The purpose of this study is to show the correlation between the present social support offered to mothers of handicapped children and their mental health, particularly, depressive tendency. The subjects were 169 mothers whose handicapped children attended G Hospital & Home for Handicapped Children. They were asked to fill out questionnaires about social support and mental health. The result showed that, concerning their children's handicaps, 46 mothers had experineces of being blamed by their husbands or other people, and 76 mothers always or sometimes blamed themselves. The average THI-D score of these mothers was significantly higher than that of other mothers' (p<0.01). Much more social support for mothers was given by their hasbands, and by their parents, brothers and sisters, or other relatives. The mothers' depressive tendency correlated with the social support by their hasbands and mothers' blaming themselves (each, β=-0.304, p<0.01; P=0.284, p<0.01).

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The purpose of this study was to translate Lederman's Prenatal Self-Evaluation Questionnaire (PSEQ) into Japanese (J-PSEQ), and to analyze reliability and validity of this instrument. The PSEQ is a questionnaire consisting of 79 items, and is composed of seven subscales (Concern for Well-Being of Self and Baby, Acceptance of Pregnancy, Identification of a Motherhood Role, Preparation for Labor, Fear of Pain, Helplessness, Loss of Control, Relationship with Mother, and Relationship with Husband), which measures the psychosocial adaptive state during the gravid period. The subjects of this study were normal and low-risk primigravidas (n=188) and multigravidas (n=142) during pregnancy. As a result, reliability coefficients (Cronbach's alpha) of the seven subscales were 0.75 to 0.85, and reliability by the internal consistency was confirmed. Pearson correlation coefficients between each subscale and State-Trait Anxiety Inventory (STAI) Form-Y were r=0.37〜0.64 (State, p<0.001) and r=0.35〜0.62 (Trait, p<0.001), and the criterion-related validity was confirmed. In addition, as a result of the item analysis of each subscale to improve the utility of the scale, 71 items were adopted.

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Sociocultural stress factors in perimenopausal women with undefined symptoms were analyzed. A total of 475 perimenopausal women were enrolled in the study. Several sociocultural stress factors were found to affect 70.1% of them. Fifty-five percent of the patients recognized problems related to health, work and human associations in the office as causes of stress. In addition, 26.9% of them recognized problems with their spouse as causes of stress. Problems related to parents (10.9%) and children (13.9%) were also relatively common stress factors for perimenopausal women. Furthermore, overlap of several stress factors were observed in 23.1% of the subjects. On the other hand, some factors were found to be higher in incidence (1997-2000) than previously (1994-1996). Factors for which incidence was significantly increased were as follows : concern worry about work responsibilities and human association in their office (2.33-fold), relationship with their spouse (1.77-fold), worry about life manners and the outlook of their children (2.21-fold), and concern over sickness and care of their parents (1.89-fold). This study suggests that many sociocultural stress factors are related to the onset of ill-defined symptoms in perimenopausal women, and that coping with stress should be included in psychological treatment in climacteric medicine.

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In this study, we investigated in detail the social circumstances, personality and source of worry of 111 patients with panic disorder seen in the Gynecological Outpatient clinic. 1) The incidence of women who had undergone surgical operation was 41.8%. Sixty-six percent of such women had undergone gynecological operation. 2) Occurence of loss had been experience by 22.5% of the patients. About 90% of those lost were men. 3) There was difficult in relationship with spouse for 38.1% of patients. 4) Alexithymic personality traits which included those of borderline cases and N type on the egogram check list were found in 67.5% and 45.0% of the patients, respectively. 5) Only 26.3% of the patients had no life event which was thought to be the cause of onset of panic disorder. Health problems (20.2%), difficulties in relationship with family member (s) (14.1%), and concerning regarding medical treatment (10.1%) were causes of worry closely associated with panic disorder. These results suggest that personality traits, past medical history, and sociological factors including life events may be responsible for the onset of panic disorder. Therefore, patients with panic disorder should be treated psychosomatically taking into consideration the sociocultural and psychological factors affecting each individual.

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The aim of this study was to evaluate clinical features at the onset and course of panic disorder in women. We examined 111 patients who visited the Women's outpatient mind-body clinic of Osaka Medical College Hospital and were diagnosed with panic disorder according to DSM-IV. Symptoms, panic attacks, agoraphobia associated with panic disorder and the timing of the first visit to the Outpatient clinic were investigated. 1) Physical symptoms such as palpitations (64.6%), numbness (30.3%), dizziness (22.2%), and psychological symptoms such as fear of dying (16.2%) commonly occurred in the first panic attack. Agoraphobia was observed in 57.7% of cases, with 20.7% unable to go outside. These patients were considered to have a lower quality of life as a result of behavioral limitations in daily life. 2) Fifty-seven of the patients (62.6%) had experienced 2 to 5 panic attacks prior to their first visit to the Outpatient clinic. Fifteen (16.5%) had experienced over 10 panic attacks prior to their first visit. 3) We observed doctor-shopping by 56.6% of patients, and 28.3% of patients had visited an emergency hospital. 4) It was observed that 36.0% and 21.6% of patients first visited the Outpatient clinic when depressive mood or hypochondriasis gradually increased and fear of anxiety gradually increased, respectively. This study revealed that patients with panic disorder commonly engaged in doctor-shopping or visited emergency hospitals. Furthermore, it was found that they tended to tolerate their symptoms without medication until fear of anxiety, depressive mood or hypochondriasis increased. These findings suggest that panic disorder should be diagnosed in the early stage and that patients should be treated psychosomaticaly.

