Support-seeking behavior among Japanese mothers at high-risk of mental health problems: a community-based study at a city health center

Aim: The aim of this small-scale study is to explore support-seeking behavior among mothers at high-risk of mental health problems on community basis in Japan. Methods: A survey using one month home visit data was conducted among mothers who registered their pregnancy at Shirakawa City Health Center, Fukushima, from April to September 2010. Probable postpartum depression at one month postpartum was assessed using the Japanese version of the Edinburgh Postnatal Depression Scale and the mother's bonding to her child at one month postpartum was measured by the Bonding Questionnaire. Results: A total of 118 out of 217 registered mothers were available for analysis. The proportion of probable depression among first time and experienced mothers was 12% and 3%, and that of low bonding was 43% and 13%, respectively. Factors that showed significant associations with probable depression and/or low-bonding among first-time mothers were financial difficulty, obstetrical problems, unhappy feeling towards pregnancy, younger maternal age, later gestational week at registration; associated factors among experienced mothers were financial difficulty and obstetrical problems. At the time of pregnancy, 35 (90%) of first-time mothers and 22 (31%) of experienced mothers expressed the intention to attend antenatal classes. None of the risk factors for probable depression or low-bonding were associated with the mother's intention to attend antenatal classes in this study. Conclusion: Pregnancy history, obstetrical problems, sociodemographic information and maternal feeling toward pregnancy should be carefully screened in antenatal phase, and those at risk of postpartum mental health problems should be screened and actively invited to antenatal classes

CD4+ T cells in aged or thymectomized recipients of allogeneic stem cell transplantations

BACKGROUND: CD4+CD25highFOXP3+ regulatory T (Treg) cells, which include thymus-derived and peripherally induced cells, play a central role in immune regulation, and are therefore crucial to prevent graft-versus-host disease (GVHD). The increasing use of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for elderly patients with thymus regression, and our case of allo-HSCT shortly after total thymectomy, raised questions about the activity of thymus-derived Treg cells and peripherally induced Treg cells, which are otherwise indistinguishable. RESULTS: We found that despite pre-transplant thymectomy or older age, both naïve and effector Treg cells, as well as naïve and effector conventional T cells, proliferated in allo-HSCT recipients. Higher proportions of total Treg cells 1 month post allo-HSCT, and naïve Treg cells 1 year post allo-HSCT, appeared in patients achieving complete chimera without developing significant chronic GVHD, including our thymectomized patient, compared with patients who developed chronic GVHD. CONCLUSIONS: Treg cells that modulate human allogeneic immunity may arise peripherally as well as in the thymus of allo-HSCT recipients