Abstract
Essential requirement for a rework program depends on the actual situation of difficulty in going back to the work place for patients with affective disorders. In Japan, a fact that the number of patients with affective disorders increased twice and changed the phenotype of symptom in a recent decade. As features of symptom of affective disorders depend on mild changes of disease and their atypicality, they are summed up in the following three points ; 1) blaming others, 2) deep anxiety and 3) excessive vigor. It is difficult even for a veteran psychiatrist to ascertain when to return to the work place. For this reason a rework program plays a very important role in preserving preparatory conditions. The elements of the rework program include ; 1) therapy as group, 2) prevention of re-sick leave, 3) medical rehabilitation contributed by co-medical staff and psychiatrists, and 4) psychosocial education. The ultimate data of 501 patients who finished the rework program showed the survival rate at 1 and 2 years after returning to the work place was 77% and 63%, respectively. In 62 patients who were considered to be cured by finishing drag treatment, the treated period was more over 700 days after returning to the work place.
