気分障害患者に対するリワークプログラムの有効性の検討

Examination of the effectiveness of the return to work program for patients with mood disorders

要旨：リワークプログラムの有効性を検討する目的で，気分障害患者13名を対象にプログラムの前後，および復職群7名と継続群6名の認知機能（BACS），社会適応度（SASS-J），心理社会的機能（GAF），うつ症状（HAM-D），躁症状（YMRS），復職準備性（PRRS）を比較した．プログラム前後の比較では，認知機能と復職準備性で有意なスコア増加を認め，プログラムの有効性が示唆された．プログラム終了時には，復職群は継続群よりSASS-Jの対人関係，GAF，PRRSの準備状況が有意に高く，気分障害患者の復職には対人関係技能と復職準備性の充実が重要と思われた．今後，サンプル数を増やした詳細な検討が必要である．

　The purpose of the study was to examine the effectiveness of the return to work (rework) program and to determine factors associated with reinstatement. Participants of the rework program were diagnosed with mood disorders. The three-month course comprised psychoeducation based on illness management and recovery twice a week and occupational therapy five times a week. The participants were evaluated using Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS), the Social Adaptation Self-evaluation Scale-Japanese version (SASS-J), the Global Assessment of Functioning (GAF), Hamilton Rating Scale for Depression (HAM-D), Young Mania Rating Scale (YMRS), and the Psychiatric Rework Readiness Scale (PRRS) before and after the program. These measures compared the reinstatement group (RG) that was able to return to work and the continuation group (CG) that was not able to return to work. Thirteen patients participated in the program. The BACS scores and the PRRS scores significantly increased after the program. The improvement in cognitive function and reinstatement readiness were the main outcomes of this program. After the program, the personal relationship scores of the PRRS were seen more in the RG than in the CG. Furthermore, significantly higher preparation conditions of the PRRS were seen in the RG than in the CG. The improvement of personal relationship skills and reinstatement readiness were considered important. It is necessary to replicate the study using an increase in the sample size in the future.