Mental Illness and Work-Related Limitations in Healthcare Workers: A Preliminary Retrospective Study

Abstract

This retrospective observational study investigated hospital staff requests for job fitness visits, addressed to occupational medicine. Specific objectives were to analyze: (1) health workers’ requests, sociodemographic characteristics, psychiatric diagnoses, assigned doctor’s fit notes, and (orthopedic, psychiatric) limitations; (2) associations between psychiatric diagnoses, sociodemographic (sex, age), and work-related (job, department) characteristics; (3) associations between the same psychiatric diagnoses/orthopedic limitations, fit notes, and/or psychiatric limitations. Data of St. Orsola-Malpighi Polyclinic health workers (N = 149; F = 73.8%; mean age = 48 ± 9.6 years), visited by both the occupational medicine physician and psychiatrist (January 2016–May 2019), were analyzed. 83.2% of the sample presented with at least one psychiatric diagnosis, including mood (47%), anxiety (13.4%), and anxious-depressive (10.7%) disorders. Significant differences between psychiatric diagnoses according to sex and fit notes (both p < 0.01) have been found, whereas no significant associations based on age and work-related characteristics have been observed. Analysis of frequencies of participants with the same psychiatric diagnosis (orthopedic limitation being equal), according to doctor’s fit notes and psychiatric work limitations, showed a high heterogeneity of assignments. The current occupational medicine procedure for fit notes/job limitations assignments does not allow taking into consideration clinical factors possibly associated with more specific assignments. To standardize the procedure and translate the psychiatrist’s clinical judgment into practice, further studies to test the usefulness of clinimetrics, which might represent a reliable approach in considering different fit notes and job limitations, are needed.

Psychopathological Burden among Healthcare Workers during the COVID-19 Pandemic Compared to the Pre-Pandemic Period

“…Initially, descriptive analyses revealed that the majority of requests came from women and nurses, as in the previous research [17]. In the general population, women present the highest number of psychiatric illness because of biological, social, cultural and psychological factors [20].…”

“…All the consecutive first visits, the so-called "application visits" (as established by the Italian law regarding workers' health), at the Department of Occupational Medicine, requested in the period between January 2017 and December 2022 (N = 205), were considered. As described in a previous publication [17], all workers asking for an application visit were evaluated first by the occupational physician for any orthopedic limitations and, subsequently, by the occupational psychiatrist for any psychiatric limitations. Thereafter, all the subjects received a medical certificate based on their physical and mental health status, as follows: fit for work, unfit for work, and fit with limitations.…”

“…Occupational Medicine took this extraordinary situation as an opportunity to highlight the importance of its role thanks to both the implementation of prevention measures at the workplace [13] to protect workers' well-being [14] and emphasis on the rehabilitation of healthcare personnel focusing on their physical health subsequent to viral exposure [15,16]. In a recent study conducted in the pre-pandemic period [17], psychopathological concerns were observed among healthcare professionals who requested medical evaluation from the Occupational Medicine department. However, the primary focus of the mentioned study was to explore job limitations assignments according to psychiatric diagnoses [17].…”

“…In a recent study conducted in the pre-pandemic period [17], psychopathological concerns were observed among healthcare professionals who requested medical evaluation from the Occupational Medicine department. However, the primary focus of the mentioned study was to explore job limitations assignments according to psychiatric diagnoses [17]. To the best of our knowledge, there are no studies evaluating healthcare workers' first visit (i.e., application visit) requests to the Occupational Medicine department, as well as their underlying psychopathological conditions before and after COVID-19.…”

The Relationship between Patients’ Demands and Workplace Violence among Healthcare Workers: A Multilevel Look Focusing on the Moderating Role of Psychosocial Working Conditions

“…High levels of stress go hand in hand with the experience of negative affective states such as tension and anxiety, [24]. Similarly, chronic stress may, in the longer run, evolve into a cynical attitude towards the patient and impaired emotional control as part of the burnout syndrome [25][26][27] that disconnects the individual from others, leading to overreaction and patient blaming [28]. Such psychological states and conditions may fuel patients' irritability, increasing the likelihood of violent incidents.…”