Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University School of Public Health, Rm. 701, 7F., No. 17, Xuzhou Rd., Zhongzheng Dist., Taipei, 100, Taiwan, Republic of China.
School of Nursing, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Rm 101, No. 1, Sec 1, Jen-Ai Rd, Taipei, 100, Taiwan, Republic of China.
Eur Arch Psychiatry Clin Neurosci. 2017 Sep;267(6):507-516. doi: 10.1007/s00406-016-0762-x. Epub 2017 Jan 2.
The aim of this study is to determine the prevalence rates of depressive, anxiety and PTSDs, and the risk factors for psychological symptoms at 6 years after occupational injury. This longitudinal study followed workers who were occupationally injured in 2009. Psychological symptoms and return to work were assessed at 3 and 12 months after injury. Injured workers who had completed the initial questionnaire survey at 3 or 12 months after injury were recruited. A self-administered questionnaire was mailed to the participants. For workers with high Brief Symptom Rating Scale and Post-traumatic Symptom Checklist scores, an in-depth psychiatric evaluation was performed using the Mini-international Neuropsychiatric Interview. A total of 570 workers completed the questionnaire (response rate, 28.7%). Among them, 243 (42.6%) had high psychological symptom scores and were invited for a phone interview; 135 (55.6%) completed the interview. The estimated rates of major depression and post-traumatic stress disorder (PTSD)/partial PTSD were 9.2 and 7.2%, respectively, and both these rates were higher at 6 years after injury than at 12 months after injury (2.0 and 5.1%). After adjustment for family and social factors, the risk factors for high psychological scores were length of hospitalization immediately after injury, affected physical appearance, repeated occupational injuries, unemployment, and number of quit jobs after the injury. At 6 years after occupational injury, the re-emergence of psychiatric disorders was observed. Relevant factors for poor psychological health were severity of injury and instability of work. Periodic monitoring of psychological and physical health and economic stability are warranted.
本研究旨在确定职业伤害后 6 年抑郁、焦虑和创伤后应激障碍的患病率，以及心理症状的危险因素。这是一项纵向研究，对 2009 年职业受伤的工人进行随访。受伤后 3 个月和 12 个月评估心理症状和重返工作岗位情况。招募完成受伤后 3 个月或 12 个月初始问卷调查的受伤工人。向参与者邮寄了一份自我管理问卷。对于 Brief Symptom Rating Scale 和 Post-traumatic Symptom Checklist 评分较高的工人，使用 Mini-international Neuropsychiatric Interview 进行深入的精神病学评估。共有 570 名工人完成了问卷（应答率为 28.7%）。其中，243 名（42.6%）工人心理症状评分较高，邀请他们进行电话访谈；135 名（55.6%）完成了访谈。估计重度抑郁症和创伤后应激障碍（PTSD）/部分 PTSD 的发生率分别为 9.2%和 7.2%，这两种发生率在职业伤害后 6 年都高于受伤后 12 个月（分别为 2.0%和 5.1%）。调整家庭和社会因素后，高心理评分的危险因素包括受伤后立即住院时间、影响外貌、反复职业伤害、失业以及受伤后辞职次数。在职业伤害后 6 年，观察到精神障碍再次出现。心理健康不良的相关因素是受伤的严重程度和工作的不稳定。有必要定期监测心理和身体健康以及经济稳定性。
