Hitoshi Kaneko

Numerous studies have been conducted regarding maternal bonding; however, there is a lack of studies investigating the association with unintended pregnancy. This study aimed to examine the effects of unintended pregnancy on maternal bonding using a longitudinal design from pregnancy to one month postpartum. Participants were 78 mothers who attended the Department of Obstetrics for prenatal care at 20.5 weeks of gestational age. They responded to the Postpartum Bonding Questionnaire (PBQ) and the Edinburgh Postnatal Depression Scale (EPDS). Furthermore, we asked whether the pregnancy was unintended. At one month postpartum, they responded to the questionnaires again. We performed two-way repeated-measures analysis of variance to assess the effect of group (unintended pregnancy or intended pregnancy) and time (during pregnancy or one month postpartum) on the PBQ and EPDS scores. Mothers who had unintended pregnancies had significantly impaired maternal bonding compared to expected pregnancy mothers, both during pregnancy and one month postpartum. In addition, both unintended and expected pregnancy mothers had significantly decreased impaired maternal bonding at one month postpartum. Regarding depression, mothers with unintended pregnancy had significantly higher EPDS scores than mothers with expected pregnancy, both during pregnancy and one month postpartum. Our findings emphasize that healthcare providers should promptly identify mothers with unintended pregnancies and conduct thorough assessments of mother-infant interactions postpartum.

Background/Objectives: Although numerous investigations have been conducted on postpartum depression, studies on the association between postpartum depression and personality traits of mothers and fathers are lacking. This study aimed to examine the association between postpartum depression and the Big Five personality models among Japanese mothers and fathers at one-month health check-ups. Methods: The participants were 82 couples, and they responded to the Edinburgh Postnatal Depression Scale (EPDS), the Japanese version of the Ten-Item Personality Inventory, and the Quality of Marriage Index (QMI). We examined the correlations among variables and analyzed the data using structural equation modeling (SEM). Results: Maternal neuroticism was significantly associated with maternal depression (β = 0.50, p < 0.001), and maternal extraversion was significantly associated with paternal depression (β = −0.64, p < 0.001). In addition, we found that maternal postpartum depression was associated with maternal marital satisfaction (r = −0.29, p = 0.037); however, this association disappeared in SEM. Conclusions: Our findings suggest that health practitioners should pay attention to depression and personality traits in both postpartum mothers and fathers. Moreover, we should consider the different associations between depression and personality in parents when initiating interventions.

The unmet need for mental health care is a global concern. There is a lack of cross-cultural studies examining adolescent help-seeking behavior from both formal and informal sources, including both high-and lower-income countries. This study investigates mental health help-seeking behavior in eight Asian and European countries. Data from 13,184 adolescents aged 13–15 (51% girls) was analysed using mixed-effects logistic regression with school-wise random intercepts to compare countries and genders. Although a significant proportion of adolescents considered getting or sought informal help, formal help-seeking remained exceptionally low, especially in middle-income countries (< 1%), while it ranged from 2 to 7% in high-income countries. Among adolescents with high emotional and behavioral problems (scoring above the 90th percentile on the Strengths and Difficulties Questionnaire), 1–2% of those in middle-income countries and 6–25% of those in high-income countries sought formal help. Girls generally seek more help than boys. The study shows the most adolescents do not receive formal help for mental health problems. The unmet need gap is enormous, especially in lower-income countries. Informal sources of support, including relatives, peers, and teachers, play a crucial role, especially in lower-income countries.

This study examined associations between self‐reported mental health problems, body image, bullying victimisation and school safety in large adolescent samples in Japan and Russia, considering the effects of gender, culture and their interactions. In both Japan and Russia, girls reported a greater number of mental health problems, less bullying victimisation and much higher body dissatisfaction than boys did. Japanese adolescents rated themselves higher on total difficulties, reported less body dissatisfaction and bullying victimisation, and rated their school safety lower than that of Russian youths. Cross‐cultural differences in total difficulties and body image were qualified by gender. Body dissatisfaction, bullying victimisation and school safety all independently contributed to adolescent mental health problems. The protective effect of school safety on total difficulties was larger for girls than for boys; the strength of the association between bullying victimisation and adolescent mental health problems differed across genders and cultures. The findings indicate a need for a cross‐cultural approach and provide a strong basis for targeted interventions that seek to improve adolescent mental health.

