Nakamura Jun
Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health.
Seishin Shinkeigaku Zasshi. 2012;114(9):1093-9.
Work-related adjustment disorder and depression are frequently work-related mental problems. Over 60% of employees feel job stress in the work place in Japan. The number of employees who become psychiatric disorders such as depressive state and depression, and lead to the suspension of jobs is increasing. It is an important issue for Japanese government is planning to introduce a new rule for mental examinations for workers using a self-check questionnaire. However, it is quite skeptical to detect depressive employees using such methods. It is well known that the sensitivity and specificity in self-rating questionnaire for depression is very low, because depression is not homogeneous disorder and patients reveals various symptoms. It is quite questionable that workers who required receiving a mental interview go to meet occupational health physicians or psychiatrists or workers answer the questionnaire in precise, because of stigma of the mental disorders or afraid of worsening evaluations to themselves by their superiors. Moreover it is actually very difficult for psychiatrist to deal with the subjects including false positive cases as well as true depressed patients. Therefore, more realistic and useful methods should be reconsidered. I think enhancing cooperation or interaction between occupational health physicians and psychiatrists is one of important issues.
与工作相关的适应障碍和抑郁症是常见的与工作相关的心理问题。在日本，超过60%的员工在工作场所感到工作压力。因出现抑郁状态和抑郁症等精神障碍而导致工作暂停的员工数量正在增加。日本政府计划引入一项针对员工的新的心理健康检查规则，使用自我检查表，这是一个重要问题。然而，使用这种方法来检测抑郁员工很值得怀疑。众所周知，抑郁症自评问卷的敏感性和特异性非常低，因为抑郁症不是一种单一的疾病，患者会表现出各种症状。由于精神障碍的污名化或担心上级对自己的评价变差，需要接受心理访谈的员工是否会去找职业健康医生或精神科医生，或者员工是否会准确回答问卷，这是很值得怀疑的。此外，对于精神科医生来说，处理包括假阳性病例以及真正抑郁的患者在内的对象实际上非常困难。因此，应该重新考虑更现实、更有用的方法。我认为加强职业健康医生和精神科医生之间的合作或互动是重要问题之一。
