Children with special health care needs and mothers' anxiety/depression: Findings from the Tokyo Teen Cohort study.

AIM: Children with special health care needs (CSHCN) are those who require more care for their physical, developmental, or emotional differences than their typically developing peers. Among a wide range of burdens that caregivers of CSHCN experience, the mental burden of caregivers is still not well investigated. This study aimed at examining the relationship between caring for CSHCN and mothers' anxiety/depression. METHODS: This study used data from the Tokyo Early Adolescence Survey, a population-based cross-sectional survey. Using screening questionnaires, we evaluated the prevalence of CSHCN and identified their primary caregivers. Focusing on mothers as caregivers, we analyzed the relationship between having CSHCN and mothers' anxiety/depression, and between the severity of children's condition and mothers' anxiety/depression. We further determined what mediates these relationships using path analyses. RESULTS: Among 4003 participants, we identified 502 CSHCN (12.5%), and 93% of responding caregivers were mothers. We found that mothers with CSHCN were significantly more anxious/depressed than those without CSHCN, which was closely related to the severity of children's condition. The mediation effect of social support on the relation between CSHCN and mothers' anxiety/depression was statistically significant. CONCLUSION: Mothers of CSHCN were more anxious/depressed than other mothers in this study. Social support was indicated to have a significant mediating effect on the relationship between CSHCN and mothers' anxiety/depression. Our results suggest that considering ways to offer social support may effectively relieve the mental stress experienced by mothers of CSHCN.

Changes in Sensory Phenomena, Tics, Obsessive-Compulsive Symptoms, and Global Functioning of Tourette Syndrome: A Follow-Up After Four Years.

Sensory phenomena and related features of Tourette syndrome are related to poorer quality of life. Therefore, sensory phenomena might also have a negative impact on global functioning. However, the influence of sensory phenomena, tics, and obsessive-compulsive symptoms (OCS) on global functioning after several years of usual treatment has not been investigated. Twenty out of 45 Japanese patients with Tourette syndrome who had previously undergone an evaluation of these clinical features were assessed again after an average of four years. We conducted a panel of assessments for premonitory urges, broader sensory phenomena, tic severity, OCS, and global functioning. Based on Pearson's correlation coefficient, current global functioning was significantly negatively correlated with previous tics and marginally negatively correlated with previous broader sensory phenomena. Current global functioning was marginally correlated with change in tics. Change in global functioning was significantly correlated with change in OCS and marginally correlated with change in premonitory urges. Due to the small sample size, it was not possible to use a multiple regression analysis to conclude that sensory phenomena, tics, and OCS predict global functioning in adolescents and adults with TS. However, it was suggested that further investigation of this relationship would be meaningful.