Stevens A, Foerster K
Sektion Forensische Psychiatrie, Universität Tübingen.
Nervenarzt. 1995 Nov;66(11):811-9.
This paper summarizes how neurotic disorders affect working capability, with an emphasis on neurotic working disorders. According to official statistics neurotic disorders account for 5.5% of all disability pensions, but they figure less often as diagnoses in medical certificates issued prior to invalidation. The true impact of neurotic disorders may only be guessed, since the diagnosis is easy to miss and only reluctantly proffered when suspected. In contrast to other neurotic disorder afflicting working behaviour, the neurotic working disorder is thematically centered within the sphere of work and profession itself. The disorder is often treated inadequately and belatedly. Typical somatic complaints clusters, characteristic neurotic conflicts and personality traits often encountered with neurotic working disorder are outlined. Diagnosis requires the taking of a psychobiographic history and some knowledge of psycho- and soziotherapy. There are many options for therapy, and there are a few studies evaluating their efficacy. In order to install treatment early, a routine checkup by a psychotherapist is suggested for all patients exceeding a certain number of days off work per year.
本文总结了神经症如何影响工作能力,重点关注神经症性工作障碍。根据官方统计,神经症在所有残疾抚恤金中占5.5%,但在致残前开具的医疗证明中,它们作为诊断的情况较少。神经症的真正影响可能只能猜测,因为这种诊断很容易被漏诊,只有在怀疑时才勉强给出。与影响工作行为的其他神经症不同,神经症性工作障碍在主题上以工作和职业领域本身为中心。这种障碍往往治疗不充分且不及时。文中概述了神经症性工作障碍常出现的典型躯体主诉群、特征性神经症冲突和人格特质。诊断需要获取心理传记史以及一些心理治疗和社会治疗的知识。治疗方法有很多,但评估其疗效的研究较少。为了尽早开展治疗,建议对每年缺勤超过一定天数的所有患者进行心理治疗师的常规检查。