Suchergebnisse

Objective: The aim of this study was to examine changes in the distribution of causes of death and mortality rates among psychiatric patients visiting a psychiatric emergency room (PER), to determine clinically useful predictors for avoiding premature mortality among these patients and to discuss possible interventions. Method: The study was designed as a historical prospective record linkage study of patients with at least one visit to a Danish PER in 1995–2007. Five consecutive 3-year cohorts of individuals aged 20 to <80 years were identified. Data from the Danish Civil Registration System were linked to the Cause of Death Register and the Central Psychiatric Research Register, and logistic predictor analyses for premature death were performed. Results: The standardised mortality ratio (SMR) of all visitors compared to the general Danish population was approximately 5. Overall, patients with drug and/or alcohol use disorder experienced at least a twofold increase in SMR compared to patients without substance use disorder. In the case of patients with schizophrenia and a concurrent substance use disorder, the SMR increased considerably. During the period, substance use disorder was the strongest predictor of premature death among visitors to a PER (odds ratio (OR) = 1.8; 95% confidence interval (CI) = 1.5, 2.2). Conclusion: Persons visiting the PER had an increased SMR and substance use disorders were the strongest predictor of premature death within 3 years. However, death caused by substance use disorder is preventable, and PERs are ideal points of early intervention. Systematic screening for substance use disorder at the PER and/or crisis intervention teams may be effective intervention strategies.

Background: Prevalence of mental disorders at work is commonly reported on the subclinical level. Data on clinical caseness as to ICD-10 among employees is scarce. Aims: (i) To establish the prevalence of psychiatric morbidity in the Danish workforce in large enterprises based on a self-report measure. (ii) To verify the screening results by use of a structured diagnostic interview. (iii) To analyze associations with demographics and work- and health-related characteristics. Methods: A two-phase design study was carried out in three Danish counties. Ten large enterprises within private and public sectors participated. A questionnaire was administrated to 1,500 employees. The Present State Examination (PSE) interview was conducted with selected respondents according to their scores on Symptom Checklist 90-revised (SCL-90R) and CAGE. Results: Nine hundred and seventy six (65%) employees responded. A large proportion (28.6%) was identified as sub-cases and 77 as cases as to ICD-10. Absenteeism and work dissatisfaction were associated with ICD-10 diagnoses. Conclusions: Common mental disorders caseness as to ICD-10 provides evidence for the clinical nature of occupational mental health phenomena. There were strong associations between some demographic and work- and health-related factors.

Background: The body of evidence verifies the predictive value of certain work characteristics for mental health problems and that various levels of adaptation mechanisms are employed when dealing with adversity. Data on the relationships between employees' mental health status, their perceptions of work, and their psychological defences are scarce. Aims: To examine the role that personal defences play in the relationship between psychiatric symptoms among working people and their working environment. Methods: Nine hundred and seventy six employees (mean age = 42.4 years, SD = 11.3) participated in a questionnaire study that included the Defence Style Questionnaire, the Symptom Checklist 90 revised, and the Copenhagen Psychosocial Questionnaire . Results: Data showed that greater maturity of psychological defences was associated with higher level of psychological functioning and there were strong associations between presence of psychopathology and the three defence clusters. Results indicated a strong positive correlation between the mature defence style and the perception of a satisfactory workplace. There was no interaction between psychopathology and defences in relation to work environment. Conclusion: Psychopathology and defences were significantly associated with work conditions, which could suggest that adaptation mechanisms and psychopathology are two independent forms of adjustment to the rapidly changing world of work.