Takeo Fujiwara

Association of childhood adversities with the first onset of mental disorders in Japan: Results from the World Mental Health Japan, 2002–2004

It is well known that childhood adversities (CAs) are a significant risk factor for mental disorders in later life. However, it is uncertain whether a similar association between CAs and mental disorders can be found in Japan. Few studies have employed an appropriate statistical model that takes into account the high comorbidity of CAs. The purpose of this study is to elucidate the association between CAs and the onset of mental disorders in Japan. We used the data from the World Mental Health Japan, 2002-2004 (n=1722). Respondents completed diagnostic interviews (the World Health Organization Composite International Diagnostic Interview) that assessed lifetime prevalence of 15 Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV) disorders. Associations of 12 retrospectively reported CAs with the lifetime prevalence of mental disorders were estimated using discrete-time survival analysis. Of the study sample, 32% reported as having experienced at least 1 CA during childhood. The studied CAs were highly comorbid. Parental mental illness showed significant sub-additive effects. The presence of 3 CAs showed a significant interactive effect on any mental health disorder. The number of CAs had a strong interactive effect on the onset of anxiety disorders. Predictive effects of CAs were found only among childhood onset mental disorders. It was confirmed that CAs are one of predictors of the onset of DSM-IV mental disorders, especially during childhood, in Japan.

Association of socioeconomic status in childhood with major depression and generalized anxiety disorder: results from the World Mental Health Japan survey 2002–2006

BackgroundLow socioeconomic status (SES) in childhood is known to be a significant risk factor for mental disorders in Western societies. The purpose of this study was to investigate whether a similar association exists in Japan.MethodsWe used data from the World Mental Health Japan Survey conducted from 2002–2006 (weighted N = 1,682). Respondents completed diagnostic interviews that assessed lifetime prevalence of major depression (MD) and generalized anxiety disorder (GAD), as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Associations between parental education (a proxy of SES in childhood) and lifetime onset of both disorders were estimated and stratified by gender using discrete-time survival analysis.ResultsAmong women, high parental education was positively associated with MD (odds ratio [OR]: 1.81, 95% confidence interval [CI]: 1.03-3.18) in comparison with low parental education, even after adjustment for age, childhood characteristics, and SES in adulthood. This same effect was not found for men. In contrast, higher parental education was associated with GAD (OR: 6.84, 95% CI: 1.62-28.94) in comparison with low parental education among men, but this association was not found among the women, in the fully adjusted model.ConclusionsIn Japan, childhood SES is likely to be positively associated with the lifetime onset of mental disorders, regardless of family history of mental disorders, childhood physical illness, or SES in adulthood. Further study is required to replicate the current findings and elucidate the mechanism of the positive association between mental disorders and childhood SES.

Racial differences in eosinophilic gastrointestinal disorders among Caucasian and Asian

BACKGROUND Although there is an increasing number of eosinophilic gastrointestinal disorders (EGID) cases including eosinophilic esophagitis (EoE) and eosinophilic gastroenteritis (EGE), being reported globally, no systematic reviews have been conducted to elucidate the racial differences in these disorders. We aimed to show the racial differences, especially among Caucasians and Asians, in the risk of EoE and EGE. METHODS We conducted a systematic review using PubMed in September 2012. All case reports and case series on EGID that involved human subjects and described race or ethnicity, as well as pathological findings, were included. For the comparison of reported cases between Caucasians and Asians, a chi-squared test was used. RESULTS Among the 687 studies found in PubMed, 121 studies fulfilled the eligibility criteria. In total, 2621 patients were reviewed. Among Caucasian EGID patients, 94% had EoE; while among Asian EGID patients, 72% had EGE (p < 0.001). Among EoE, Asians were significantly less likely to have dysphagia and heartburn, but more likely to have vomit and abdominal pain, compared to Caucasians (p < 0.001). Further, among EGE, Asians were significantly more likely to have eosinophil-infiltrated colon than Caucasians (OR: 3.22, 95% confidence interval [CI]: 1.60-7.04), but were less likely to have eosinophil-infiltrated stomach (OR: 0.29, 95% CI: 0.17-0.49). CONCLUSIONS We found that EoE occurs more frequently in Caucasian EGID patients than Asian EGID patients, while the reverse is true for EGE. Also, racial disparities in symptoms and eosinophil-infiltrated tissues were observed. Our findings suggest further genetic and environmental studies to elucidate the etiology of EGID.

Self-Reported Prevalence and Risk Factors for Shaking and Smothering Among Mothers of 4-Month-Old Infants in Japan

BACKGROUND To estimate the prevalence of shaking and smothering and to determine risk factors in a population-based sample of mothers with 4-month-old infants in Japan. METHODS We administered a questionnaire to women who participated in a 4-month health checkup program in Aichi Prefecture, Japan (n = 6487; valid response rate, 66.8%), and assessed frequency of shaking and smothering during the past 1 month, as well as maternal, infant, and familial characteristics. Associations of shaking, smothering, and either shaking or smothering with possible risk factors were analyzed using multiple logistic regression. RESULTS Self-reported prevalence of shaking, smothering, and either shaking or smothering at least once during the past month was 3.9% (95% confidence interval [CI], 3.5%-4.4%), 2.7% (95% CI, 2.3%-3.1%), and 5.4% (95% CI, 4.9%-6.0%) respectively. Several different risk factors were found for shaking and smothering. Risk factors for either shaking or smothering were age 34 years or younger (especially 24 years or younger), age 40 years or older, full-time working, later attendance at 4-months health checkup, primiparity, living in a detached house, living on the 2nd floor or higher (especially on the 10th floor or higher), economic adversity, perceived excessive crying, and postpartum depression. Protective factors against infant abuse were living in a four-room house and having a larger number of people to consult with. CONCLUSIONS Self-reported prevalences of shaking and smothering among mothers in Japan were similar to prevalences reported in western countries. These finding may be useful for identifying mothers at increased risk of shaking and smothering their infants.

