Workplace phobia – A first explorative study on its relation to established anxiety disorders, sick leave, and work-directed treatment

Abstract

Workplace phobia is defined as a phobic anxiety reaction with symptoms of panic occurring when thinking of or approaching the workplace. People suffering from workplace phobia regularly avoid confrontation with the workplace and are often on sick leave. The specific characteristics of workplace phobia are investigated empirically in comparison to established anxiety disorders. Two hundred thirty patients from an inpatient psychosomatic rehabilitation hospital were interviewed concerning workplace phobia and established anxiety disorders. Additionally, the patients filled in self-rating questionnaires on general and workplace phobic symptom load. Subjectively perceived degree of work load, sick leave, and therapy participation were assessed. Participants with workplace phobia reached significantly higher scores in workplace phobia self-rating than did participants with established anxiety disorders. A similar significant difference was not found concerning the general psychosomatic symptom load. Workplace phobics were more often on sick leave than patients with established anxiety disorders. Workplace phobia can occur as an alonestanding anxiety disorder. It has an own clinical value due to its specific consequences for work participation. Workplace phobia requires special therapeutic attention and treatment instead of purely 'sick leave' certification.

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

“…The interview has good test-retest reliability ( ϭ 0.76 -0.93) and sensitivity and specificity (0.70 and 0.85, respectively). 28 To identify patients with workplace phobic anxiety, a validated interview module (interrater reliability, ϭ 0.89 11,29 ) about "workplace phobia" was added. Accordingly, patients with a diagnosis of workplace phobia fulfilled the criteria that they suffer from panic-like anxiety when being at or simply thinking of their workplace, they try to avoid the workplace whenever possible, and because of the anxiety symptoms have impaired functioning when at the workplace.…”

“…Workplace phobia can appear as an additional syndrome beside "general" non-work-associated mental disorders. 11,18 People with workplace phobia have been found to react with physiologic arousal when imagining the workplace, whereas people without workplace phobia do not. 12 Of patients with mental disorders receiving psychosomatic rehabilitation, 60% suffer from different forms of workplace-related anxieties, and 17% suffer from workplace phobia.…”

“…12 Of patients with mental disorders receiving psychosomatic rehabilitation, 60% suffer from different forms of workplace-related anxieties, and 17% suffer from workplace phobia. 11,14 Among employees presently working who were not receiving treatment because of mental disorders and who showed no exaggerated general anxiety, about 5% reported tendencies of workplace avoidance due to workplace-related anxiety. 19 If patients want to avoid the workplace because of work-related anxiety, the only way to do this without legal problems or financial losses is through a sick leave certificate.…”

“…Workplace phobia thus can be a kind of pathologic real angst, 11 which means that patients with workplace phobia may be accurate in their perception that there are problems or dangers at their workplace, such as requirements to achieve, superiors, aggressive clients/students/ patients, team conflicts with colleagues, toxic substances, etc. Nevertheless, workplace phobic anxiety is clinically significant because the anxiety and avoidance reactions lead to problems at work, sick leave, or loss of the job-and therefore broader negative consequences for the person's professional biography.…”

“…Thus, sick leave certification alone cannot be the solution, but specific anxiety-and workrelated therapeutic approaches are needed. 11 With regard to workplace-related anxieties, it is difficult to conduct exposition therapy directly at the workplace because of its inability to be controlled. Furthermore, it cannot be done anonymously, like in vivo exposition exercises in a tube.…”