Improvement in social anxiety following a return-to-work intervention for patients with depression.

PURPOSE: To retrospectively examine depression and social anxiety improvement in patients on sick leave due to depression who participated in a return-to-work intervention (RTW-I) program. METHODS: Patients visited a psychiatric outpatient clinic simulating workplaces to learn recurrence prevention skills through RTW-Is, including group cognitive behavioral therapy, from April 1, 2013, to September 30, 2017. The Beck Depression Inventory-Second Edition (BDI-II), Social Adaptation Self-Evaluation Scale (SASS), and Liebowitz Social Anxiety Scale (LSAS) scores of 112 patients were analyzed before and after the intervention program. Missing postprogram data were substituted using the last observation carried forward scores. Next, 45 patients who responded to the work continuity survey 1 year after RTW-I were categorized into Group A (patients who continued working: 37) and Group B (those who did not continue: 8). RESULTS: The mean BDI-II scores significantly decreased from preintervention 19.4 to postintervention 7.9 (t = 13.303, P < .001). The mean SASS scores significantly increased from preintervention 31.9 to postintervention 36.0 (t = -5.953, P < .001). The mean LSAS scores significantly decreased from preintervention 54.7 to postintervention 37.0 (t = 8.682, P < .001), and all scores demonstrated an improvement. Patients who continued working showed improved depressive and social anxiety symptoms. The BDI-II and SASS scores showed no significant differences between the groups, but the postintervention LSAS scores were significantly different (P = .041). LSAS score changes: Group A = -26.2; Group B = -9.8; estimated difference: -17.920, 95% CI: -32.181 to -3.659, P = .015. CONCLUSIONS: The RTW-I program improved depressive and social anxiety symptoms. Patients with improved scores continued working for 1 year after the intervention.Trial registration: This trial was retrospectively registered with the UMIN Clinical Trial Registry (UMIN-CTR) (ID: UMIN000037662) on August 10, 2019.

A 1-year follow-up study of coping in patients with panic disorder.

We conducted a longitudinal study of methods used by patients with panic disorder to cope with stress, in order to investigate the characteristics of coping among these patients and to determine whether coping changes as therapy progresses and whether coping affects outcome. The Lazarus Type Stress Coping Inventory was performed on 43 patients with panic disorder and 315 normal subjects. The Stress Coping Inventory was repeated after 1 year therapy in the patients with panic disorder. Compared with normal subjects, panic disorder patients obtained significantly higher scores for emotional coping strategies (P =.04), and for seeking social support (P =.02) and escape-avoidance (i.e., wishful thinking) (P =.0008) as coping styles. On repeat assessment, these patients obtained significantly higher scores for cognitive coping strategies (P =.002), emotional coping strategies (P <.0001), planful problem solving (P =.02), confrontive coping (P =.002), seeking social support (P =.02), escape-avoidance (P <.0001), distancing (P =.002), and positive reappraisal (P =.001) than the normal subjects. A group x time interaction was significant for a self-controlling coping style (P =.01). On repeat assessment, the patients with a good outcome (Global Assessment of Functioning [GAF] score > 60) obtained a significantly higher score for self-controlling coping style, and the intractable patients (GAF score < or = 60) obtained a significantly lower score than on initial assessment. The results suggest that coping styles such as emotional coping strategies, seeking social support, and escape-avoidance are trait-dependent characteristics of patients with panic disorder. As therapy progressed, state-dependent changes, such as an increase in adaptive coping, were seen as well, and changes in coping also differed significantly based on outcome. These findings suggest that changing coping strategies in patients with panic disorder could be used as a goal of therapy.