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精神卫生服务使用者在英格兰经历和预期的工作场所歧视和精神疾病隐瞒与精神科诊断及其他预测因素。

Psychiatric diagnosis and other predictors of experienced and anticipated workplace discrimination and concealment of mental illness among mental health service users in England.

机构信息

Department of Psychiatry, Zikei Hospital/Zikei Institute of Psychiatry, Okayama, Japan.

Department of Psychiatry, Kawasaki Medical Graduate School, Kurashiki, Japan.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2018 Oct;53(10):1099-1109. doi: 10.1007/s00127-018-1561-7. Epub 2018 Jul 9.

Abstract

PURPOSE

This study aims to examine whether psychiatric diagnosis is associated with likelihoods of experienced and anticipated workplace discrimination and the concealment of psychiatric diagnoses.

METHODS

5924 mental health service users in England were interviewed as part of the Viewpoint survey between 2009 and 2014 using the Discrimination and Stigma Scale. Associations of psychiatric diagnosis with experienced and anticipated work-related discrimination or the concealment of mental illness were examined with the use of logistic regression models.

RESULTS

25.6% of the participants reported experiencing discrimination in at least one work-related domain, contrasting with the 53.7% who anticipated workplace discrimination and the 72.9% who had concealed their mental illness. There was strong evidence that patients with schizophrenia and schizoaffective disorder had a decreased risk of experienced discrimination in keeping a job compared to those with depression, anxiety disorder, bipolar disorder or personality disorder. Furthermore, patients with depression were more likely to report anticipated discrimination in applying for education or training compared to those with schizophrenia and schizoaffective disorder. In addition, patients with depression were more likely to conceal their mental illness compared to those with schizophrenia and schizoaffective disorder and bipolar disorder.

CONCLUSION

This study suggests that psychiatric diagnosis is a predictor of experienced and anticipated workplace discrimination and the concealment of mental illness and that more support is needed for employees with common mental disorders and their employers to enable better workplace outcomes for this group.

摘要

目的

本研究旨在探讨精神科诊断是否与经历和预期的工作场所歧视以及精神科诊断的隐瞒有关。

方法

2009 年至 2014 年间,5924 名在英国接受心理健康服务的患者在观点调查中接受了访谈,使用歧视和耻辱量表。使用逻辑回归模型检验精神科诊断与经历过和预期的与工作相关的歧视或隐瞒精神疾病之间的关联。

结果

25.6%的参与者报告在至少一个与工作相关的领域经历过歧视,而 53.7%的参与者预计会在工作场所受到歧视,72.9%的参与者隐瞒了自己的精神疾病。有强有力的证据表明,与患有抑郁症、焦虑症、双相情感障碍或人格障碍的患者相比,精神分裂症和分裂情感性障碍患者在保住工作方面遭受歧视的风险较低。此外,与精神分裂症和分裂情感性障碍患者相比,患有抑郁症的患者更有可能报告在申请教育或培训方面受到歧视。此外,与精神分裂症和分裂情感性障碍患者以及双相情感障碍患者相比,患有抑郁症的患者更有可能隐瞒自己的精神疾病。

结论

本研究表明,精神科诊断是经历和预期的工作场所歧视以及精神疾病隐瞒的预测因素,需要为患有常见精神障碍的员工及其雇主提供更多支持,以改善这一群体的工作场所结果。

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