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Koyo Hashijiri,1 Yuichiro Watanabe,1 Naoki Fukui,1 Takaharu Motegi,1 Maki Ogawa,1 Jun Egawa,1 Takayuki Enomoto,2 Toshiyuki Someya1 1Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 2Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, JapanCorrespondence: Yuichiro Watanabe Email yuichiro@med.niigata-u.ac.jpPurpose: Identification of pregnant women with bonding difficulties is important to provide early intervention. However, few studies have examined the utility of self-report questionnaires that assess mother–infant bonding as screening tools for bonding difficulties. This longitudinal study aimed to identify pregnant women with bonding difficulties using the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) and to estimate its optimal cutoff points in the peripartum period.Patients and Methods: A total of 1301 pregnant women completed the MIBS-J and Hospital Anxiety and Depression Scale (HADS) at three time points: first trimester (T1; approximately 12– 15 weeks gestation), third trimester (T2; approximately 30– 34 weeks gestation), and postpartum (T3; approximately 4 weeks postpartum). A two-step cluster analysis was conducted to classify pregnant women based on their MIBS-J subscale scores at the three time points. Based on the cluster analysis results, receiver operating characteristic curve analysis was performed to estimate the optimal cutoff scores for the MIBS-J total score at each time point.Results: The two-step cluster analysis produced two clusters: Cluster 1 (n = 824) and Cluster 2 (n = 477). Both the MIBS-J and HADS scores were significantly higher in Cluster 2 than in Cluster 1 at all time points. The MIBS-J tentative cutoff points were 3/4, 3/4, and 2/3 at T1, T2, and T3, respectively.Conclusion: We identified two distinct groups across the perinatal period: pregnant women with bonding difficulties and pregn

Maki Ogawa,1 Yuichiro Watanabe,1 Takaharu Motegi,1 Naoki Fukui,1 Koyo Hashijiri,1 Ryusuke Tsuboya,1 Takuro Sugai,1 Jun Egawa,1 Rie Araki,2 Kazufumi Haino,3 Masayuki Yamaguchi,3 Koji Nishijima,4 Takayuki Enomoto,3 Toshiyuki Someya1 1Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 2Nursing, Niigata University Medical and Dental Hospital, Niigata, Japan; 3Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 4General Center for Perinatal, Maternal and Neonatal Medicine, Niigata University Medical and Dental Hospital, Niigata, JapanCorrespondence: Yuichiro WatanabeDepartment of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachidori-Ichibancho, Chuo-ku, Niigata 951-8510, JapanTel +81-25-227-2213Fax +81-25-227-0777Email yuichiro@med.niigata-u.ac.jpPurpose: The Hospital Anxiety and Depression Scale (HADS) is a self-report questionnaire widely used to assess anxiety and depression. To the best of our knowledge, only four studies have examined the factor structure of the HADS for assessing pregnant women, with conflicting results. This study aimed to assess the factor structure and measurement invariance of the HADS for use with pregnant Japanese women.Participants and Methods: A total of 936 pregnant Japanese women completed the HADS questionnaire at three time points: the first and third trimester of pregnancy, and postpartum. We examined the factor structure of the HADS in Group 1 (n = 466) using exploratory factor analysis (EFA). We then compared the models identified in Group 1 with those from previous studies using confirmatory factor analysis (CFA) in Group 2 (n = 470). We performed multiple-group CFA for Group 2 to test the measurement invariance of the best-fit model across the three time points.Results: The EFA for the Group 1 data at the three time points revealed a two-factor model. In the CF