Kessler R C, Frank R G
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
Psychol Med. 1997 Jul;27(4):861-73. doi: 10.1017/s0033291797004807.
To examine relationships between recent DSM-III-R psychiatric disorders and work impairment in major occupational groups in the US labour force.
Data are from the US National Comorbidity Survey (NCS), a survey of respondents ages 15-54 in the US. Employed people are the focus of the report.
There is substantial variation across occupations in the 30-day prevalences of NCS/ DSM-III-R psychiatric disorders, with an average prevalence of 18.2% (range: 11.0-29.6%) for any disorder. The average prevalences of psychiatric work loss days (6 days per month per 100 workers) and work cutback days (31 days per month per 100 workers), in comparison, do not differ significantly across occupations. Work impairment is more strongly concentrated among the 3.7% of the workforce with co-morbid psychiatric disorders (49 work loss days and 346 work cutback days per month per 100 workers) than the 14.5% with pure disorders (11 work loss days and 66 work cutback days per month per 100 workers) or the 81.8% with no disorder (2 work loss days and 11 work cutback days per month per 100 workers). The effects of psychiatric disorders on work loss are similar across all occupations, while effects on work cutback are greater among professional workers than those in other occupations.
The results reported here suggest that work impairment is one of the adverse consequences of psychiatric disorders. The current policy debate concerning insurance coverage for mental disorders needs to take these consequences into consideration.
研究美国劳动力中主要职业群体近期患DSM-III-R精神疾病与工作受损之间的关系。
数据来自美国国家共病调查（NCS），该调查针对美国15至54岁的受访者。报告重点关注就业人员。
NCS/DSM-III-R精神疾病的30天患病率在不同职业间存在显著差异，任何疾病的平均患病率为18.2%（范围：11.0 - 29.6%）。相比之下，精神疾病导致的工作损失天数（每100名工人每月6天）和工作减少天数（每100名工人每月31天）的平均患病率在不同职业间无显著差异。工作受损在患有共病精神疾病的3.7%劳动力中更为集中（每100名工人每月49个工作损失天数和346个工作减少天数），高于患有单纯疾病的14.5%（每100名工人每月11个工作损失天数和66个工作减少天数）或无疾病的81.8%（每100名工人每月2个工作损失天数和11个工作减少天数）。精神疾病对工作损失的影响在所有职业中相似，而对工作减少的影响在专业工人中比对其他职业更大。
此处报告的结果表明工作受损是精神疾病的不良后果之一。当前关于精神疾病保险覆盖范围的政策辩论需要考虑这些后果。