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Sleep disorders that occur around the time of menopause are the main symptoms of climacteric syndrome, as well as being an effect of aging. The main cause of this problem is yet to be determined. We have therefore studied the frequency and severity of sleep disorders, using subjective rating scales correlated with other symptoms, and have assessed the effectiveness of hormone replacement therapy (HRT) by menopausal index and sleep log. We examined 275 patients, 77 with climacteric syndrome (C group : age range 46-55, mean 51.3 years), and 198 general gynecology patients with nonmenopausal symptoms (N group : age range 45-57, mean 52.7 years). The results were as follows: 1) In the C group, 37.8% of the patients had difficulty going to sleep (DCS) and 36.0% had difficulty staying asleep (DSA). In the N group, these figures were 12.4% and 10.4%, respectively. The number of patients affected was significantly higher in the C group than in the N group (p<0.001). These sleep disorders were found to be characteristic symptoms of climacteric syndrome. 2) There was a strong correlation (r>0.5) between the symptom of DCS and those of DSA, nervousness, irritability, melancholia, headache and palpitation call symptoms of menopause. There was a similar correlation between DSA and the symptoms of melancholia, nervousness and irritability. 3) HRT caused a marked improvement in those patients suffering from DCS (p<0.001) and DSA (p<0.005). 4) The sleep log evaluation showed that the ratio of deep sleep to total time in bed in the C group was significantly small (vs. N group) and the patients felt less refreshed for their sleep. In the C group, HRT caused an improvement sleep quality so that it equalled that of the N group. These results suggest that the main changes in the sleep patterns of menopausal women are linked to the rapid endocrinological changes of peri and post-menopause, in the same way as vasomotor symptoms such as, for example, hot flushes.

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The sleep disorder associated with pregnancy usually is biphasic, which typically begins with excessive sleepiness and develop to severe insomnia. The purpose of this study is to investigate into actual circumstances about sleep health, habits and symptoms of sleep disorders in pregnancy. Normal pregnant women (n=364, 29.7±4.2 years old) and healthy non-pregnant women (n=194,34.0±4.2 years old) living in the same area were asked the sleep-health used self-reported questionnaire with informed consent. There was no difference for sleep onset time between pregnant and non-pregnant women. Delayed rising time and prolonged sleep length in all trimesters of pregnancy were shown. The sleep maintenance and sleep initiating were disturbed in pregnant women. The prevalence of possible restless legs syndrome/possible periodic limb movement disorder was highest in 2 nd trimester (9.0%), however lower than it in the report of USA. Sleep bruxism was shown the highest prevalence in 1st trsis gravidarum disturbed sleep maintenance, sleep initiating and caused the deteriorated waking-up. This study showed that sleep was disturbed in 1 st trimester of pregnancy with high psychological anxiety, hyperemesis gravidarum. It was also suggested that the symptoms caused difficulty of sleep initiating, i. e. possible restless legs syndrome/possible periodic limb movement disorder, were appeared during all trimesters of pregnancy.imester. The prevalence of nocturnal leg cramps increased in pregnant women significantly. Hypereme

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Delivery and subsequent child care are major development processes during which a woman becomes a mother. Therefore, we followed up 323 couples (55.5%) of parents 1, 10, and 18 months after childbirth for changes in the mother's consciousness and effects of factors of the father in primiparas and multiparas. The total score of mother's consciousness was highest 1 month after birth and decreased significantly after 10 and 18 months in both the primiparas and multiparas. In the primiparas, the score of mother's consciousness was lower 1 month after childbirth but became significantly higher after 10 and 18 months than in the multiparas. The total score of the couple relationship decreased with time. It was higher in the primiparas than in the multiparas, and the differences were significant 1 and 18 months after childbirth. No change was observed in the scores of non-depression, sexrole orientation, and self-esteem among the 3 investigation points. In the fathers, the father's consciousness increased significantly. Although their housework decreased after childbirth, the score of child care by the father increased after 10 months and decreased after 18 months. High mother's consciousness was closely correlated with high non-depression, high self-esteem, good couple relationship, and high father's consciousness. The results in the multiparas were similar to those in the primiparas. These results suggest that depression and self-esteem of the mother, couple relationship, and involvement of the father in child care promote the development of the mother's consciousness.

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