiveness of their program: according to the studies, the beneficial effects on dyadic interactions generally appear after several weeks of treatment, and for some programs the effects may persist over time; three authors show a reduction of maternal depressive symptoms. Only Australia and Switzerland have published recommendations targeting BPD mothers in the perinatal period. Conclusion Interventions with BPD mothers in the perinatal period can be based on reflexives theoreticals models or be in connection with the emotional dysregulation from which these mothers suffer. They must be early, intensive and multi-professional. Given the lack of studies that have analysed the efficacy of their programs, no intervention currently stands out, so it seems important to continue the investigations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.005 | 0.008 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.004 | 0.005 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".