The aim of this study was to determine whether graded activity restored occupational function in industrial blue-collar workers who were sick-listed for 8 weeks because of subacute, nonspecific, mechanical low back pain (LBP). Patients with LBP, who had been examined by an orthopedic surgeon and a social worker, were randomly assigned to either an activity group (n = 51) or a control group (n = 52). Patients with defined orthopedic, medical, or psychiatric diagnoses were excluded before randomization. The graded activity program consisted of four parts: (1) measurements of functional capacity; (2) a work-place visit; (3) back school education; and (4) an individual, submaximal, gradually increased exercise program, with an operant-conditioning behavioral approach, based on the results of the tests and the demands of the patient's work. Records of the amount of sick leave taken over a 3-year period (ie, the 1-year periods before, during, and after intervention) were obtained from each patient's Social Insurance Office. The patients in the activity group returned to work significantly earlier than did the patients in the control group. The median number of physical therapist appointments before return to work was 5, and the average number of appointments was 10.7 (SD = 12.3). The average duration of sick leave attributable to LBP during the second follow-up year was 12.1 weeks (SD = 18.4) in the activity group and 19.6 weeks (SD = 20.7) in the control group. Four patients in the control group and 1 patient in the activity group received permanent disability pensions. The graded activity program made the patients occupationally functional again, as measured by return to work and significantly reduced long-term sick leave.

Sixty healthy non-smoking white collar employees, aged 30-50, from a large corporation in Sweden participated in the study. There were four groups: 15 male and 15 female middle managers, 15 male and I5 female clerical workers. Each participant was examined individually with regard to cardiovascular and neuroendocrine functions and self-reports for 12 consecutive hours under each of two conditions: (1) a normal day at work (9 a.m. -5 p.m.) and after work (6-9 p.m.), and (2) for the same time period during work-free conditions at home. In addition, everyone was given a videotaped type A-interview and a general health check-up including blood-lipid determination. Attitudes towards work, total workload (including responsibilities outside the paid work) and sex role identity were examined by questionnaires. As expected, all groups showed a moderate increase in cardiovascular and neuroendocrine activity during the day at work. After work, however, interesting group differences emerged, suggesting slower unwinding in female managers. Differences related to occupational level and/ or sex were found for autonomy and social support at work, competitiveness, sex role and reported corifict between demands from paid work and other responsibilities. The stress profie of the female managers was considered in terms of possible long-term health risks.

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Objective: Obsessive-Compulsive Disorder (OCD) defined at the diagnostic level encompasses divergent symptoms and is often associated with other psychiatric problems.The present study examines OCD versus co-morbid symptom patterns in OCD in children and adolescents in order to investigate the presence of diagnostic heterogeneity Subjects and methods: One-hundred and thirteen outpatients with primary OCD participated.The patients' and primary caretakers' responses on semi-structured interviews (child version of Schedule for Affective Disorders and Schizophrenia and the Children's Yale-Brown Obsessive Compulsive Scale) and parents' responses on the Child Behaviour Checklist were used in the study. Psychiatric diagnoses were related to CBCL syndrome scores and CBCL scores were compared with the Swedish normative data.Results: Co-morbid diagnoses were very common and only one out of five patients had only OCD. The most common group was the neuropsychiatric disorders (47%) where tic disorders were most common (27%), especially among boys (40.8%; p= .006, Fisher's exact test). Also anxiety disorders were common (39.8%) as were affective disorders (24.8%) neither with any gender differences. Diagnoses of disruptive disorders were less common (8.8%), almost exclusively of the oppositional kind (ODD) (8.8%). From the dimensional point of view using the CBCL, patients with OCD scored higher than Swedish youngster generally do, and some gender differences were seen in that girls scored higher on anxiety and depression while both girls and boys had high scores on thought problems, attention problems and especially aggressive behaviour. Comorbidities explained from 25-50% of the CBCL sub-syndrome scales, often with both main effects and through complex patterns of interaction with gender, OCD-severity and other co-morbid problems.OCD co-morbidity Conclusions: While co-morbid problems is an important facet of OCD, sub-syndromal levels of symptoms that can be assessed using a dimensional approach, is a large part of the total symptom burden in these youngsters. Our data indicate contributions of different pathways for girls and for boys for several comorbid problems together with OCD-severity.

The association between psychological and physiological stress responses was examined in 20 male workers at an assembly line. Each worker was studied during a 2 h period on two consecutive days in their normal job and, in order to obtain physiological baseline values, during a corresponding paid 2 h period off the job on the third day. Self-reports of work demands, mood, etc., measurements of catecholamine and cortisol excretion and of systolic and diastolic blood pressure and heart rate were obtained at the end of each of the three 2 h periods. Work induced a significant elevation in almost all psychological and physiological measurements. Levels were consistently lower in workers reporting a 'good' workday compared to those reporting a 'normal' or a 'bad' day. Correlations between selfreports and physiological values showed that catecholamine and cortisol responses, respectively, tended to be associated selectively with different psychological conditions, catecholamine values being associated with feelings of time pressure and pressure by demands, cortisol values with irritation, tenseness and tiredness. The results show that perceived stress at an assembly line is consistently reflected in cardiovascular and neuroendocrine functions of the workers.