The risk of eating disorder relapse during pregnancy and after delivery and postpartum depression among women recovered from eating disorders.

BACKGROUND: Studies have shown that women of reproductive age develop eating disorders (EDs). Few studies have examined EDs in women by performing long-term follow-ups during pregnancy and after delivery. Our study aimed to identify relapse of EDs during pregnancy and after delivery as well as postpartum depression in women who had complete remission of EDs. METHODS: Of the 1008 patients with EDs who visited our outpatient clinic between 1994 and 2004, 55 experienced ED remission and pregnancy. Of these, 25 (21 with BN and 4 with AN) consented to participate in this study. Finally, 24 patients were included in this study after 1 patient was excluded owing to a miscarriage. They were interviewed every 2 weeks both during pregnancy and after giving birth. We used the Eating Attitudes Test-26 (EAT-26) and Edinburgh Postnatal Depression Scale (EPDS) as reference scales for diagnosing the EDs and the postpartum depression, respectively. We used a two-sided unpaired test for the statistical analysis. RESULTS: Sixteen participants (67%) experienced ED relapse during pregnancy and twelve (50%) relapsed after birth. Twelve (50%) had postpartum depression, four of whom (33%) had low-birth-weight infants. Among the participants who did not have postpartum depression, there were no low-body-weight infants. There was no significant difference (p = 0.065) in birth weight between the postpartum depression and non-depression groups. CONCLUSIONS: Our study revealed that recurrence of EDs and the occurrence of postpartum depression were higher in this population, indicating the need to closely monitor EDs both during pregnancy and after birth.

Electroencephalogram abnormalities in panic disorder patients: a study of symptom characteristics and pathology.

BACKGROUND: Since the 1980s, a high EEG abnormality rate has been reported for patients with panic disorder. However, how the EEG abnormalities of panic disorder patients are related to the clinical features and pathology of these patients has yet to be clarified. In this study we investigated whether or not EEG abnormalities are related to the 13 symptoms in the DSM-IV criteria for a diagnosis of panic attacks. METHODS: Subjects were 70 patients diagnosed with panic disorder.Logistic regression analysis was performed with EEG findings as dependent variables and age, sex and with or without the 13 symptoms as independent variables. RESULTS: (1)EEG findings for panic disorder patients with EEG abnormalities: Of the 17 patients, 13 had repeated slow waves in the θ-band; the most prevalent EEG abnormality found in this study. Paroxysmal abnormality interpreted as epileptiform was found in only two cases. (2)Nausea or abdominal distress (37.7% vs 82.45%, OR-12.5), derealization or depersonalization (7.5% vs 47.1%, OR = 13.9,) and paresthesias (43.4% vs 64.7%, OR = 7.9,) were extracted by multivariate analysis as factors related to EEG abnormalities. CONCLUSION: Of the 70 patients studied, 17 had EEG abnormalities. Among these 17 cases, "repeated slow waves in the θ-band" was the most common abnormality. The factors identified as being related to EEG abnormalities are nausea or abdominal distress, derealization or depersonalization, and paresthesias. The study indicated that physiological predispositions are closely related to panic attacks.

Stress and psychological factors before a migraine attack: a time-based analysis.

BACKGROUND: The objective of this study is to examine the stress and mood changes of Japanese subjects over the 1-3 days before a migraine headache. METHODS: The study participants were 16 patients with migraines who consented to participate in this study. Each subject kept a headache diary four times a day for two weeks. They evaluated the number of stressful events, daily hassles, domestic and non-domestic stress, anxiety, depressive tendency and irritability by visual analog scales. The days were classified into migraine days, pre-migraine days, buffer days and control days based on the intensity of the headaches and accompanying symptoms, and a comparative study was conducted for each factor on the migraine days, pre-migraine days and control days. RESULTS: The stressful event value of pre-migraine days showed no significant difference compared to other days. The daily hassle value of pre-migraine days was the highest and was significantly higher than that of buffer days. In non-domestic stress, values on migraine days were significantly higher than on other days, and there was no significant difference between pre-migraine days and buffer days or between pre-migraine days and control days. There was no significant difference in the values of domestic stress between the categories. In non-domestic stress, values on migraine days were significantly higher than other days, and there was no significant difference between pre-migraine days and buffer days or between pre-migraine days and control days.There was little difference in sleep quality on migraine and pre-migraine days, but other psychological factors were higher on migraine days than on pre-migraine days. CONCLUSION: Psychosocial stress preceding the onset of migraines by several days was suggested to play an important role in the occurrence of migraines. However, stress 2-3 days before a migraine attack was not so high as it has been reported to be in the United States and Europe. There was no significant difference in the values of psychological factors between pre-migraine days and other days.

