ABSTRACT
Objetivos: Calcular la prevalencia de los trastornos mentales como causa deincapacidad temporal (IT) en la Comunidad de Madrid y describir que trastornosmentales asociados al trabajo son más prevalentes por profesión, edad y sexo.Métodos: Estudio observacional descriptivo, cuyo ámbito es la población dela Comunidad de Madrid. Se han estudiado los pacientes en situación de IT con pagodirecto por el Instituto Nacional de la Seguridad Social (INSS): desempleados,trabajadores del régimen de autónomos, empleadas de hogar y régimen agrario. Elperiodo estudiado incluye desde enero de 2002 a septiembre de 2003. Se han registradolas siguientes variables: edad, sexo, régimen de la Seguridad Social, diagnóstico(CIE-10), ocupación, duración de la baja, desempleo y si alegan relación de susituación de incapacidad con el trabajo. Se ha calculado la prevalencia de trastornosmentales entre los pacientes en IT y la prevalencia de aquellos que relacionabansu patología con el trabajo. Se han utilizado técnicas estadísticas descriptivas,para sintetizar los resultados.Resultados: Un total de 1.628 trabajadores en IT (11,2%) presentaban comodiagnóstico principal algún trastorno mental, de los cuales el 17,8% (289) relacionansu patología con el trabajo. La edad media fue de 43,5 años (DE = 11,5). Lasmujeres presentan con mayor frecuencia T. mental como causa de IT, sin embargoel porcentaje de hombres que lo asocian al trabajo es significativamente mayor. Delos 289 trabajadores que relacionan su patología con el trabajo un 39,4% presentancomo diagnóstico un T. Adaptación, un 27,7% un T. mixto ansioso-depresivo yun 20,8% un episodio depresivo. Los trabajadores cualificados: directivos (41%),técnicos científico-intelectuales (30%) y empleados administrativos (27%) son losque presentan mayor prevalencia de sintomatología depresiva asociada al trabajo.Conclusiones: Los trastornos mentales son la segunda causa de IT de largaduración. Uno de cada cinco pacientes relaciona su patología con el trabajo, siendolos diagnósticos más prevalentes los trastornos de adaptación, trastornos mixtos ansioso-depresivos y los episodios depresivos. En tres de cada cuatro casos la duraciónmedia de la IT supera los seis meses. Los trabajadores cualificados: directivos,técnicos científico-intelectuales y empleados administrativos son los que presentanmayor prevalencia de sintomatología depresiva asociada al trabajo
Objectives: To calculate the prevalence of mental disorders as cause ofshort-term disability in Madrid Community and to describe work-related depressionsymptoms by occupation, age and sex.Method: We conducted a descriptive observational study in MadridCommunity. Patients in Short-term Disability (STD) paid by The National Instituteof Social Security (NISS) have been studied. It have been used the databaseof the NISS in Madrid as a source of information. The recorder variableswas: age, sex, social security status, diagnosis (ICD-10), occupation, unemployed,and work related depression symptoms. Assessment was made by calculatingthe mental disorders prevalence in patients with short-term disabilityand work related depressive symptoms. Descriptive statistic techniques hasbeen used.Results: In total 1628 workers in short-term disability (11,2%) were diagnosisfor mental disorders, 17,8% (289) of them were work related pathology.The mean age of patients was 43,5 (SD = 11,5). The prevalence of mentaldisorders as cause of short-term disability is higher in females, but males presentsmore work-related depression symptoms. The 39,4% presents adaptationdisorder diagnosis, 27% mixed anxious-depressive disorders and 20,8% depressiveepisode. Women between 30 and 40 years old, and men of more tan 50years were more frequently work related pathology. In 75% of the cases themedium time of STD was six months. Qualified workers: directors (41%), scientificintellectual technicians (30%) and administrative workers (27%) werethe ones who presents more prevalence of work-related depressive symptoms.Conclusions: Mental disorders were the second cause of short term disabilityin Madrid. One of each five patients present work-related depressivesymptoms. The more prevalence diagnosis were adaptation disorders mixedanxious-depressive disorders and depressive episodes. In three of each fourcases, the medium last of STD was six months. Qualified workers: directorsscientific intellectual technicians and administrative workers, were the oneswho presents more prevalence of work-related depressive symptoms
Subject(s)
Male , Female , Adult , Middle Aged , Humans , Stress, Psychological/epidemiology , Depressive Disorder/epidemiology , Sick Leave/statistics & numerical data , Epidemiology, Descriptive , Mental Disorders/epidemiology , Occupational Diseases/epidemiologyABSTRACT
On the basis of the hypothetical utility of clonazepam (CLN) for the treatment of affective disorders, by means of previous references and etiopathogenic hypothesis like the Kindling phenomenon we have been developing a study in order to evaluate that usefulness and efficacy which, includes 32 patients with affective disorders; 23 of them with a diagnosis of bipolar disorder (manic) the greatest part of the subjects had been previously treated with lithium antidepressants or neuroleptics, and clonazepam was introduced because of an inadequate response, treatment intolerance or searching for a specific effect. Our results suggest a prevalence of partial and good responses (85%) The same in the objective evaluations as in the subjective ones being the levels of response higher than in previous treatments. The study supports the use of CLN in the treatment of patients who suffer from affective disorders, particularly in hypomanic episodes.
Subject(s)
Clonazepam/therapeutic use , Mood Disorders/drug therapy , Adolescent , Adult , Aged , Drug Evaluation , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
The existence of seasonal variations in the dexamethasone suppression test (D.S.T.) has been remarked. In a sample of 345 patients with affective symptomatology and various psychiatric diagnostics, patient with major depression have higher non suppression levels in spring and winter; a similar but stronger seasonal variations is observed in patients with melancholic and patients with psychotic syndrome showed a similar tendency. In patients with diagnostics different from depression (dementia, schizophrenia, mania, anxiety disorders), the non suppression level is higher in winter. Some similarities with the contributions of other authors are observed but in general disagreements are more frequent, which suggests us the influence of latitude and geo-climatic changes, since the seasonal variability can not be explained by means of seasonal changes in demographic or clinical variables, as diagnostic or psychiatric syndrome.
