Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jad.2025.119763

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Exclusive breastfeeding is essential for the health and well-being of both mothers and infants, but various factors may influence whether mothers are able to sustain exclusive breastfeeding during the early postpartum period. In this study, we explored the relationship of obstetric characteristics, the timing of delivery during the COVID-19 pandemic, and the season of birth with exclusive breastfeeding among Japanese mothers. Data included self-report survey and medical records of 5719 Japanese mothers at 1 month postpartum. We conducted path analysis on parity, maternal age, type of delivery, type of birth, pandemic-related delivery, birth season, and feeding method. The findings of a good-fit model suggested that being a first-time mother, older maternal age, having twins, giving birth during the pandemic, and delivering in winter were all associated with lower rates of exclusive breastfeeding (all P = 0.001). Mothers who were younger, had previous childbirth experience, delivered a singleton, gave birth before the pandemic, and delivered in summer, spring, or autumn were more likely to breastfeed exclusively. These findings support the need for targeted breastfeeding interventions that address obstetric, seasonal, and pandemic-related risk factors.

DOI： 10.1038/s41598-025-20766-4

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Other Link： https://www.nature.com/articles/s41598-025-20766-4

Publishing type：Research paper (scientific journal)   Publisher：Frontiers Media SA  

Background

Despite the acknowledged importance of addressing postpartum anxiety alongside postpartum depression, standardized screening tools specifically developed for this purpose remain limited.

Objective

This study aimed to validate the anxiety factor of the Edinburgh Postnatal Depression Scale (EPDS) and to determine optimal cutoff scores for screening postpartum anxiety.

Methods

EPDS and the State-Trait Anxiety Inventory (STAI) were collected from 100 Japanese women at one month postpartum at Niigata University Medical and Dental Hospital between May 18, 2021, and December 28, 2022, using random convenience and purposive sampling. Confirmatory factor analysis (CFA) was conducted on data from 84 participants to test six previously proposed EPDS factor models, and receiver operating characteristic (ROC) analysis was performed on data from 83 participants to determine area under the curve (AUC) values and cutoff scores. The EPDS anxiety subscales with three items (EPDS-3A) and four items (EPDS-4A) were separately evaluated as predictor variables, with STAI state and trait anxiety as criterion measures. We assessed accuracy, sensitivity, and specificity.

Results

All models with two-factor and three-factor showed a good fit to the data, with two models with EPDS-3A being superior among other models (comparative fit index = 1.000, root mean square error of approximation = 0.001). ROC analyses indicated good testing accuracy of the EPDS anxiety subscales for detecting both state and trait anxiety. For EPDS-3A, the AUCs were 0.832 (95% CI 0.735–0.930) for state anxiety with an optimal cutoff of ≥3 (sensitivity 79.2%, specificity 79.7%), and 0.912 (95% CI 0.837–0.988) for trait anxiety with an optimal cutoff of ≥4 (sensitivity 82.4%, specificity 84.8%). For EPDS-4A, the AUCs were 0.833 (95% CI 0.736–0.930) for state anxiety with an optimal cutoff of ≥4 (sensitivity 79.2%, specificity 71.2%), and 0.935 (95% CI 0.867–1.000) for trait anxiety with an optimal cutoff of ≥5 (sensitivity 88.2%, specificity 87.9%).

Conclusion

Both the EPDS-3A and EPDS-4A demonstrated good model fit and screening accuracy for anxiety at one month postpartum. Integrating anxiety screening into routine postpartum care may improve maternal mental health outcomes. Future studies involving clinical settings and larger cohort studies are recommended to improve external validity.

DOI： 10.3389/fpsyt.2025.1659497

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Publishing type：Research paper (scientific journal)   Publisher：Frontiers Media SA  

Objectives

Attention deficit hyperactivity disorder (ADHD) can significantly impact multiple life conditions across the lifespan. Reliable clinical practice guidelines (CPGs) are crucial for the clinical decision-making for the diagnosis and management of ADHD. This study aimed to assess the quality of current CPGs for the diagnosis and management of ADHD.

Methods

We conducted a systematic literature search within Pubmed, Google Scholar, the Agency for Healthcare Research and Quality, Dynamed, the National Institute for Health and Care Excellence (NICE), the National Health and Medical Research Council (NHMRC), and other local and online databases started January 19, 2022. We assessed the guideline quality using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. All of the included guidelines were critically appraised by five independent reviewers. We also evaluated the interrater reliability of each AGREE II domain and the overall domain score by calculating the intraclass correlation coefficient (ICC) using IBM SPSS Statistics version 28.

