Kaori WATANABE's research while affiliated with The University of Shiga Prefecture and other places

Postpartum depression (PPD) is a common condition and may be exacerbated unless treated. There is, however, a lack of longitudinal studies about the relationship between PPD and changes in physiological status and social role postpartum. We enrolled longitudinally 65 Japanese mothers (36 primiparas) and measured their psychological responses at 1 week, 1 month, and 4 months postpartum. The physiological indicators were three urine catecholamine fraction levels, cortisol levels, and heart-rate variability. We used the Edinburgh Postnatal Depression Scale (EPDS) and 28-item General Health Questionnaire (GHQ) for psychological evaluation. Eleven participants had an EPDS score ≥9 (cutoff point) at 1 month and five at 4 months. With GHQ total score, 32 participants had ≥6 (cutoff point) at 1 month and 17 at 4 months. The psychological indicators underwent change from childbirth to 4 months postpartum. However, there was no correlation between the psychological and physiological indicators. We likewise found EPDS and GHQ scores were not influenced by parity or undertaking of social activities. The mothers׳ high education level may mean that the results are not generalizable to Japan overall. We were unable to evaluate the status of 11 mothers who dropped out. The participants may have lacked sufficient time to complete questionnaires, resulting in diminished accuracy. We could not determine the prevalence of PPD. Irrespective of parity status, postpartum mothers showed physiological and mental changes caused by childrearing-related stress. To prevent PPD, postnatal mothers need continuous screening with appropriate evaluating indicators and individualized advice. Copyright © 2015 Elsevier B.V. All rights reserved.

The purpose of this study is to organize and review the relationship among the evaluation methods of physiological evaluation indicators, psychological evaluation indicators and social evaluation indicators of the stress reaction of mothers during the time of infant rearing using previous studies as data. Regarding the research method, a keywords search was conducted in three stages. The words at the first stage were, "Infant-Rearing", "Maternal" and "Postpartum", at the second stage were, "Anxiety" and "Depression" and at the third stage were, "Autonomic", "Hormone", "Immunity" and "Oxidative stress marker" using "Japana Centra Revuo Medicina Web version 4" and "Pub Med" for the years 2000 to 2010 (through the end of September). The subjects of analysis were a total of twenty six pieces of literature consisting of eight domestic articles and eighteen foreign articles. We analyzed the subject literature in relation to "subject person", "time of study", "kind of evaluation indicators", and "physiological evaluation indicators", "psychological evaluation indicators" and "social evaluation indicators". As a result, cortisol was the most common physiological evaluation indicator and the most common specimens were blood, salvia and urine. Also, although there were common reports indicating cortisol is positively associated with a psychological negative response, there were results with a slightly different indication and a report showing a non-direct relationship. Moreover, each report indicated a different result in regard to dopamine, thyroid hormone, ovarian hormone and S-IgA. As stated above, it is suggested that it is necessary to perform a cross-discipline study from physiological・psychological・social viewpoints using the most appropriate evaluation indicators for studying maternal stress reaction during the time of infant rearing.

The aim of the present study was to clarify the relationship of menstrual symptoms with menstruation support function and self care in order to obtain suggestions regarding the acquisition of self care skills for reducing menstrual symptoms in university female students. The modified Japanese version of the Menstrual Distress Questionnaire (MMDQ) was conducted on female university students regarding menstrual symptoms, menstruation support function and self care, and valid responses from 187 students were analyzed. Based on the results of exploratory factor analysis, reliability coefficient and confirmatory factor analysis regarding menstruation support function, 4 factors and 10 items were extracted, overall internal consistency was confirmed, the model showed high goodness of fit and construct validity was also confirmed. Comparison of the implementation or absence of self care and MMDQ scores revealed that students using analgesics had significantly higher scores on the MMDQ. Comparison of the implementation or absence of self care and menstruation support function revealed significantly higher support scores for students implementing self care in the six extracted items, while scores for students who simply tolerated symptoms were significantly lower. These findings suggest the need for an educational system that includes menstruation support in order to encourage students to perform self care.