A return to work program improves parasympathetic activity and psychiatric symptoms in workers on sick leave due to depression
Saki Hattori,
Ikuko Kishida,
Akira Suda,
Chiaki Kawanishi,
Masatoshi Miyauchi,
Yohko Shiraishi,
Mami Fujibayashi,
Natsuki Tsujita,
Chie Ishii,
Toshio Moritani,
Yusuke Saigusa,
Yoshio Hirayasu
Affiliations
Saki Hattori
Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan; Corresponding author.
Ikuko Kishida
Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan; Fujisawa Hospital, 383 Kotuka, Fujisawa, Kanagawa, 251-8530, Japan
Akira Suda
Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
Chiaki Kawanishi
Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine, S-1, W-16, Chuo-ku, Sapporo, 060-8543, Japan
Masatoshi Miyauchi
Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
Yohko Shiraishi
Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
Mami Fujibayashi
Division of Physical and Health Education, Setsunan University, 17-8 Ikedanakamachi, Neyagawa, Osaka, 572-8508, Japan
Natsuki Tsujita
Graduate School of Human and Environmental Studies, Kyoto University, Yoshidanihonmatsucho, Sakyo-ku, Kyoto, 606-8316, Japan
Chie Ishii
Fujisawa Hospital, 383 Kotuka, Fujisawa, Kanagawa, 251-8530, Japan
Toshio Moritani
Faculty of General Education, Kyoto Sangyo University, Kamo-motoyama, Kita-ku, Kyoto, 606-8555, Japan
Yusuke Saigusa
Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
Yoshio Hirayasu
Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan; Hirayasu Hospital, 346 Kyozuka, Urasoe, Okinawa, 901-2553, Japan
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-Åsberg 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.
