Resilience building for mood disorders: Theoretical introduction and the achievements of the Re-Work program in Japan

Return-to-work support program outcomes for people on leave due to mood and stress-related disorders

BACKGROUND

Mood disorders and stress-related disorders are the two leading causes of long-term employee absenteeism and cause significant social losses. Therefore, strengthening the support systems is essential to help employees return to work.

OBJECTIVE

This study aimed to investigate the outcomes of a return to work (RTW) rehabilitation program and to explore factors associated with RTW and continued employment.

METHODS

A five-times-a-week RTW intervention was implemented for three to four months for people on leave who had been diagnosed with a mood or stress-related disorder. RTW rates within one year of completing the program and RTW retention rates one year after returning to work were examined to explore factors associated with RTW and employment retention.

RESULTS

Of the 47 participants, 41 completed the RTW intervention, 35 returned to work (85.4%) within one year after the intervention, and 29 were still working one-year post their RTW (82.9%). The non-RTW group had a lower attendance rate for the program and showed an increase in anxious temperament. Additionally, compared to the RTW group, the non-RTW group showed significantly lower interpersonal relationship scores and decreased finger dexterity in the post-program evaluation, which may be associated with difficulties in returning to work. There was little improvement in cognitive function in the RTW non-continuation group, with a disrupted rhythm of life, depression, panic, and non-assertive self-expression.

CONCLUSION

The RTW intervention demonstrated effectiveness for treating patients with mood and stress-related disorders. Future studies should investigate comparative trials with a control group while also increasing the sample size.

Relationship between duration of sick leave and time variation of words used in return-to-work programs for depression

BACKGROUND

Return-to-work (RTW) programs are provided as rehabilitation for people who have taken sick leave from work because of mental health problems. However, methods to present this information to workplaces objectively remain limited.

OBJECTIVE

This study aimed to conduct an exploratory investigation of the relationship between duration of sick leave and time variation of words used in RTW programs for depression from textual data collected from electronic medical records as a new evaluation indicator.

METHODS

The study subjects were those who had taken sick leave because of major depressive or adjustment disorder and had participated in an RTW program. The study data comprised demographic characteristics and texts. Textual data were collected from electronic medical records and classified based on the SOAP note. Thereafter, the textual data were quantified into category scores based on a standard text analysis dictionary. A generalized linear mixed model was used for the statistical analysis, with the score for each category (emotional, social, cognitive, perceptual, biological, motivational, relativity, and informal) as the dependent variable and the duration of sick leave, time, and interaction between the duration of sick leave and time as the independent variables. The level of statistical significance was set at 0.05.

RESULTS

In total, 42 participants were included in the analysis. The results revealed a significant interaction between the social (p = 0.001) and emotional (p = 0.002) categories.

CONCLUSION

The findings suggest a relationship between word changes in electronic medical records and the duration of sick leave.

Effects of treatment contents on changes in resilience among workers with mood or anxiety disorders: A 3-month longitudinal study

Aim

The aim of this study was to identify factors that influence changes in resilience among workers with mental health disorders, leading to effective treatment and support.

Methods

Among the new patients at an institution, 81 who were working and had the ICD-10 diagnoses F3 and F4 were included. Resilience was measured at the initial visit and 3 months later using the S-H resilience test. Univariate and multiple regression analyses were conducted using the change in resilience between the two measurements as the objective variable, and treatment and attendance at work as explanatory variables.

Results

There were no significant differences in resilience abilities between pre- and postmeasurement for the subjects as a whole. However, tests for the subgroups of diagnostic category, attendance at work, and treatment showed that resilience improved significantly in the mood disorder group, the leaving employment group, and the group receiving additional treatment. The results of the multiple regression analysis showed that treatment type (with or without additional treatment) had an effect on the degree of change in resilience, and among these "inpatient treatment" and "re-work program" were suggested to have an effect.

Conclusion

The resilience of workers with mental health disorders was found to improve even after only 3 months of treatment, depending on the content of the treatment. We believe the significance of this study is the quantitative indication of the transition of resilience, which has not been made concrete until now.

Outcomes of an interdisciplinary return to work intervention including occupational therapy for mood and adjustment disorders: A single-arm clinical trial

BACKGROUND

Mood and adjustment disorders are two major causes of long-term sick leave among employees, leading to large social losses. Therefore, a return to work (RTW) intervention was attempted, targeting patients with mood and adjustment disorders.

OBJECTIVE

This study aimed to investigate the outcome of an interdisciplinary RTW intervention including occupational therapy implemented within the Japanese healthcare framework.

METHODS

An interdisciplinary RTW intervention including occupational therapy was conducted five times a week for approximately three months, targeting individuals with mood and adjustment disorders who took a leave of absence. Their mental symptoms, cognitive functioning, job performance, temperament, social adaptation, psychosocial state, and readiness to RTW before and after the intervention were evaluated. Full-time RTW ratios at 3, 6, 12, 18, and 24 months from baseline were followed up and compared with those of prior studies.

RESULTS

A total of 30 individuals completed the intervention. After the intervention, participants' psychological symptoms, cognitive function, vocational aptitude, temperament, social adaptation, psychosocial state, and readiness to RTW improved (p≤0.001-0.0279). The ratios of RTW at 3, 6, 12, 18, and 24 months from the baseline were 6.7%, 46.7%, 73.3%, 77.8%, and 82.6%, respectively, reflecting a higher pattern than prior reports.

CONCLUSIONS

The interdisciplinary RTW intervention including occupational therapy has the potential to improve not only depressive symptoms but also cognitive functioning, job performance, social adaptation, and readiness to RTW. They can also raise RTW ratios.

Relationship between emotional words in electronic medical records and leave periods of users of a return-to-work program with depression

Introduction

We attempted to score data extracted from written medical records containing assessment results using natural language processing, and to clarify the relationship between duration of sick leave and the use of emotional words among return-to-work (RTW) program users on sick leave due to mental health problems.

Method

Participants were users of an RTW program. We extracted textual data from their electronic medical records, and gave all words a score based on the following two considerations: positivity score (the degree of positive emotion a word has) and emotion score with respect to seven emotions (sadness, anxiety, anger, disgust, trust, surprise, and joy), with the score for each emotion measured for each word. We analyzed relationships between duration of sick leave and each score.

Results

Forty-two users participated. The results showed that high positive scores (β = -0.42, p < 0.00) and high sadness scores (β = -0.60, p < 0.00) were related to a shorter duration of sick leave, and high anger score (β = 0.52, p < 0.00) was related to a longer duration of sick leave.

Conclusion

Professional assessments based on occupational therapy and natural language processing of medical records may predict the appropriate timing of RTW.