Kobelt Axel, Grosch Eberhard, Hesse Bettina, Gebauer Erika, Gutenbrunner Christoph
Deutsche Rentenversicherung Braunschweig-Hannover, Arztlicher Dienst.
Psychother Psychosom Med Psychol. 2009 Jul;59(7):273-80. doi: 10.1055/s-2008-1067457. Epub 2008 Jul 8.
In Germany the number of invalidity pensions due to mental disorders is increasing. More than one third of these insurants do not take part in rehabilitation measures before their early retirement. Only 6 % return into their employment relationship.
Data of all insurants (of DRV Braunschweig-Hannover) under 50 who drew a short-term benefit due to complete reduction in earning capacity in 2004 (n = 352) were collected with the help of an anonymous questionnaire (response rate = 54 %). This questionnaire compiled data on their general health status, their functional capacity and work ability, their motivation for returning to work as well as psychosocial aspects. At the same time, socio-demographic characteristics from the regional pension insurance database were analyzed.
Compared to patients treated in hospitals, those insurants who had been on a two-year temporary leave were psychologically strongly distressed. There was also a gender effect: Women in particular showed significant limitations in daily activities/routines, a higher level of anxiety and somatization. Less than 30 % of the pensioners were motivated for vocational rehabilitation in order to return to their jobs. The motivation was not dependant on the psychological load and the age but most probably on the somatization tendencies and the daily activities.
It seems that classic vocational rehabilitation for insurants who already receive a disability pension does not lead to a higher rate of reintegration into work. The relatively large number of insurants who want to return to their jobs implies the necessity of a special rehabilitation programme with concepts for reintegration: an individual case-management should help to continually counsel the patients and, by means of work-trial phases, prepare them for their return into their career.
在德国,因精神障碍而领取伤残抚恤金的人数正在增加。超过三分之一的这类参保人员在提前退休前未参加康复措施。只有6%的人恢复工作。
借助一份匿名问卷(回复率 = 54%)收集了2004年因完全丧失工作能力而领取短期福利的所有50岁以下参保人员(DRV不伦瑞克 - 汉诺威)的数据(n = 352)。该问卷收集了他们的总体健康状况、功能能力和工作能力、重返工作的动机以及社会心理方面的数据。同时,分析了地区养老保险数据库中的社会人口特征。
与在医院接受治疗的患者相比,那些休了两年临时假的参保人员心理压力很大。还存在性别差异:尤其是女性在日常活动/事务方面存在明显限制,焦虑和躯体化程度较高。不到30%的养老金领取者有动机接受职业康复以重返工作岗位。动机不取决于心理负担和年龄,而很可能取决于躯体化倾向和日常活动。
对于已经领取伤残抚恤金的参保人员来说,经典的职业康复似乎并不能带来更高的重返工作率。相当数量的参保人员希望重返工作岗位,这意味着需要一个有重新融入概念的特殊康复计划:个案管理应有助于持续为患者提供咨询,并通过工作试验阶段让他们为重返职业生涯做好准备。