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Takaharu Motegi,1 Yuichiro Watanabe,1 Naoki Fukui,1 Maki Ogawa,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: Postpartum depression is a well-known risk factor, and postpartum anxiety and parity are potential risk factors, for mother–infant bonding disorder. However, few studies have focused on the relationships among these factors and mother–infant bonding. This cross-sectional study explored the associations between depression, anxiety and parity, and mother–infant bonding.Materials and Methods: Japanese mothers, both primiparas and multiparas, completed the Mother-to-Infant Bonding Scale (MIBS) and the Hospital Anxiety and Depression Scale (HADS) one month after childbirth. We performed a stepwise multiple regression analysis with the forward selection method to assess the effects of HADS anxiety and depression scores and parity as independent variables on mother–infant bonding as the dependent variable.Results: A total of 2379 Japanese mothers (1116 primiparas and 1263 multiparas) took part in the study. MIBS score (2.89 ± 2.68 vs 1.60 ± 2.11; p < 0.0001) was significantly higher in primiparas than in multiparas. HADS anxiety (6.55 ± 4.06 vs 4.63 ± 3.41; p < 0.0001) and depression (6.56 ± 3.43 vs 5.98 ± 3.20; p < 0.0001) scores were also significantly higher in primiparas than in multiparas. A stepwise multiple regression analysis with the forward selection method revealed that HADS depression and anxiety scores and parity were significantly associated with MIBS score (p = 0.003, 0.015 and 0.023).Conclusion: Depression, anxiety and primiparity were negatively associated with mother–infant bonding one month after childbirth.Keywords: HADS, Japanese, MIBS, parity, postpartum

Norio Sugawara,1,2 Norio Yasui-Furukori,1,2 Manabu Yamazaki,3 Kazutaka Shimoda,1,2 Takao Mori,3 Takuro Sugai,2,4 Hiroshi Matsuda,3 Yutaro Suzuki,2,4 Yuji Ozeki,2,5 Kurefu Okamoto,3 Toyoaki Sagae,3,6 Toshiyuki Someya2,4 1Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan; 2Japanese Society of Clinical Neuropsychopharmacology, Chiyoda-ku, Tokyo 101-0003, Japan; 3Japan Psychiatric Hospital Association, Minato-ku, Tokyo 108-8554, Japan; 4Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-ku, Niigata 951-8510, Japan; 5Department of Psychiatry, Shiga University of Medical Science, Otsu, Shiga 520-2134, Japan; 6Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, Yonezawa, Yamagata 992-0025, JapanCorrespondence: Norio SugawaraDepartment of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 321-0293, JapanTel +81-28-287-2153 (extension: 7141)Fax +81-28-286-5187Email nsuga3@dokkyomed.ac.jpBackground: Reliable and easy screening for metabolic syndrome (MetS) is important for patients with schizophrenia. The aim of this study was to assess the predictive utility of body mass index (BMI) for MetS among patients with schizophrenia in Japan.Methods: In total, 8468 patients (4705 males, 3763 females) with schizophrenia or schizoaffective disorders based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), or the International Classification of Diseases, tenth revision (ICD-10), were assessed for MetS using the criteria of the National Cholesterol Education Program Adult Treatment Panel III (ATP III-A). We applied a stratum-specific likelihood ratio (SSLR) analysis, which is independent of the prevalence of the target disease.Results: The mean (± standard deviation) age of these patients was 57.4 ± 13.5 years. The prevalence of MetS was 20.4%. Among males, the SSLRs predicting MetS were 0.03 (95% CI 0.02– 0.06), 0.54 (95% CI 0.48– 0.60), 2.77 (95% CI 2.44– 3.14) and 8.75 (95% CI 7.40– 10.36) for BMI < 20 kg/m2, 20 kg/m2 ≤ BMI < 25 kg/m2, 25 kg/m2≤ BMI < 28 kg/m2, and 28 kg/m2≤BMI, respectively. For females, the SSLRs predicting MetS were 0.08 (95% CI 0.05– 0.12), 0.73 (95% CI 0.66– 0.82), 2.50 (95% CI 2.16– 2.90) and 4.83 (95% CI 4.12– 5.67) for the same BMI categories, respectively.Conclusion: The predictive utility of BMI is confirmed, and BMI has more predictive value in males than in females. Patients with a BMI of 28 kg/m2 or greater had a significantly higher SSLR than those with a BMI less than 28 kg/m2.Keywords: body mass index, metabolic syndrome, schizoaffective disorder, schizophrenia