Association of oxytocin level and less severe forms of childhood maltreatment history among healthy Japanese adults involved with child care

Background: Oxytocin (OT) is known to play a role in stress regulation. The association between childhood maltreatment history and neuropeptide OT concentration is inconsistent due to the varying degrees of severity of childhood maltreatment, among other contributing factors. Less severe forms of childhood maltreatment history might enhance OT concentrations as a response to coping with social stress within the family. The purpose of this study is to investigate the association between less severe forms of childhood maltreatment history and OT concentrations among healthy adults. Method: Eighty adults (49 women and 31 men) with 18- to 48-month-old children were recruited using a snowball sample in Tokyo, Japan. Urine samples were collected for OT measurement. Less severe (low and moderate) childhood maltreatment history, including physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse, was assessed using the self-report questionnaire, the Childhood Trauma Questionnaire. Results: Less severe physical abuse was significantly associated with higher OT concentration after adjusting for age (p = 0.014). Also, less severe forms of physical abuse were independently significantly associated with higher OT concentration after controlling for other types of childhood maltreatment (p = 0.027). A positive dose-response association between the number of less severe childhood maltreatment types and OT concentration was observed (p = 0.031). Conclusion: A history of less severe forms of childhood physical abuse was associated with higher OT concentration in healthy adults. Poly-victimization of several types of less severe childhood maltreatment was also associated with higher OT concentrations. Less severe forms of childhood maltreatment might enhance OT concentrations in order to cope with social stress.

Child deaths with persistent neglected experiences from medico-legal documents in Japan

Few studies have examined the actual conditions of fatal neglect in Japan. The aims of this study were to investigate persistent neglect among child fatalities using medico‐legal documents, and to describe the characteristics of the socio‐familial background and biological data.

Association between facial expression and PTSD symptoms among young children exposed to the Great East Japan Earthquake: a pilot study

“Emotional numbing” is a symptom of post-traumatic stress disorder (PTSD) characterized by a loss of interest in usually enjoyable activities, feeling detached from others, and an inability to express a full range of emotions. Emotional numbing is usually assessed through self-report, and is particularly difficult to ascertain among young children. We conducted a pilot study to explore the use of facial expression ratings in response to a comedy video clip to assess emotional reactivity among preschool children directly exposed to the Great East Japan Earthquake. This study included 23 child participants. Child PTSD symptoms were measured using a modified version of the Parent’s Report of the Child’s Reaction to Stress scale. Children were filmed while watching a 2-min video compilation of natural scenes (‘baseline video’) followed by a 2-min video clip from a television comedy (‘comedy video’). Children’s facial expressions were processed the using Noldus FaceReader software, which implements the Facial Action Coding System (FACS). We investigated the association between PTSD symptom scores and facial emotion reactivity using linear regression analysis. Children with higher PTSD symptom scores showed a significantly greater proportion of neutral facial expressions, controlling for sex, age, and baseline facial expression (p < 0.05). This pilot study suggests that facial emotion reactivity, measured using facial expression recognition software, has the potential to index emotional numbing in young children. This pilot study adds to the emerging literature on using experimental psychopathology methods to characterize children’s reactions to disasters.

Association between Parental Workaholism and Body Mass Index of Offspring: A Prospective Study among Japanese Dual Workers

The purpose of the study was to investigate the association between parental workaholism and child body mass index (BMI) among Japanese dual-income families. In 2011, 379 dual-income families from urban Tokyo with children aged 0–5 years were recruited for a baseline survey, and 160 (42.2%) were followed up in 2012. Demographics, workaholism, work demands, work control, time spent with children, and parental and child weights and heights were assessed using a questionnaire. Structural equation modeling was performed to determine the association between maternal and paternal workaholism in 2011 and child BMI in 2012, considering the mediating effects of time spent with children. Paternal workaholism showed a direct significant positive association with child BMI after 1 year (standardized coefficient: 0.19; p < 0.001), while maternal workaholism was not associated with child BMI. Both maternal and paternal time spent with children did not mediate the association. Paternal work demands showed a strong positive association with workaholism but paternal work control did not. Paternal, but not maternal, workaholism was associated with an increase in child BMI over 1 year. Interventions that target workaholism by reducing paternal work demands might be effective in preventing overweight in offspring.

The effects of workplace psychosocial factors on whether Japanese dual-earner couples with preschool children have additional children: a prospective study.

This study explored the effect of workplace psychosocial factors (job demand, job control, and workplace social support) on dual-earner couples in Japan having additional children, using a prospective study design. We conducted a 2-year prospective cohort study with 103 dual-earner couples with preschool children in Japan, as part of the Tokyo Work–Family Interface Study II. We used multivariable logistic regression analyses to evaluate the prospective association of job strain (categorized into low-strain job, active job, passive job, and strain job groups) and workplace social support (high and low) with couples having additional children during the follow-up period, adjusting for age, for men and women separately. Men in the active job group (i.e., with high job demands and high job control) had a significantly higher odds ratio (OR) of having additional children during the follow-up period, after controlling for age (OR 9.07, 95% confidence interval: 1.27–64.85). No significant association between any workplace psychosocial factor and having additional children was confirmed among women. Having an active job may have a positive influence on having additional children among men in dual-earner couples.

Association of temperament and social behavior with oxytocin levels among toddlers

Abstract Background: Children with poor communication skills, such as autism, are known to have lower levels of oxytocin. However, reports on the association between social behavior and oxytocin levels in children are