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患有慢性精神障碍的基层医疗患者的工作场所恐惧症、工作场所问题及工作能力

Workplace phobia, workplace problems, and work ability among primary care patients with chronic mental disorders.

作者信息

Muschalla Beate, Linden Michael

机构信息

From the Department of Work and Organizational Psychology, University of Potsdam, Germany (BM); Psychosomatic Rehabilitation Research Group, Charité University of Medicine, Berlin, Germany (BM, ML); and the Department of Behavioral Medicine, Rehabilitation Center Seehof, Teltow, Germany (ML).

出版信息

J Am Board Fam Med. 2014 Jul-Aug;27(4):486-94. doi: 10.3122/jabfm.2014.04.130308.

Abstract

PURPOSE

Work-related anxieties are frequent and have a negative effect on the occupational performance of patients and absence due to sickness. Most important is workplace phobia, that is, panic when approaching or even thinking of the workplace. This study is the first to estimate the prevalence of workplace phobia among primary care patients suffering from chronic mental disorders and to describe which illness-related or workplace-specific context factors are associated with workplace phobia.

METHODS

A convenience sample of 288 primary care patients with chronic mental disorders (70% women) seen by 40 primary care clinicians in Germany were assessed using a standardized diagnostic interview about mental disorders and workplace problems. Workplace phobia was assessed by the Workplace Phobia Scale and a structured Diagnostic and Statical Manual of Mental Disorders-based diagnostic interview. In addition, capacity and participation restrictions, illness severity, and sick leave were assessed.

RESULTS

Workplace phobia was found in 10% of patients with chronic mental disorders, that is, approximately about 3% of all general practice patients. Patients with workplace phobia had longer durations of sick leave than patients without workplace phobia and were impaired to a higher degree in work-relevant capacities. They also had a higher degree of restrictions in participation in other areas of life.

CONCLUSIONS

Workplace phobia seems to be a frequent problem in primary care. It may behoove primary care clinicians to consider workplace-related anxiety, including phobia, particularly when patients ask for a work excuse for nonspecific somatic complaints.

摘要

目的

与工作相关的焦虑很常见,会对患者的职业表现产生负面影响,并导致因病缺勤。最重要的是职场恐惧症,即在接近甚至想到工作场所时出现恐慌。本研究首次估计了患有慢性精神障碍的初级保健患者职场恐惧症的患病率,并描述了哪些与疾病相关或特定于工作场所的背景因素与职场恐惧症有关。

方法

德国40名初级保健临床医生接诊的288名患有慢性精神障碍的初级保健患者(70%为女性)组成的便利样本,通过关于精神障碍和工作场所问题的标准化诊断访谈进行评估。职场恐惧症通过职场恐惧症量表和基于《精神障碍诊断与统计手册》的结构化诊断访谈进行评估。此外,还评估了能力和参与限制、疾病严重程度和病假情况。

结果

在患有慢性精神障碍的患者中,10%被发现患有职场恐惧症,即约占所有全科患者的3%。患有职场恐惧症的患者病假时间比没有职场恐惧症的患者更长,并且在与工作相关的能力方面受损程度更高。他们在参与生活其他方面也受到更高程度的限制。

结论

职场恐惧症似乎是初级保健中常见的问题。初级保健临床医生可能应该考虑与工作场所相关的焦虑,包括恐惧症,尤其是当患者因非特异性躯体不适而寻求工作借口时。

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