Introduction: Despite the high proportion of children and adolescents living in low‐ and middle‐income countries, 95% of all specialized child and adolescent mental health resources are located in high‐income countries. To strengthen child and adolescent mental health services (CAMHS), first it is necessary to complete an assessment of the available services and training programs to determine what is needed, particularly in regions with young populations, such as Southeast Europe, the Far East, and the Middle East. The aim of this article is to compare the status of child and adolescent psychiatry (CAP) training programs and the workforce in CAMHS in three geographical regions, to identify similar problems, highlight success stories, and to make recommendations for future studies.Methods: This study compared CAP training programs and CAMHS workforce using the World Psychiatric Association, CAP Section's regional studies data.Results: This study included data from 44 countries: 18 countries in the Far East, 15 countries in the Middle East, and 11 countries in Southeast Europe. There were significant differences both within, and between, the three included regions with regards to availability and infrastructure of CAP training programs. Besides Greece, all included countries reported the need for more child and adolescent psychiatrists and allied child and adolescent mental health professionals.Discussion: There is an urgent need for more qualified child and adolescent psychiatrists and allied professionals in a very large group of countries in three different geographic regions with great differences in religion, culture, and economy.

Background: Frailty has been associated with a risk of adverse outcomes, and mortality in patients with various conditions. However, there have been few studies on whether or not frailty is associated with mortality in patients with accidental hypothermia (AH). In this study, we aim to determine this association in patients with AH using Japan’s nationwide registry data. Methods: The data from the Hypothermia STUDY 2018&19, which included patients of ≥18 years of age with a body temperature of ≤35 °C, were obtained from a multicenter registry for AH conducted at 120 institutions throughout Japan, collected from December 2018 to February 2019 and December 2019 to February 2020. The clinical frailty scale (CFS) score was used to determine the presence and degree of frailty. The primary outcome was the comparison of mortality between the frail and non-frail patient groups. Results: In total, 1363 patients were included in the study, of which 920 were eligible for the analysis. The 920 patients were divided into the frail patient group (N = 221) and non-frail patient group (N = 699). After 30-days of hospitalization, 32.6% of frail patients and 20.6% of non-frail patients had died (p < 0.001). Frail patients had a significantly higher risk of 90-day mortality (Hazard ratio [HR], 1.64; 95% confidence interval [CI], 1.25–2.17; p < 0.001). Based on the Cox proportional hazards analysis using multiple imputation, after adjustment for age, potassium level, lactate level, pH value, sex, CPK level, heart rate, platelet count, location of hypothermia incidence, and rate of tracheal intubation, the HR was 1.69 (95% CI, 1.25–2.29; p < 0.001). Conclusions: This study showed that frailty was associated with mortality in patients with AH. Preventive interventions for frailty may help to avoid death caused by AH.

Impaired maternal bonding has been associated with antenatal and postnatal factors, especially postpartum depression. Only a few population-based, longitudinal studies have examined the association between maternal depression and bonding in outside western countries. In addition, little is known about the association between psychosocial factors during pregnancy and impaired maternal bonding. The aim of this study was to investigate risk factors associated with impaired maternal bonding 3 months after delivery using Japanese population-based, longitudinal study from pregnancy period to 3 months after delivery. This study was performed at the public health care center in Hekinan city, Aichi prefecture, Japan. Mothers who participated the infant’s health check-up 3 months after delivery from July 2013 to Jun 2015 completed the Postpartum Bonding Questionnaire (PBQ) and the Edinburgh Postnatal Depression Scale (EPDS) 1 month after delivery. Information was also provided from home visit at 1 month after delivery, birth registration form, and pregnancy notification form. The study included 1060 mothers with a mean age of 29.90 years, who had given birth at a mean of 38.95 weeks. Bivariate and multivariate logistic regression analyses were conducted to identify the association between antenatal and postnatal factors and impaired maternal bonding. The main findings were that maternal negative feelings about pregnancy (OR = 2.16, 95% CI = 1.02–4.56) and postpartum depression at 1 month after delivery (OR = 7.85, 95% CI = 3.44–17.90) were associated with higher levels of impaired maternal bonding 1 months after delivery. Mothers who had delivered their first child had increased odds of a moderate level of impaired maternal bonding 3 months after delivery (OR = 1.85, 95% CI = 1.22–2.81). The findings emphasize the importance of identifying mothers with depression and those with maternal negative feelings towards pregnancy to assess possible impaired maternal bonding.

This nationwide population-based register study examined the family and parental risk factors associated with offspring reactive attachment disorder (RAD). We identified 614 children diagnosed with RAD from the Finnish Care Register for Health Care and each case was matched with four controls. Univariate and multivariate models examined the associations between risk factors and RAD. In the multivariate model, offspring RAD was associated with only mother, only father and both parents having psychiatric diagnoses. Increased odds were observed for maternal smoking during pregnancy, single motherhood and paternal age ≥ 45 years. This study provides information on several parental adversities and offspring RAD that have important implications for public health, when planning early prevention and interventions in infant mental health.