Cross-National Differences in Psychosocial Factors of Perinatal Depression: A Systematic Review of India and Japan

Abstract

Perinatal depression is prevalent worldwide. However, there are few available studies that discuss the different cultural factors affecting perinatal depression within Asian countries. This study aims to compare the literature regarding related factors relating to perinatal depression in India and Japan, and to synthesize the evidence common to both countries in addition to the country-specific evidence. We conducted a systematic review using several databases (CINAHL, MEDLINE, Pubmed, Ovid, SCOPUS, IndMED, and ICHUSI). Keywords were “antenatal depression” or “postpartum depression”, and “India” or “Japan”. Both Japanese and English language papers were reviewed. The identified evidence was compared between the two countries, as well as with non-Asian countries based on previous reports. In total, 15 articles on India and 35 on Japan were reviewed. Although several factors were shared between the two countries as well as with other non-Asian countries (vulnerable personality, being abused, age, marital conflict, and lower socio-demographic status), some differing factors were identified between India and Japan and non-Asian countries; India: poor socioeconomic status, living only with the husband, pregnancy not welcomed by the husband, a female baby, and poor relationship with in-laws; Japan: infertility treatment, conflict with work–life balance, poor relationships with biological mother or in-laws, and concerns about social relations with the other mother’s friends. To conclude, involving the family and community may be important for implementing both global standardized and culture-specific interventions. In India, treatment involving the in-laws may be effective because large family structure is a significant predictor of perinatal depression. In Japan, a family/community approach involving not only the mother’s family of origin but also the working environment is essential.

Does the Mode of Conception Influence Early Postpartum Depression? A Prospective Comparative Study from South India

“…The mothers who conceived after infertility treatment do not have any gender preference in comparison to naturally conceived mother, as such a baby is precious to them. 9 In our study, partner support was not significantly influencing the early postpartum depression as the immediate primary caregivers for mothers are better in Indian culture following delivery, whereas it might influence at a later part of the postpartum period where mothers are expected to return to their husband's family. 16,22 A study done by Tendais et al found no change in postpartum anxiety score between mothers who conceived spontaneously versus postinfertility treatment group with regard to multiple births of the baby.…”

“…The mothers who conceived after infertility treatment do not have any gender preference in comparison to naturally conceived mother, as such a baby is precious to them. 9 …”

“… 8 Gender of the baby adds to the mother’s stress in countries like Japan and India due to the prevalent sociocultural beliefs. 9 , 10 Limited prospective study is available on the association between the mode of conception and early postnatal depression in women who receive infertility treatment in developing countries. 11 This study was conducted to find out whether the mode of conception is associated with early postpartum depression.…”

Evaluation of peripartum depression in females

“…in Japan. [21] This may be because women feel more secure and safe in such positive environment; good care of pregnant women and more helping hands are there to take care of the newborn, which reduces the stress of the mother and she can have sufficient rest. Such association between support from in-laws and depression is also seen in a study by Gupta et al .,[12] Bener et al .,[15] and Morikawa et al .…”

An Illustration of Interpersonal Psychotherapy for Perinatal Depression

“…The impact is noted to be higher on women in low- and middle-income countries [ 15 ]. In addition to biological vulnerability to major depression, low social support, interpersonal conflict, and difficulties in role transition and gender inequality are important risk factors leading to perinatal depression [ 18 – 20 ].…”