Results

A total of 11 CPGs were included in the study. The majority of the CPGs achieved the highest score in domain 4 “Clarity of Presentation” (mean ± standard deviation, 73.73% ± 12.5%). The domains that achieved the lowest scores were domains 5 “Applicability” (mean ± standard deviation, 45.18% ± 16.4%) and 3 “Rigor of Development” (mean ± standard deviation, 51.09% ± 24.1%). The American Academy of Pediatrics (AAP), NICE, and the Malaysian Health Technology Assessment Section (MAHTAS) CPGs were identified as the strongly recommended guidelines. All AGREE II domains yielded varied interrater reliability results; the full domain ICC ranged from 0.265 (95% confidence interval, −0.470 to 0.665) to 0.758 (95% confidence interval, 0.515 to 0.889).

Conclusions

Our appraisal indicated that the quality of current ADHD guidelines is varied, and three CPGs were classified as strongly recommended. Our findings offer relevant healthcare providers valuable insight into the appropriate selection of ADHD guidelines in clinical practice.

Systematic review registration

https://inplasy.com/inplasy-2022-8-0001/, identifier INPLASY202280001

DOI： 10.3389/fpsyt.2025.1576538

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Language：English   Publishing type：Research paper (scientific journal)  

This study aimed to determine how paternal and maternal parenting before adolescence affects adult attachment to a partner during the perinatal period, using three different models of attachment. We used the Parental Bonding Instrument (PBI) and the Relationship Questionnaire (RQ) to examine perceived parenting practices and adult attachment styles, respectively. The participants included 4586 Japanese women who were pregnant or who had given birth, up until one month after childbirth. We performed structural equation modeling analysis between PBI and RQ scores with three different category models, including the four-category model (secure, fearful, preoccupied, and dismissive attachment) as Model 1, the two-category model (model of the self and others) as Model 2, and the single-category model (total attachment style) as Model 3. Models 1 and 2 showed a good fit. Both path models showed a significant association between adult attachment style and perceived paternal and maternal parenting before adolescence, where high care and low overprotection from both paternal and maternal parents predicted adult attachment. Our findings indicate that attachment styles are best described using the four-category and two-category models, and suggest that both paternal and maternal overprotection and care influence adult attachment with a partner during the perinatal period.

DOI： 10.1038/s41598-023-42674-1

PubMed

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Language：English  

INTRODUCTION: Chronic pain remains a health problem that is difficult to treat adequately. Its unknown cause and complex comorbidity with other illnesses, including mental disorders, amplify the severity of symptoms, which consequently decreases the quality of life of patients long term. In our clinical practice, we coincidentally found evidence that methylphenidate (MPH) effectively managed chronic pain in an adult patient with attention deficit hyperactivity disorder (ADHD). The effectiveness of MPH in the treatment of ADHD is well-established; however, its utility in treating pain remains unclear. CASE PRESENTATION: We present a rare case of a 43-year-old male patient with 15 years of chronic idiopathic pain symptoms that did not adequately respond to standard pain management, such as acetaminophen, non-opioid analgesics, and muscle relaxers. Pain also persisted after treatments with antidepressants and an epidural block. Furthermore, symptoms worsened following several sessions of modified electroconvulsive therapy. After a thorough assessment at our child and adolescent psychiatric outpatient clinic, we confirmed a diagnosis of adult ADHD with a predominantly inattentive type. Considering this newly established diagnosis, we prescribed osmotic-release oral system (OROS) methylphenidate. Within 1 month of treatment at a dose of 18 mg/day of OROS-MPH, the patient's chronic pain unexpectedly improved dramatically, and the patient no longer experienced pain symptoms. The dosage of OROS-MPH was titrated monthly, reaching 72 mg/day as a maintenance dose, and ADHD symptoms improved after 4 months of treatment. The patient was followed up regularly for 7 years during his OROS-MPH treatment. No adverse effects were reported, including stimulant addiction. He was stable overall and functioned well in his daily activities. His pain never recurred. CONCLUSION: This case report suggests that MPH may be potentially effective in treating chronic pain. Further studies are needed to confirm whether MPH improved chronic pain simultaneously with or separately from the improvement in ADHD. Moreover, elucidating the anatomical sites and molecular pharmacological mechanisms related to the action of MPH in pain modulation and perception is essential. Such sites include the descending dopaminergic pain pathway and higher cortical areas. Furthering our understanding may reinforce the justification for treating chronic pain using MPH.

