Anxiety disorders and workplace-related anxieties

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Abstract

Background: Workplace-related anxieties are often connected with sick leave. There are no established instruments which allow to assess this phenomenologically heterogeneous group of disorders. Method: One hundred and thirty-two psychosomatic inpatients were interviewed with a standardized diagnostic interview in respect to mental illnesses, especially primary anxiety disorders, and in addition in respect to different work-related anxiety disorders. Results: Seventy-one percent of women and 54% of men complained about work-related anxiety. 20.5% of participants are suffering from work-related panic, 58% from work-related phobia, 34.1% from work-related social phobia, 39.4% from work-related generalized anxiety, and 1.5% from work-related PTSD. There is a moderate relation between mental disorders or primary anxiety disorders and work-related anxiety. Fourteen percent of the participants did only suffer from workplace-related anxiety and did not report any other anxiety disorder outside the workplace situation. Conclusion: There are various types of workplace-related anxieties. They are partly independent clinical phenomena deserving special diagnostic and therapeutic attention.

Introduction

Anxiety disorders are frequent and result in suffering for the patient and costs for the society (Greenberg et al., 1999, Ninan, 2001). Anxiety disorders are a heterogeneous group of disorders including specific phobias, social phobia, agoraphobia and panic disorders, generalized anxiety, OCD, PTSD, hypochondriasis and somatization disorders (ICD-10, World Health Organization (1993); DSM-IV, American Psychiatric Association, 1994).

There is growing evidence that the workplace can have an important role in the development of anxiety problems and disorders. This is discussed under headings like “mobbing”, “work stress”, “burnout”, or “work-load” (Brodsky, 1988; Buddeberg-Fischer, Klaghofer, & Buddeberg, 2005; Greif, Bamberg, & Semmer, 1991; Gusy, 1995, Hasalm et al., 2005; Helge, 2001a, Helge, 2001b; Hobson & Beach, 2000; Kawakami et al., 1996, Kirchner, 1993, Leyman, 1993; Maslach & Jackson, 1981; Rohmert, 1984, Selye, 1983, Turnipseed, 1998; Zapf, Knorz, & Kulla, 1996; Nagata, 2000, Rahe et al., 2002). Special attention has been given to workplace-related posttraumatic stress disorders (Laposa, Alden, & Fullerton, 2003; MacDonald et al., 2003; Price, Monson, Callahan, & Rodriguez, 2006) and anxiety phenomena in special professional settings (Fehm & Schmidt, 2006).

Independent of their nature and origin, anxiety disorders can interfere with the ability of participants to work (Haines, Williams, & Carson, 2002; Linden and Baron, 2005; Linden, Oberle-Thiemann, & Weidner, 2003; Linden and Muschalla, 2005). Work-related anxieties can manifest in the form of phobia, social anxiety, generalized anxiety, fears of insufficiency, or hypochondrial anxiety in relation to work, working conditions, or colleagues and superiors.

Section snippets

Statement of the problem and purpose of the study

To date it is unknown to what degree anxiety disorders and work-related anxiety disorders are interrelated. Do all anxiety disorders also involve the workplace? Are work-related anxieties always a symptom of a primary anxiety disorder? To our knowledge there is no systematic study on the interrelation of anxiety disorders and work-related anxiety disorders. In order to answer these questions we wanted to investigate the relationship between anxiety disorders in general and anxiety exhibited in

Assessment of anxiety disorders and work-related anxiety disorders

All participants were interviewed with the standardized Mini International Psychiatric Interview MINI (Sheehan et al., 1994), based on the diagnostic criteria of the DSM-IV. The interview allows to assess all major psychiatric disorders, including all anxiety disorders.

On the basis of this interview, we developed an additional interview kit for the assessment of work-related anxieties, the “MINI work anxiety interview”. This second interview targeted panic, situational phobia, social phobia

Results

According to the standardized interview, the predominant diagnoses in female participants were depression (44%) and generalized anxiety disorders (50%), and in male participants generalized anxiety disorders (31%), social phobia (31%) and dysthmia (27%). There were 17.4% of participants who were not suffering from other mental problems but, e.g., from migraine or pain disorders. Table 2 shows the prevalence of anxiety disorders in general and other major mental disorders, the prevalence of

Discussion

This study is an investigation on the relationship between anxiety in general and anxiety exhibited in the workplace. Clinical experience shows that disabling anxiety must not always affect all parts of live, but can be related very specifically to the workplace only. Any workplace has features which can provoke anxiety. Workplaces are hierarchically organized so that superiors can exert sanctions, there are demands which can result in failure, there is rivalry between colleagues, there can be

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