The changes of parental functioning of the patients with bipolar disorder and major depression since discharging from hospital: A longitudinal study

Aims and Objectives This study examined the changes in patients' parental functioning and the associated factors, including manic, depressive symptoms and social support from before discharge to 6 months post-discharge. Background For parents with bipolar disorder and major depression, parenting is a recovery factor for patients, but little research examines the dynamic parental functioning from acute hospitalisation to a remission stage. Design A longitudinal design was used. The STROBE Checklist were used in presenting this research. Methods Participants were inpatients with bipolar disorder or major depression (n = 33) recruited within one week before discharge from the acute psychiatric ward in Taiwan. Data on parental functioning was collected four times: before discharge (T1), the 1st (T2), the 3rd (T3) and the 6th (T4) months of post-discharge. Baseline parental functioning before admitting to the acute word was retrospectively assessed at T0. The questionnaires included positive and negative domains of parenting practice, hypomanic/manic symptoms, depressive symptoms and social support. Generalised estimating equations were applied for data analysis. Results The negative parenting domains (poor monitoring, inconsistent discipline) decreased during hospitalisation but increased at one month post-discharge, except corporal punishment at 3-months discharge. The positive parenting domains (parental involvement and nurturance/responsiveness) did not recovery to baseline. While clinical symptoms remained stable during 6 months post-discharge, social support decreased at 3 and 6 months post-discharge. Higher depressive symptoms and low social support were associated with positive parenting domains but not related to negative parenting domains. Manic symptoms were not associated with positive or negative parenting domains. Conclusions Positive parenting domains did not fully return to the usual situation during 6 months post-discharge. Relevance to clinical practice Parenting functioning recovery program targeting at the impacts of depressive symptoms on the parenting functioning and insufficient social support is needed from hospitalisation to post-discharge.

Automated summary

This study examined the changes in parental functioning of patients with bipolar disorder and major depression from before discharge to 6 months post-discharge. The results showed that positive parenting domains did not fully recover during this period, while negative parenting domains increased at one month post-discharge. Depressive symptoms and social support were associated with positive parenting domains, but manic symptoms were not related to parenting functioning. These findings suggest that a parenting recovery program targeting depressive symptoms and insufficient social support is needed from hospitalization to post-discharge.