Three major symptoms of perimenopausal syndrome are vasomotor, psychiatric, and physical symptoms. While hot flashes are most commonly seen, we also often encounter psychiatric symptoms, such as insomnia, anxiety, and depression. We review the combination effect of hormone replacement therapy (HRT) and antidepressants (AD) for the treatment of perimenopausal depression (newly onset depression during the perimenopausal period). We conducted a literature search using PubMed, and found numerous articles about the effect of HRT and AD for treatment of hot flashes. However, we found a very small number of articles about the effect of HRT and AD for perimenopausal depression, and most of them were single arm trials of HRT or AD. We discovered only nine articles of HRT/AD combination therapy. The outcomes were inconsistent, and the effect of HRT/AD combination therapy for perimenopausal depression remains unclear. We discussed the challenges in assessment of severity, process, diagnosis of perimenopausal depression, and dropout due to side effects. Furthermore, we notified the needs of collaboration between gynecologists and psychiatrists. To obtain sufficient reliable data for perimanopausal depression, further investigation will be needed through multidisciplinary cooperation.

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The objective of this study was to investigate the psychological support needs of rheumatoid arthritis (RA) patients and to design a psychological support program. The subjects were 20 RA patients (18 women, 2 men) who were receiving medical treatment. Semi-structured interviews were conducted, and verbatim transcriptions of the interviews were prepared and analyzed by the grounded theory approach. Most of the subjects required telephone counseling, RA-related websites, e-mail counseling, individual in-person counseling, psychoeducation, and participation in a self-help group. The creation of a comprehensive support program by a team consisting of a physician, nurse, and clinical psychologist may improve the quality of life (QOL) of RA patients. Psychoeducation programs required when a definite diagnosis has been made may include : 1) a detailed explanation of RA, 2) physical care, 3) psychological care, and 4) advice in regard to recuperation, and psycho-education programs required at the start of biological drug treatment may incude : 1) a detailed explanation of the effects and side effects, 2) self injection, 3) cost, and 4) anxiety and expectation in regard to biological drugs. Psychoeducation programs required for family members may include : 1) lectures on RA, 2) mental health of RA patients, and 3) mental care for family members. Moreover, a comprehensive support program based on dialectical behavior therapy may be effective as a psycho-logical care model for RA patients, and may contribute to the effectiveness of treat to target.

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This study aims to clarify the social disadvantage experienced by educationally deprived women who gave birth upon graduating junior high school, and to evaluate the subsequent impact and long-term persistence of social disadvantage. A sample of two women was interviewed about the difficulties they face, and support they obtained, which highlighted three period of social disadvantage : a perinatal period ; a pre-work childcare period ; and a childcare period while working. In the third period they're likely to be employed for the first time in their lives, when their working conditions connect directly with their living conditions. It was found that social support, advice, financial assistance, childcare support, etc., can check adverse influences on their lives when working. Thus it is necessary to provide a comprehensive support plan for all three periods after pregnancy is reported, providing continuous, unbroken support covering health, medical treatment, welfare, education, living conditions, and employment.

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