2002 International International Biennial Scientific Meeting

WHY ARE JAPANESE MOTHERS WITH POSTNATAL DEPRESSION NOT DETECTED IN THE COMMUNITY?

Tadaharu Okano and TCS-PND group

Centre for Health, Mie University, Japan

okano@ab.mie-u.ac.jp

Objectives: Women with postnatal depression are apt to be not detected in the community care system in Japan. It is suspected that many specific factors must be associated these problems.

Methods: As part of a comparative research project being conducted in TCS-PND, mothers suffering from postnatal depression (PND) were interviewed in Mie, Japan to determine typical referral pathways and to investigate factors associated with referral delays.

Results: The majority of patients are followed their mothers' suggestions and received initial consultations from obstetricians before progressing to psychiatric services. Of these subjects, 35% contacted other caregivers without the benefit of a referral, suggesting that a) a significant number of primary care providers are insufficiently prepared to handle PND cases, or b) relationships among providers are unsatisfactory. Delays between PND onset and initial consultation ranged from 1 to 17 weeks-shorter than expected. Average delays for patients with somatic problems (60% of all subjects) were longer than for those with symptoms of depression or anxiety, although the difference was not statistically significant. No significant differences were found between Japanese and EU PND patient responses except in terms of travel time to the health care provider-much longer in Japan.

Conclusions: The implications of these findings are discussed within the context of the EU research centres, which is aimed at improving mental health care in community settings. While Japan appears to have caught up with the West in terms of somatic medicine, the same is not true for psychiatric services. It is suggested that the reason for this disparity is administrative and not cultural. The most important conclusion of the study is that liaisons among Japanese care providers are inadequate.