After the onset of a mental disorder, individuals may become increasingly susceptible to mental distress. It is therefore necessary to provide support focused on improving resilience in patients who were employed, in order to enable them to continue working without relapse. In this paper, we postulate that "monitoring swings in one's condition," "dealing with swings as appropriate," "maintaining interpersonal relationships," and "efforts to continue working" are important in improving resilience in bipolar disorder, and we summarize and discuss findings reported to date.
In terms of monitoring swings in one's condition, it is thought that the widely―used "activity record," the creation of an "individual early symptom list" (as described in the psychosocial education program of Vieta et al.), and the Hypomanic Check List (HCL; developed by Angst), may be useful. As for "managing swings in one's condition," it is believed that useful guidance may be provided via the number of applicable items in the" individual early symptom list" and/or "precursor sign list," or by evaluating the individual's condition based on the HCL cutoff point.
In terms of maintaining interpersonal relationships, treatment aims to stabilize social rhythms by mediating the impact of interpersonal stress through interpersonal relationship rhythm therapy, but it is also considered desirable to offer other measures that can be utilized by the individuals concerned. As for "efforts to continue working," it is necessary to provide psychological support around the issue of "how to live one's own life after accepting one's bipolar disorder," and it is thought that use of the Re-work Program would be desirable in this context.
It is believed that broader inclusion in educational materials for service users-as well as in treatment guidelines-of recommendations that support the improvement of resilience, will contribute to improvements in work continuation in individuals with bipolar disorder.
<Authors' abstract>
Improvement of Resilience and Support for Continuation of Work: Bipolar Disorder: Improvement of Resilience and Continuation of Work
1 Department of Neuropsychiatry, NTT Medical Center
2 Ishiki Hospital
3 Department of Quality Improvement, NTT Medical Center Tokyo
4 The University of Tokyo, Graduate School of Medicine, Department of Mental Health
5 Shinagawa Ekimae Mental Clinic
6 Department of Clinical Psychology, Faculty of Psychology, Atomi University
7 Nagasaki University Student Accessibility Office
2 Ishiki Hospital
3 Department of Quality Improvement, NTT Medical Center Tokyo
4 The University of Tokyo, Graduate School of Medicine, Department of Mental Health
5 Shinagawa Ekimae Mental Clinic
6 Department of Clinical Psychology, Faculty of Psychology, Atomi University
7 Nagasaki University Student Accessibility Office
Psychiatria et Neurologia Japonica
122: 202-211, 2020
<Keywords:bipolar disorder, resilience, work continuation, monitoring, interpersonal relationship>