Antenatal Risk Factors of Postpartum Depression at 20 Weeks Gestation in a Japanese Sample: Psychosocial Perspectives from a Cohort Study in Tokyo.

BACKGROUND: Prevalence of postnatal depression (PND) is high (Western countries, 10-15%; Japan, 17%). PND can cause parenting impairment and affect family health (e.g. child behaviors, cognitive development and physical health). This study aimed to reveal the risk factors of PND during the pregnancy period in a Japanese sample, and to identify the psychosocial risk factors of PND that should be appended to existing obstetric interview sheets. A cohort study with a Japanese sample was conducted. METHODS: All 14 obstetrics hospitals in the Setagaya ward, Tokyo, Japan, participated in this study. Pregnant women who booked their delivery between December 2012 and May 2013 were enrolled. Data used for this study were collected at 20 weeks gestation, a few days and one month postnatal. The questionnaires consisted of psychosocial factors and the Edinburgh Postnatal Depression Scale (EPDS). To identify PND risk factors, multivariate analyses were performed. RESULTS: A total of 1,775 women participated in this study. Eventually, the data of 1,133 women were used for the multivariate analyses. The demonstrated significant risk factors include EPDS score, primipara, "a perceived lack of family cohesion", "current physical illness treatment" and "current psychiatric illness treatment". CONCLUSION: This study highlights the importance of mental health screening using psychological measures during the pregnancy period. In addition, family environment, parity, physical and psychiatric illness should be paid attention by professionals in maternal and child health. The results also suggest that mothers' feelings of developing their families should be supported.

Association of maternal developmental disorder traits with child mistreatment: a prospective study in Japan.

Maternal mental disorders are known risk factors for child mistreatment. However, little is known about the involvement of maternal developmental disorder traits. The aim of this study was to examine maternal traits related to Pervasive Developmental Disorder (PDD) and Attention Deficit Hyperactivity Disorder (ADHD), and their possible association with child mistreatment. Maternal PDD and ADHD were assessed through a self-administered questionnaire (N=846) during mid-pregnancy using the Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS) and Adult ADHD Self-Report Scale (ASRS). The mothers completed another questionnaire on child mistreatment when the offspring was approximately 18 months of age. The associations between maternal PDD and ADHD traits and child mistreatment score were analyzed using linear regression models adjusted for covariates. Mothers who exhibited stronger PDD traits showed significantly higher child mistreatment score, even after adjustment for maternal characteristics at baseline and ADHD traits. At the same time, ADHD traits were significantly associated with child mistreatment after adjustment of covariates, although the association became non-significant after adjustment of PDD traits. Mothers who showed PDD and ADHD traits during pregnancy were more likely to mistreat their children. It is essential to educate mothers with such traits with appropriate, easy-to-follow childcare instructions, preferably in simple language combined with pictorial aids.

Utility of the Kyoto Scale of Psychological Development in cognitive assessment of children with pervasive developmental disorders.

Based on the clinical records of 74 children with pervasive developmental disorders (PDD; mean age, 45.2 months; 62 boys), the utility of the Kyoto Scale of Psychological Development in cognitive assessment of young and/or mentally retarded PDD children was investigated. Because the overall developmental quotient (DQ) had the highest correlation with the IQ (Pearson's r, 0.88) and the Cognitive-Adaptive DQ showed a non-significant difference in mean (65.8) from the IQ (66.4), they both seem useful as an equivalent to an IQ. The test would enable clinicians to carry out continual developmental assessments and to develop appropriate remedial programs for those children from infancy.

Predicting children with pervasive developmental disorders using the Wechsler Intelligence Scale for Children-Third Edition.

An original combination score (i.e. the sum of Vocabulary and Comprehension subtracted from the sum of Block Design and Digit Span) was created from the four Wechsler Intelligence Scale for Children-Third Edition (WISC-III) subtests identified by discriminant analysis on WISC-III data from 139/129 children with/without pervasive developmental disorders (PDD; mean, 8.3/8.1 years) and its utility examined for predicting PDD. Its best cut-off was 2/3, with sensitivity, specificity, positive and negative predictive values of 0.68, 0.61, 0.65 and 0.64, respectively. The score seems useful, so long as clinicians are aware of its limitations and use it only as a supplemental measure in PDD diagnosis.

Association between residents' perception of the neighborhood's environments and walking time in objectively different regions.

OBJECTIVE: The purpose of this study is to delineate the association between residents' perception of the neighborhood's environments and walking time in objectively different regions in Japan. METHODS: Two regions were selected as high and low walkable regions on the basis of differences in their residential density, mixed land use and street connectivity. The subjects in this study were participants in a health promotion program focused on walking sponsored by local governments. A questionnaire was sent to the participants asking about how their perception of the neighborhood's environment related to walking, and the time spent walking per week. There were 237 residents from the high walkable region and 195 from the low walkable region who completed the study survey. RESULTS: The high walkable region had a larger residential density, a high mixed land use and a higher street connectivity than the low walkable region. Walking time, and the scores of the perception of the neighborhood's environment for the high walkable region residents were significantly higher than those for the low walkable region residents. Thus, residents' perception of the neighborhood's environment generally reflected the actual physical environmental characteristics. Residents in the high walkable region whose scores for accessibility and aesthetics were high, spent significantly more walking time. Residents in the low walkable region whose scores for accessibility, safety, convenience and aesthetics were high, spent significantly more walking time. CONCLUSION: The study results suggested that the neighborhood's environment may influence daily walking time. The perceptions of the neighborhood's environmental factors that correlate with walking times differ between the different regional physical environments. Therefore, to promote physical activity, the consideration of environmental factors unique to residents' neighborhood's environments is needed.