MDGuidelines, ReedGroup Ltd., Westminster, Colorado, USA.
Mental Health and Behavioral Medicine, Veterans Affairs Texas Valley Coastal Bend Health Care System, Harlingen, Texas, USA.
J Trauma Stress. 2022 Oct;35(5):1368-1380. doi: 10.1002/jts.22836. Epub 2022 Apr 16.
Acts of violence are the fifth leading cause of nonfatal occupational injuries in the United States. Experiencing a traumatic event at work can have serious mental health consequences, including the development of posttraumatic stress disorder (PTSD). This study aimed to quantify the prevalence of PTSD caused by workplace violence (WPV) in a statewide workers' compensation system and compare the outcomes and treatment of WPV cases versus those caused by other traumatic events. Using a retrospective cohort study design, workers who reported PTSD as the primary reason for a workers' compensation claim and had no coexisting physical injuries were found in California during 2009-2018. A total of 3,772 PTSD cases were identified, 48.9% of which were attributed to WPV. Demographic risk factors associated with WPV PTSD included lower income, younger age, female gender, and employment in retail or finance, p < .001-p = .007. For individuals who returned to work, claims due to WPV resulted in longer medically approved time away from work than non-WPV causes (Mdn = 132.5 days vs. Mdn = 91 days, respectively), p < .001. Three of the top 10 most frequently prescribed medications were administered against evidence-based guidelines. This study found that many treatments prescribed to PTSD patients are based on insufficient evidence, and the provision of existing empirically supported treatments is needed, particularly in generalized populations. The findings support the need for additional recognition of the cause of workplace PTSD to facilitate appropriate referrals to WPV or PTSD specialists to support return-to-work efforts.
在美国，暴力行为是导致非致命性职业伤害的第五大主要原因。在工作中经历创伤性事件会对心理健康产生严重影响，包括创伤后应激障碍（PTSD）的发展。本研究旨在量化全州工人赔偿系统中由工作场所暴力（WPV）引起的 PTSD 的患病率，并比较 WPV 病例与其他创伤性事件引起的病例的结果和治疗。使用回顾性队列研究设计，在加利福尼亚州，2009 年至 2018 年期间，发现报告 PTSD 是工人赔偿索赔的主要原因且没有同时存在身体损伤的工人。共确定了 3772 例 PTSD 病例，其中 48.9%归因于 WPV。与 WPV PTSD 相关的人口统计学风险因素包括收入较低、年龄较小、女性和从事零售或金融工作，p<.001-p=.007。对于返回工作岗位的个人，WPV 导致的索赔导致离开工作岗位的医疗批准时间比非 WPV 原因长（Mdn=132.5 天 vs. Mdn=91 天，分别），p<.001。十大最常开处方药物中有三种是根据循证指南开的。本研究发现，许多开给 PTSD 患者的治疗方法的依据不足，需要提供现有的循证治疗方法，特别是在普通人群中。这些发现支持需要进一步认识工作场所 PTSD 的原因，以便为 WPV 或 PTSD 专家提供适当的转介，以支持重返工作岗位的努力。