Prevalence of eating disorders: a comparison of Western and non-Western countries.

OBJECTIVE: To compare the prevalence of eating disorders between Western and non-Western countries. METHOD: Potential references were identified through an English-language literature search using Medline and Medscape articles. RESULTS: Prevalence rates in Western countries for anorexia nervosa ranged from 0.1% to 5.7% in female subjects. Prevalence rates for bulimia nervosa ranged from 0% to 2.1% in males and from 0.3% to 7.3% in female subjects in Western countries. Prevalence rates in non-Western countries for bulimia nervosa ranged from 0.46% to 3.2% in female subjects. Studies of eating attitudes indicate abnormal eating attitudes in non-Western countries have been gradually increasing. CONCLUSION: The prevalence of eating disorders in non-Western countries is lower than that of the Western countries but appears to be increasing.

[Job stress among Japan Overseas Cooperation volunteers--using the Brief Job Stress Questionnaire].

Mental health problems have recently increased among Japan Overseas Cooperation volunteers since 1965, when the Ministry of Foreign Affairs (Japan International Cooperation Agency) launched this volunteer work project for improving hygiene and socioeconomic conditions in developing countries. There was little research on job stress among them dispatched despite previous surveys indicating job as an important stressor. To investigate stress and job-related stressors among them, we conducted a cross-sectional epidemiological study from October to December in 2003. The subjects were all 1,084 Japan Overseas Cooperation volunteers aged 20-40, who worked in 67 countries worldwide at the time of this study (485 and 599 males and females, 316, 332 and 436 for those staying overseas for 11, 7 and 4 months, respectively). Approximately 80% were involved in their dispatching occupational organizations as professionals in information technology, health & welfare, education, and research. Our main outcome measure used was the Brief Job Stress Questionnaire, which was developed to assess stress and job-related stressors or buffers for Japanese workers. Demographic and personality (Egogram) characteristics as well as other health information were obtained. The response rate was 86.9%. For psychological stress, prevalence was 5.5% (n = 49). Means (+/- SD) were 4.22 (+/- 3.98), and 4.89 (+/- 4.40) for males and females (p < 0.05), and 5.15 (+/- 4.17), 5.05 (+/- 4.45), 3.93 (+/- 4.40) for those staying overseas for 11, 7 and 4 months (p < 0.01), respectively. For physical stress, prevalence was 2.9% (n = 26). Means (+/- SD) were 1.10 (+/- 1.68), and 1.41 (+/- 1.74) for males and females (p < 0.01), and 1.47 (+/- 1.77), 1.35 (+/- 1.89), 1.11 (+/- 1.55) for those staying overseas for 11, 7 and 4 months (p < 0.05), respectively. The factors significantly associated with psychological stress were high job demand, poor human relationships at work, low job suitability, low social support from supervisors and colleagues, and being dissatisfied with their life, according to multiple logistic regression analysis. The present study suggested that psychological stress was more prevalent than physical. It also implied a significant relationship between psychological stress and job-related stressors among the subjects of this study as in employees in Japan. Mental health check-ups and counseling in the early stage of psychological stress is important from the viewpoint of prevention of developing stress-related mental health disorders. Education on stress-coping skills should be considered in a training program before they are sent overseas.