DOI： 10.3389/fpsyt.2023.1091399

PubMed

J-GLOBAL

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: There is a rising interest in perinatal mental health studies, and proper psychometric tools to assess autistic traits among this population in Japan are vital. OBJECTIVE: This study aimed to clarify the optimal factor structure of the AQ as part of a perinatal mental health research project. METHODS: We used the Japanese version of the AQ (AQ-J) to measure autistic-like traits in pregnant women. Participants were 4,287 Japanese women who were pregnant or who had given birth within the last month. We performed exploratory factor analysis (EFA) using the first sample group (n = 2,154) to obtain factor structures for the final item selections. We performed confirmatory factor analysis (CFA) using the second sample group (n = 2,133) to obtain a model with good fit, then compared the model to all previously proposed models to determine the best-fitting model. RESULTS: The EFA analysis identified a model consisting of 25 items distributed across three factors. Cronbach's alpha for the total 25-item AQ-J, 9-item "Social interaction" factor, 11-item "Non-verbal communication" factor, and 5-item "Restricted interest" factor was 0.829, 0.829, 0.755, and 0.576, respectively. McDonald's omega and its 95% confidence interval were 0.826 (0.821-0.836), 0.835 (0.821-0.837), 0.755 (0.744-0.766), and 0.603 (0.556-0.596), respectively. CFA confirmed that the three-factor structure had an acceptable fit (goodness of fit index: 0.900, comparative fit index: 0.860, root mean square error of approximation: 0.066). These findings indicated that the three-factor model was better than the 13 existing models. CONCLUSION: The findings are discussed in relation to the adequacy of the AQ-J for assessing autistic traits in perinatal women. We recommend the use of this 25-item, three-factor AQ-J model for this population owing to its superiority to all previous models.

DOI： 10.3389/fpsyt.2023.1275043

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Coronavirus disease (COVID-19) not only has a long-term effect on its survivors, it also affects their quality of life, including inducing depression as a possible manifestation of central nervous system disruption. Favipiravir shows promising efficacy as an antiviral drug for the treatment of COVID-19. However, its effect on the sequelae of COVID-19 has not been explored. Therefore, this study aims to assess the impact of Favipiravir and address the factors associated with post-COVID depression in Indonesia. METHOD: This cohort study conducted a post-COVID-19 survey on Indonesian patients who were diagnosed by using real-time polymerase chain reaction (RT-PCR) and antigen tests until January 2022. An online questionnaire was distributed to obtain information on demographics, comorbidities, health behavior, symptoms, and treatment. The propensity technique was used to allocate the participants into the favipiravir and nonrecipient groups (1:1). The Patient Health Questionnaire-9 (PHQ-9) was used for outcome measurement. The cohort was followed up biweekly for 60 days after onset/diagnosis to determine the occurrence of depression. Cox regression analysis with an adjusted odds ratio and 95% confidence interval was used to estimate the effect of favipiravir on post-COVID-19 depression. RESULTS: The data included the information of 712 participants, of whom 18.54% had depression within 60 days after onset/diagnosis. Depression was higher in the nonrecipient group (21.06%) than in the favipiravir group (16.01%). After adjustment by other factors, favipiravir prescription was found to be associated with depression (aOR 0.488, 95% CI 0.339-0.701 p < 0.001). In accordance with the PHQ-9 subset, favipiravir exerted a significant protective effect against depressive mood and loss of interest. However, patients living alone were prone to experiencing loss of interest (aOR 2.253, 95% CI 1.329-3.818, p = 0.003). CONCLUSION: The data obtained in this preliminary survey suggested that favipiravir may be useful for preventing post-COVID depression. However, further study is needed. Moreover, the provision of mental health support, particularly to those who live alone, must be ensured. TRIAL REGISTRATION: Registry NCT05060562.

DOI： 10.1371/journal.pone.0279184

PubMed

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Language：English  

The internet has become an indispensable tool in people´s daily lives during the COVID-19 pandemic. Internet and video game use are experiencing rapid growth in the youth and adult populations as a major source of entertainment. However, excessive gaming may cause addiction and negatively impact mental health, entailing low psychosocial well-being, poor social skills, and decreased academic achievement. We report the case of a 16-year-old student with a "typical" pattern of internet gaming disorder (IGD) developed during the pandemic, which improved after weeks of treatment with pharmacotherapy and psychosocial interventions. This case highlights that it is essential for the mental health professionals to know the psychopathology of IGD and multimodal approaches to treat it.

DOI： 10.11604/pamj.2022.41.224.33941

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Faculty of Medicine, Universitas Indonesia  

DOI： 10.13181/mji.v20i1.429

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J-GLOBAL

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J-GLOBAL

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