Specific Job Anxiety in Comparison to General Psychosomatic Symptoms at Admission, Discharge and Six Months after Psychosomatic Inpatient Treatment

Abstract

Objective: Job anxiety is a severe problem in many patients with chronic mental disorders, as it usually results in specific participation problems in the workplace and long-term sick leave. The aim of this study was to explore the development of sick leave in dependence on general psychosomatic complaints and job anxiety from admission to a psychosomatic inpatient treatment until 6 months after discharge. Method: A convenience sample of 91 patients, suffering from multiple mental disorders, filled in self-rating questionnaires on job anxiety (Job Anxiety Scale) and on general psychosomatic symptom load (Symptom Checklist-90-Revised) at the beginning, the end, and 6 months after discharge from an inpatient psychosomatic treatment. Additionally, sick leave status and employment status were assessed before and 6 months after the treatment. Results: 15.4% of 91 patients were on sick leave before inpatient treatment and at follow-up (SS group), 20.9% were fit for work at intake and follow-up (FF group), 6.6% were fit for work initially and on sick leave later (FS group), and 57.1% on sick leave first and working at follow-up (SF group). In regard to general psychosomatic complaints, there were initially high scores on the SCL, a marked reduction during inpatient treatment, and a bouncing back to initial levels at follow-up for all 4 patient groups. SS and FS patients showed the highest scores at intake and follow-up. Concerning job anxiety, SS patients had the highest scores at all three assessments, while FF patients had significantly lower scores, with only low variation between assessments. SF patients started with comparatively high scores of job anxiety, which even increased before reentering work, but decreased in the follow-up period when they were confronted with work again. FS patients started low (like the FF patients) at intake, reduced their job anxiety further till discharge, but increased to higher scores at follow-up. Conclusions: General psychosomatic symptom load and job anxiety show a different course during treatment and are differently related to sick leave. General psychosomatic symptom load can be understood as a measure of the degree of the chronic illness status, whereas job anxiety reflects specific additional context-related problems, i.e. problems with work. A core finding is that job anxiety is related to work avoidance, but work exposure may reduce job anxiety. This has direct consequences for putting patients on sick leave or not.

Work-Anxiety and Sickness Absence After a Short Inpatient Cognitive Behavioral Group Intervention in Comparison to a Recreational Group Meeting

“…This is similar to the course of recovery effects during and after vacation. 33 In patients from the WAG, the course of work-anxiety in comparison to general mental wellbeing is stable. This shows that work-anxiety is a specific quality of psychopathology and does not show an effect of relieve in a therapeutic milieu when patients are confronted with the topic of return to work (due to the rehabilitation setting, this is the case even for patients from the RG).…”

Methodological Recommendations for Trials of Psychological Interventions

“…They may be more conservative than clinician-rated outcomes in assessing changes over time [74,75]. Many self-rating scales reflect general aspects of distress and not necessar- ily specific treatment targets [76]. Self-rated methods might be particularly indicated in the case of computerassisted internet-delivered treatments [77].…”

Workplace Phobia, Workplace Problems, and Work Ability among Primary Care Patients with Chronic Mental Disorders

“…The scale was validated in previous studies with different non-work-related anxiety and general psychopathology questionnaires. 34,35 The WHO-5 rating was used as an indicator of the amount of mental symptom load present. The WHO-5 well-being rating 22 has 5 items and asks whether the patient felt well, relaxed, active, and full of interest for life during the past 2 weeks.…”