We examined the prognosis of 90 newborn infants delivered by mothers with psychiatric disorders (excluding epilepsy) at the Obstetrics and Gynecology Department of Shiga University of Medical Science from January 2010 to May 2015. We investigated factors related to NICU admission, onset of neonatal withdrawal syndrome (NWS), and admission to an orphanage. We performed Mann-Whitney U test, Fisher’s exact test for statistical processing. NICU admission was associated with use of tricyclic/tetracyclic antidepressants (P=0.0094), use of anxiolytics (P=0.0157), and the number of concomitant drugs (P<0.0001). NWS was related to maternal age (P=0.0423), use of SSRI (P=0.0023), use of tricyclic/tetracyclic antidepressants (P=0.0372), and the number of concomitant drugs (P=0.0003). The factor related to orphanage admission was self-discontinuation of medication (P=0.0204). In multiple logistic analysis, NICU admission was most closely associated with the number of concomitant drugs (odds ratio 5.862, 95% CI ; 1.784-19.259) and orphanage admission was associated with self-discontinuation of medication (odds ratio 13.12, 95% CI ; 1.078-159.609). In patients with these risks, psychiatric disorders should be adequately controlled before pregnancy, patients should be instructed not to discontinue medication, and relevant healthcare workers (e.g., NICU staff and social workers) should coordinate after delivery.
It is said that the patients’ behavior called “doctor-shopping” is one reason of the recent health care costs increasing. We think that the patient’s communication skill is one reason of “doctor-shopping”, and examined the relation between this skill and Autism Spectrum tendency which affects communication.
The method is suggested by “Score of Indefinite Complaints” (below SIC) in our department. SIC is constituted from four points of ‘the characteristics of the patients with Autism Spectrum including interviews’ showed by Honda, and they were scored and compared. They were (1) need for structured sight (use of drawings or prints; below ‘sight’), (2) saying same repetition (below ‘repeat’) (3) deviation in conversation (below ‘deviation’), (4) localized or patterned thought, action and etc. (below ‘localization’). This subject is the 92 first female outpatient of our department from 9/1/2013 to 6/30/2017.
About the management term in our outpatient after their first coming, there was no significant difference in the numbers of other hospitals where they consulted before coming to our hospital and the numbers of their complaints, but were in aging, without SIC. Following on the SIC, there were four points in this examination, so it was suggested that doctors and patients would be able to understand both sides by using them. They were (1) the prints using Gothic font, in ‘sight’ (2) continuing the conversation using question, in ‘repeat’ and ‘deviation’ (3) changes in dress or talking etc. when they were getting better, in ‘localization’ (4) potentially higher total point of SIC, without regard to age, disease duration and number of complaints, is not good at communication faculty, so we are needed to listen carefully to complaints of patients and required attention to the understanding of the description of the doctors. We think that if doctors consider and devise medical methods along patients more, it is possible to build relationship both them. Therefore, we will be able to decrease in “doctor-shopping”, and control health care costs increasing.
Women who suffer from menstruation-related symptoms need to be supported not only by medical treatment but also by psychosocial support in order to live their lives to their fullest extent. Therefore this study developed a method to assess this psychological suffering. 318 women aged 20 to 39 years old completed an original version of a scale designed to assess psychological sufferings in menstruation-related symptoms (PSMS). A factor analysis indicated two contributing factors ; one consisting of 12 items of “a feeling of being out of control” and the other of 8 items of “a feeling of obscurity.” The Cronbach’s α coefficient of each factor of the PSMS scale had a high internal consistency. The PSMS scale correlated significantly with the Menstrual Distress Questionnaire (MDQ) and PMS-Impact Questionnaire. The scale was expected to have a high level of reliability and validity. The result of a multiple regression analysis shows that women who feel changes during their premenstrual period have greater psychological suffering than women who do not feel changes until their menstrual period has begun. The PSMS scale is expected to become a standard for assessing the effects of psychological interventions to support the well-being of women suffering from menstruation-related symptoms.
The aim of this study was to measure the effects of baby massage sessions performed by mothers for their infants, using the physiological and psychological indicators, and evaluate the stress relief effects for both mother and infant. The study was conducted for 18 pairs of mothers and infants who attended the massage classes. Saliva was collected from both mother and infant before starting the massage, and 30 and 60 min after the massage. Psychological aspects were assessed from the mother side using the short form of POMS. As a result, significant decrease in the salivary cortisol levels was observed 60 min after the massage sessions in infants when compared with those observed before the sessions (p=.005). On the other hand, as for mothers, cortisol concentrations in saliva significantly increased 30 min after the massage sessions compared with those observed before the sessions (p=.008), but there was no significant difference between 60 min after the massage sessions and those observed before the sessions. The mothers’ POMS scores significantly decreased 30 min after the sessions for low orders of the scales “tension-anxiety”, “fatigue”, and “confusion” (p<.05). The results demonstrate that infants got relief from stresses and mothers’ mood states improved by a massage given by mother to infant.