Franche Renée-Louise, Carnide Nancy, Hogg-Johnson Sheilah, Côté Pierre, Breslin F Curtis, Bültmann Ute, Severin Colette N, Krause Niklas
Occupational Health and Safety Agency for Healthcare in British Columbia, Vancouver, British Columbia.
Can J Psychiatry. 2009 Aug;54(8):534-46. doi: 10.1177/070674370905400806.
To estimate prevalence, incidence, and course of depressive symptoms and prevalence of mental health treatment following a workplace injury, and to estimate the association between depressive symptoms and return-to-work (RTW) trajectories.
In a prospective cohort study, workers filing a lost-time compensation claim for a work-related musculoskeletal disorder of the back or upper extremity were interviewed 1 month (n = 599) and 6 months (n = 430) postinjury. A high level of depressive symptoms was defined as 16 or more on the self-reported Center for Epidemiologic Studies-Depression (CES-D) Scale. The following estimates are reported: prevalence of high depressive symptom levels at 1 and 6 months postinjury; incidence, resolution, and persistence of high depressive symptom levels between 1 and 6 months; and prevalence of self-reported mental health treatment and depression diagnosis at 6 months postinjury.
Prevalence of high depressive symptom levels at 1 month and 6 months postinjury were 42.9% (95% CI 38.9% to 46.9%) and 26.5% (95% CI 22.3% to 30.7%), respectively. Among participants reporting high depressive symptom levels at 1 month postinjury, 47.2% (95% CI 39.9% to 54.5%) experienced a persistence of symptoms 6 months postinjury. By 6 months, 38.6% of workers who never returned to work or had work disability recurrences had high depressive symptom levels, compared with 17.7% of those with a sustained RTW trajectory. At 6-month follow-up, 12.9% (95% CI 5.8% to 20.1%) of participants with persistently high depressive symptom levels self-reported a depression diagnosis since injury and 23.8% (95% CI 14.7% to 32.9%) were receiving depression treatment.
Depressive symptoms are pervasive in workers with musculoskeletal injuries, but transient for some, and seldom diagnosed as depression or treated.
评估工伤后抑郁症状的患病率、发病率和病程，以及心理健康治疗的患病率，并评估抑郁症状与重返工作岗位（RTW）轨迹之间的关联。
在一项前瞻性队列研究中，对因工作相关的背部或上肢肌肉骨骼疾病提出误工补偿申请的工人在受伤后1个月（n = 599）和6个月（n = 430）进行访谈。自我报告的流行病学研究中心抑郁量表（CES-D）得分16分及以上被定义为高抑郁症状水平。报告了以下估计值：受伤后1个月和6个月时高抑郁症状水平的患病率；1至6个月期间高抑郁症状水平的发病率、缓解率和持续率；以及受伤后6个月时自我报告的心理健康治疗和抑郁症诊断的患病率。
受伤后1个月和6个月时高抑郁症状水平的患病率分别为42.9%（95%可信区间38.9%至46.9%）和26.5%（95%可信区间22.3%至30.7%）。在受伤后1个月报告高抑郁症状水平的参与者中，47.2%（95%可信区间39.9%至54.5%）在受伤后6个月症状持续存在。到6个月时，从未重返工作岗位或工作残疾复发的工人中有38.6%有高抑郁症状水平，而持续RTW轨迹的工人中这一比例为17.7%。在6个月随访时，持续高抑郁症状水平的参与者中有12.9%（95%可信区间5.8%至20.1%）自伤后自我报告有抑郁症诊断，23.8%（95%可信区间14.7%至32.9%）正在接受抑郁症治疗。
抑郁症状在肌肉骨骼损伤的工人中普遍存在，但对一些人来说是短暂的，很少被诊断为抑郁症或接受治疗。
