A study of psycho-social risk factor for postnatal depression-Influences by mother-baby interaction and life events.

我们参加了关于产后抑郁症的欧盟项目(欧洲卫生系统内产后抑郁症的跨文化研究：统一研究方法和促进母子健康)的培训研讨会(Keele 1998，Paris 1998，Tyrol 1999，Florence 2000)，并制定了产后抑郁症的具体定性研究方法(COMEN，SCID-II-PND版本，Path，CSRI-PND，HOME)，并在多中心研究中进行了试点。在这些项目中，我们研究了以下研究：(1)在4个月时使用母婴互动全球评级(GRMII)，我们发现患有产后抑郁的日本母亲与其婴儿之间的互动受到显著影响。(2)通过分析产后抑郁的途径，日本照顾者之间的联系在社区环境中是不够的。(3)CSRI-PND(客户服务收据问卷)显示，日本产后抑郁母亲在公共利益、助产士、家庭医生、初级保健和托儿所方面的支持很少。日本和西方产后抑郁症妇女在获取障碍方面没有差异，但日本母亲的耻辱比例似乎高于西方母亲。(4)主要信息者使用卫生服务研究专业访谈的结果显示，日本社区卫生保健中的心理健康和围产期政策之间的卫生服务存在较大差异。我们将从2001年起与多中心的同一成员一起推进这些阶段的第一阶段和下一阶段项目的第二阶段。

We attended the training workshops (Keele 1998, Paris 1998, Tyrol 1999, Florence 2000) for European Union Project (Transcultural study of postnatal depression (PND) within European Health System : Harmonization of research methods and promotion of mother-child health) of postnatal depression and developed the specific qualitative research methods for postnatal depression (CAME, SCID-II-PND version, Pathway, CSRI-PND, HOME) and piloted them in multi-centre studies. In these projects, we studied the following studies ;(1) Using the Global Rating of Mother-Infant Interaction (GRMII) at four months, we found that the interaction among the Japanese mothers with postnatal depression and their baby was significantly affected.(2) Liaisons among Japanese care providers are inadequate in community settings by analyzing the pathway of postnatal depression.(3) CSRI-PND (Client Service Receipt Inventory) showed that Japanese mother with postnatal depression has few supports in the point of public benefit, midwife, family doctor, primary care and Creche. There are no differences of the barrier to access between Japanese and occidental women with postnatal depression but the percentages of stigma among Japanese mothers seemed to be higher than that of occidental mothers.(4) The results of key informants using the health service research professional interview showed that there is large discrepancies of the health services between the mental health and perinatal policy in Japanese community health care.We are going to progress these Phase I and start the Phase II of next projects with same member of the multi-centres from 2001.