Search Results

The book concludes by enumerating at least five contemporary omens that signal the possible futures of newborn screening. The first omen suggests a future in which screening for rare genetic disorders will become increasingly routinized and statistically monitored. The second omen became apparent when US Secretary of Health and Human Services Kathleen Sebelius added Severe Combined Immunodeficiency Disorder (SCID) as a 55th disorder to the recommended uniform screening panel. The third omen signals a more cautionary stance toward newborn screening program expansion, suggesting that program retrenchment and cost-cutting measures could stifle its continued growth. The fourth omen is concerned with false positives, which are an inevitable consequence of any screening program needing to strike a balance between specificity and sensitivity. Finally, the fifth omen is concerned with the retention, by state governments, of dried blood samples from nearly every US newborn.

Surveys focusing on the use of psychological tests in the forensic setting have confirmed the widespread use of objective tests and measures. A review of all currently available tests and measures is beyond the scope of this chapter, so it provides only a review of the most frequently used psychometric tests and personality inventories used to assess the following: DSM–IV–TR Axis I and Axis II disorders (e.g., Structured Clinical Interview for the DSM-IV-TR [SCID], Structured Interview of Reported Symptoms [SIRS], Minnesota Multiphasic Personality Inventory [MMPI], Millon Multiaxial Clinical Inventory-III [MCMI-III], and Personality Assessment Inventory [PAI]) and frontal lobe/executive and intellectual functioning (e.g., Wisconsin Card Sort Test [WCST], Stroop Color and Word Test [Stroop], Trail Making Test [TMT], California Verbal Learning Test-II [CVLT-II], Wechsler Adult Intelligence Scale–Third Edition [WAIS-III], Wechsler Adult Intelligence Scale–Fourth Edition [WAIS-IV], and Wechsler Memory Scale–Fourth edition [WMS-IV]).

This chapter reviews the most important devices for assessing the prevalence of mental disorders, as well as assessing levels of distress, impairment, and need. A brief discussion of the history of methods in psychiatric epidemiologic studies of prevalence is included. The assessment devices include those for screening, such as the K-6 scale, the CESD-r, and the World Health Organization Disability Assessment Schedule (WHODAS). Also included are assessment instruments designed for use by clinicians, such as the Structured Clinical Interview for Diagnosis (SCID) and Structured Clinical Assessment in Neuropsychiatry (SCAN). A brief section includes guidance for conducting field surveys of mental disorders in the general population. Methods of evaluating the measurement properties are discussed, and a review of studies of agreement between survey interviewers and clinicians is presented.

Postnatal depression (PND) in Japan, despite a traditional support system for perinatal women and cultural differences, is no less common than in western countries. Our previous two studies, which began in the 1990s, found that PND was experienced by about 15% of Japanese women. First, 98 Japanese women living in England (Yoshida et al. 1997) and then 88 Japanese women living in Japan (Yamashita et al. 2000) were recruited into two prospective studies of PND from late pregnancy to 3 postnatal months. Using the same research protocol and diagnostic method, (Schedule for Affective Disorders and Schizophrenia, Research Diagnostic Criteria), the incidence of PND was 12% and 17% respectively. We have a traditional support system for perinatal women called Satogaeri Bunben. Satogaeri means returning to their home towns where their families of origin live and Bunben means delivery. Pregnant women return to their home towns several weeks prior to their delivery and remain there, with their babies, after delivery for a couple of months. It seems to be a very supportive system. However, Satogaeri Bunben itself did not lower the incidence of PND in either of the groups mentioned above. A disadvantage of Satogaeri Bunben is that a woman cannot be monitored by the same midwife or obstetrician and her husband has to work and live separately until their reunion in their marital home (Yoshida et al. 2001). Most mothers with PND are unlikely to access psychiatric care, even though their depressive symptoms are serious (Mclntosh 1993). Therefore neonatal home visits by health visitors were seen as a potentially useful opportunity for detecting mothers with PND. Luckily, a home visit system by community health visitors has been well organized throughout Japan since the late 1940’s. In the past, the focus was on reducing infant death and promoting infant growth and development. In our city, the neonatal home visit service is provided for mother–baby dyads where (a) a baby’s birth weight is less than 2500 g, (b) first-born babies with a birth weight of less than 2800 g, (c) babies with perinatal or pediatric physical health problems.