Tveråmo Aksel, Dalgard Odd Steffen, Claussen Bjørgulf
Jessheimklinikken, Akershus Universitetssykehus, Trondheimsveien 82, 2050 Jessheim.
Tidsskr Nor Laegeforen. 2003 Aug 14;123(15):2011-5.
Between 1990 and 2000, the number of disability benefit recipients in Norway increased by 19.3%. We wanted to examine changes in the way people cope with society's demands, our hypothesis being that changing demands increase psychological stress; this again leads to increasing numbers of disability benefit recipients with a psychiatric diagnosis.
We examined the ability to support oneself financially among the 20 to 39-year-olds, traditionally the period in people's lives when they are at their most adaptive. We used data for the 1990-2000 period on sickness absence of one year or more, medical or occupational rehabilitation, long-term unemployment, welfare payments without entitlement, and disability benefits. We examined the diagnoses used for one-year sickness absence, medical rehabilitation and disability benefit status. Data were obtained from the relevant public-sector registers.
The prevalence of social security clients in the 20-39 age group was up from 6.4% in 1994 to 7.7% in 2000, an increase of 20%. The biggest increases (1992 to 2000 data) were related to minor psychiatric disorders, 152%, and milder forms of musculoskeletal disorders, 111%.
Changing demands in the workplace have increased the load of psychological stress in society, but changing demands in people's private lives are a contributing factor. The results imply an increasing mismatch between the adaptation required in our society and people's resources for coping with what is expected of them. Our health care and social security systems in their present form cannot properly come to grips with this situation; they may even exacerbate it by demanding too little of patients and thereby socialising them into the patient role.
1990年至2000年间,挪威领取残疾津贴的人数增加了19.3%。我们想要研究人们应对社会需求方式的变化,我们的假设是需求的变化会增加心理压力;这进而导致患有精神疾病诊断的残疾津贴领取者数量增加。
我们研究了20至39岁人群的经济自给能力,这一阶段传统上是人们一生中适应能力最强的时期。我们使用了1990 - 2000年期间关于一年及以上病假、医疗或职业康复、长期失业、无资格领取的福利金以及残疾津贴的数据。我们研究了用于一年病假、医疗康复和残疾津贴状况的诊断。数据来自相关公共部门登记册。
20 - 39岁年龄组中社会保障客户的患病率从1994年的6.4%上升至2000年的7.7%,增长了20%。增幅最大的(1992年至2000年数据)与轻度精神障碍(152%)和较轻形式的肌肉骨骼疾病(111%)有关。
工作场所需求的变化增加了社会中的心理压力负担,但人们私人生活需求的变化也是一个促成因素。结果表明,我们社会所要求的适应能力与人们应对期望的资源之间的不匹配日益加剧。我们目前形式的医疗保健和社会保障系统无法妥善应对这种情况;它们甚至可能通过对患者要求过低从而使他们适应患者角色而加剧这种情况。