A return to work program improves parasympathetic activity and psychiatric symptoms in workers on sick leave due to depression
A return to work program improves parasympathetic activity and psychiatric symptoms in workers on sick leave due to depression
复制标题
DOI：
10.1016/j.heliyon.2019.e02151
复制
发表时间：
2019-07-01
期刊：
影响因子：
4
通讯作者：
Hirayasu, Yoshio
中科院分区：
文献类型：
--
作者：
Hattori, Saki;Kishida, Ikuko;Hirayasu, Yoshio
背景：抑郁症患者存在自主神经功能紊乱。在日本，因抑郁症而休假的工人在休假期间经常在精神健康医院接受以工作为重点的干预计划，称为重返工作（RTW）计划。然而，其生物学功效仍不清楚。我们调查的生物学疗效的RTW程序，包括自主神经系统（ANS）活动的变化，在病假的工人由于depressioninjapan.Methods：这项研究涉及104名工人因严重抑郁症或双相情感障碍谁进行了3个月的RTW程序在横滨市立大学医院的病假。在3个月RTW计划开始和结束时，使用心率变异性评估所有患者的ANS活动。采用蒙哥马利-阿斯伯格抑郁量表-日本（MADRS-J）和社会适应自我评价量表（SASS）评估精神症状。我们随访了3个月后结束的程序和调查之间的关联成功返回工作3个月内结束后的RTW程序和几个因素，包括ANS活动，抑郁症状，和人口factors.Results：副交感神经活动显着较高，抑郁症状的严重程度显着低于在程序结束时比基线。Logistic回归分析表明，抑郁症状的变化显着相关的成功返回work.Conclusion：我们建议，RTW程序改善副交感神经活动以及精神症状。ANS活动并不能预测因抑郁症而休病假的工人在计划结束后3个月内成功重返工作岗位，但需要更大样本量的进一步研究。
Background: People with depression have autonomic function disturbances. In Japan, workers who take leave due to depression often undergo a work-focused intervention program called the return to work (RTW) program at a mental health hospital during their leave of absence. However, its biological efficacy remains unclear. We investigated the biological efficacy of the RTW program, including changes in autonomic nervous system (ANS) activity, in workers on sick leave due to depression in Japan.Methods: The study involved 104 workers on sick leave due to major depressive disorder or bipolar disorder who underwent the RTW program for 3 months in Yokohama City University Hospital. The ANS activity of all patients was evaluated using heart rate variability at the beginning and end of the 3-month RTW program. Psychiatric symptoms were evaluated using the Montgomery-Asberg Depression Rating Scale-Japanese (MADRS-J) and Social Adaptation Self-evaluation Scale (SASS). We followed up 3 months after the end of the program and investigated the association between the success in returning to work within 3 months after the end of the RTW program and several factors, including ANS activity, depressive symptoms, and demographic factors.Results: Parasympathetic activity was significantly higher and depressive symptom severity was significantly lower at program end than at baseline. Logistic regression analysis showed that the change in depressive symptoms was significantly associated with success in returning to work.Conclusion: We suggest that the RTW program improves parasympathetic activity as well as psychiatric symptoms. ANS activity was not a predictor of a successful return to work within 3 months after the end of the program in workers on sick leave due to depression, but further studies with a larger sample size are needed.