Psychiatric morbidity and elderly offenders

Lovett (2001), commenting on our article ‘Incidence, correlates and predictors of post-traumatic stress disorder in the pregnancy after stillbirth’ (Turton et al, 2001) took issue with our reporting a possible association between post-traumatic stress disorder and holding the dead infant which did not reach statistical significance.

We should like to make two points. First, we were at pains to make it clear that numbers were small and not significant statistically. Second, although your correspondent could not know this at the time of writing, we have subsequently published a paper reporting a significant relationship between seeing the dead infant and disorganisation of mother—infant attachment in the next-born child at the age of 12 months (Hughes et al, 2001). This was an unexpected finding for us.

Our main concern is that a profound change in clinical practice (seeing and holding the dead infant) was introduced with great enthusiasm in maternity units in the UK and elsewhere on the basis of limited and non-systematic clinical observation. Our published findings to date do not offer any evidence in support of this practice. We concur with Dr Lovett that this is an area which demands further investigation and rigorous evaluation.