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Aims: Psychotic disorders are one of the main causes of chronic disability in young people. An at-risk mental state (ARMS) is represented by subclinical symptoms that precede the first episode of psychosis (FEP). The PsyYoung project aims to optimize the detection of an ARMS while reducing unnecessary psychiatric treatments. It investigates the effects of service changes on the referrals and outcomes of young people with ARMS or a FEP., Methods: Six psychiatric outpatient clinics in three cantons (Basel-Stadt, Vaud, and Geneva) participated in the project. They passed through an implementation phase including service changes and the adaptation of a standardized stepped care model for diagnosis and assessment, in addition to measures for increasing the awareness, networking and training of local professionals., Preliminary Results: All participating cantons had entered the implementation phase. By March 2023, there were 619 referrals to participating sites. A total of 163 patients (37% FEP and 31% ARMS) and 15 close relatives had participated in individual longitudinal assessments, and 26 patients participated in qualitative interviews., Conclusion: This national collaborative project addresses the issue of early intervention for emerging psychoses, and creates spaces for fruitful reflections and collaboration in Switzerland. The ultimate aim of PsyYoung is to harmonize clinical practices in early intervention of psychosis on a national level.

Maternal representations play a key role in intrapsychic conflicts relating to accession to parenthood and in the formation of the mother-baby bond. Around the birth of the child, the shadows of past objects are cast on the baby and the parent's self-image. Mother-baby psychoanalytic psychotherapy helps us to understand internal conflicts that tend to interfere with the mother's representations of her child or of herself as a mother, as well as aiming to reduce the risk of difficulties for the child. Through a clinical case, this article explores the development of maternal representations in a course of parenthood-centred psychotherapy that begins during pregnancy and ends 11 months after the baby's birth. The psychic change carried out by the mother frees the mother-baby bond from the projections of the past. Excerpts from clinical sessions illustrate mother-baby interactions during the session, the projection of the mother's internal objects on to the baby, and the elaboration and reintrojection of the mother's internal conflicts. Changes in the mother's representations were measured both qualitatively and quantitatively using the 'R' interview, which allows various dimensions of these representations to be measured on a Likert scale.

Aim: To determine the prevalence of anxiety-depressive symptomatology and associated risk factors in a population of pregnant women in the low-income neighborhood of Roquetes (Barcelona, Spain)., Design: Quasi-experimental, cross-sectional study., Location: The study was carried out at the Primary Care Center, Roquetes Canteres, Barcelona., Participants: Between 2015 and 2017, all pregnant women who visited the Sexual and Reproductive Care Team in Primary Care (ASSIR) or their Family Physician (FP) were invited to take part in a study if they met the following criteria: (a) over 18 years old (b) able to understand in any of the 4 study languages. Of a total of 239 gestating women, 19 declined to participate, 14 moved away from the area and 16 underwent voluntary termination of pregnancy, leaving a sample of 190 subjects., Material and Methods: The Edinburgh Postnatal Depression Scale (EPDS) was used to detect depressive symptomatology, the State-Trait Anxiety Inventory (STAI) was used to assess anxiety, and a sociodemographic data questionnaire was administered. Once all descriptive demographic data from the whole sample was analyzed, baseline clinical and demographic characteristics were compared using the independent t-test for continuous variables and the chi-squared analysis for categorical variables., Results: The t-test showed that 48% of pregnant women presented an at-risk degree of anxiety-depressive symptomatology, double that found in the general population. Applying a chi-squared test to the at-risk and non-risk groups revealed associated prenatal risk factors including: having a history of violence; living in a rented room, mistreatment in infancy and mental health issues. The ROC curves analysis obtained a cutoff point score of 4 Accumulated Associated Factors (AAF) (AUC 0.765, p  < .001, 57% sensitivity and 79% specificity)., Conclusions: Our study shows that rates of anxiety-depressive symptomatology in a population with considerable socio-economic deprivation can more than double. AAF in the population at risk of anxiety and depression were detected, highlighting the need to allocate resources to identification and prevention during pregnancy. This requires the involvement of a multidisciplinary, professional team with a biopsychosocial perspective.

Objectives: Depression and anxiety are major causes of distress amongst parents during the perinatal period. Their pervasive effects on the parents' self-confidence, on the parent-infant relationship and on the child's development have been well documented. The aims of the present study were to describe the psychological characteristics of mothers consulting during the perinatal period and to assess the effect of brief Psychotherapy Centred on Parenthood (PCP) on the mothers' depressive and anxiety symptoms. The evolution of the mother-infant relationship is also documented. PCP is a brief mother-infant psychotherapy which focuses on the mother-infant relationship as well as the mother's mental representations in order to reduce her psychological conflicts., Method: Thirty-four mothers consulting an infant-parent outpatient clinic were assessed with respect to depression, anxiety, global functioning, severity of symptoms and the quality of their adaptation to the infant (T1). They were offered a brief PCP with an average of seven sessions. Outcome measures were collected after the end of the therapy (T2)., Results: Overall, 28 of 34 mothers completed the therapy (83%), and 23 participated in the post-therapy evaluation. Paired samples t-tests showed that completers of PCP displayed significant improvement in post-treatment measures of depression (EPDS: t = 5.13; p <0.001), anxiety (STAI-State: t = 3.06; p = 0.006), clinical impression (CGI: n = 21; t = 4.50; p <0.001), and global functioning (GAF: t = -5.05; p <0.001). The quality of adaptation in the infant-parent relationship showed a tendency to improve (PIRGAS: t = -1.98; p = 0.062)., Conclusions: These preliminary results suggested that providing PCP to this sample of consulting mothers is feasible and accompanied by high rate of clinical and functional improvement.

This pilot study explores the effects of a brief individual psychoanalytic therapy on perinatal depressive symptoms. This intervention is based on the Geneva's mother-infant intervention model. A sample of 129 pregnant women was recruited in Geneva (Switzerland) and screened for depressive symptoms with two instruments: the 'Edinburgh postnatal depression scale' (EPDS) and the 'Dépistage anténatal de la dépression postnatale'. A group of 40 women presenting depressive symptoms (treatment group) participated in a four-session intervention called 'Psychotherapy centred on parenthood (PCP)'. It consists in two antenatal and two postnatal sessions and is focussed on changing problematic representations of parenthood. This treatment group was compared to a control group of 88 women without depressive symptoms and following the usual obstetrical care. The main outcome measure was EPDS at 3 and 6 months after delivery. The 'Global assessment functioning scale' was administered at the end of each therapeutic session. The 'Parent-infant relationship global assessment scale' was administered at the two postnatal sessions in order to explore if PCP was also effective in preventing the potential negative effects of depression on mother-infant relationship. Results show that in the treatment group (N = 31), EPDS scores dropped from 12.8 to 4.8; none of these women met the EPDS cut-off score of 12 at 3 and 6 months postpartum. Mother-infant relationship was well adapted for all 31 dyads at the end of the intervention. These results suggest that PCP is a promising intervention for treating perinatal depression and helping mothers engaging in parenting.