This study assessed the underexplored factors associated with significant improvement in mothers’ mental health during postpartum inpatient psychiatric care.

This study analyzed clinical improvement in a prospective cohort of 869 women jointly admitted with their infant to 13 psychiatric Mother-Baby Units (MBUs) in France between 2001 and 2007. Predictive variables tested were: maternal mental illness (ICD-10), sociodemographic characteristics, mental illness and childhood abuse history, acute or chronic disorder, pregnancy and birth data, characteristics and mental health of the mother's partner, and MBU characteristics.

Two thirds of the women improved significantly by discharge. Admission for 25% was for a first acute episode very early after childbirth. Independent factors associated with marked improvement at discharge were bipolar or depressive disorder, a first acute episode or relapse of such an episode. Schizophrenia, a personality disorder, and poor social integration (as measured by occupational status) were all related to poor clinical outcomes.

Most women improved significantly while under care in MBUs. Our results emphasize the importance of the type of disease but also its chronicity and the social integration when providing postpartum psychiatric care.

Childhood-onset schizophrenia (COS) is a rare but severe psychiatric disorder with important individual, family and societal consequences. Its prevalence is approximately 2 per 10.000 in the general population and the incidence of COS increases with age.

The main objective of our study was to evaluate the prevalence of COS in French medical-social institutions or psychiatric day hospitals for children and adolescents in the PACA region. The secondary objectives were:

1. (1) to estimate the prevalence of children with both COS and autism diagnosis,

2. (2) to characterize clinical and neurocognitive presentation of COS using the evaluation of intensity of positive and negative symptoms (PANSS, SANS), of thought disorganization (TLC), of cognitive functioning, and of attention and executive functions (verbal fluency, TMT A, TMT B).

Subjects were patients from medical-social and psychiatric care centers for children and adolescents in three PACA sub-regions in the south-east of France. The study included French speaking girls and boys between 7 and 18 years old, registered in a partner structure of the study, and presenting an IQ > 35 (WISC-IV). The study design was constituted by two phases: the first one was the categorical diagnostic phase using the psychosis section of the Kiddie-SADS Present and Lifetime Version. The second phase consisted of the dimensional COS diagnosis and neurocognitive exploration for the subjects fulfilling the DSM-IV diagnostic criteria for schizophrenia.

The diagnosis of COS was not exceptional in this population. Most subjects diagnosed with COS also presented autism diagnosis and mental retardation.

Electronic medical records (EMR) are currently being implemented in psychiatric hospitals throughout Europe. The perceptions of health care professionals can contribute important information that may predict their acceptance of and desired mode of use for EMR, thus guiding EMR implementation.

To develop a self-administered instrument designed to assess health care professionals’ satisfaction regarding EMR in a psychiatric hospital, based only on the professional point of view, according to the psychometric standards.

The development was supervised by a steering committee and undertaken by three standard steps. Item generation was derived from 115 face-to-face interviews with health care professionals in a French, public, psychiatric hospital. The item-reduction process resulted in a 25-item questionnaire. The validation process was based on construct validity, reliability and some aspects of external validity.

The final version of the questionnaire contained 25 items that described five dimensions, leading to a global score. The factor structure accounted for 72% of the total variance. Internal consistency was satisfactory (item-internal consistency over 0.40 and Cronbach's alpha coefficients ranged from 0.86 to 0.95). The scalability was satisfactory with INFIT statistics inside an acceptable range. Scores of dimensions were strongly positively correlated with visual analogue scale scores (all p < 0.001). External validity showed statistical associations between scores and age, gender, seniority in psychiatry and ward type. Participation rate was 66%.

The availability of a reliable and valid questionnaire (professionals’ satisfaction questionnaire with electronic medical records [PSQ-EMR]) concerning health care professionals’ satisfaction regarding EMR in psychiatry, exclusively generated from interviews with health care professionals, enables legitimate feedback to be incorporated into EMR implementation in order to formulate a high-quality health care.