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Post-traumatic Stress Disorder Among Workers After Occupational Injury.
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Post-traumatic Stress Disorder Among Workers After Occupational Injury The labor who has exposed to a traumatic event may display significant psychiatric disorders that make them unable to return to the work place. The proportion of those returned to the work place, but immediately retarded has been increased. According to the overseas report, it is about one third of patients who have shown the symptoms of post-traumatic stress disorder (PTSD) after the occupational disaster. So far, in Taiwan there has no research focused on the prevalence and risk factor of post-traumatic stress disorder in the workplace. However, PTSD has been included in the list of occupational diseases. Background The purposes of this study are to determine the prevalence rates of post-traumatic stress disorder in the workplace after occupational injuries and to determine the risk factors of post-traumatic stress disorder after occupational injuries. Objective In this cross-sectional study, we conducted a two stages questionnaire investigation. In the first stage of investigation, we sent a self-report questionnaire including Brief Symptom Rating Scale (BSRS-50) and SPAN-C (an acronym for four items: Startle, Physiological arousal, Anger, and Numbness) to 3143 injured workers at 3 months after injury. Until a total of 1424 workers had completed the self-report questionnaire (response rate 45.3%), we screened out 21.6% (308/1424) of those who got high scores of BSRS-50 and were highly suspected of having post-traumatic stress disorder into second stage investigation (Table1). In the second stage of investigation, a diagnostic structure interview of Mini-international Neuropsychiatric Interview (MINI) was conducted by the psychiatrist using telephone interview for workers’ psychiatric diagnosis, including post-traumatic stress disorder. Material and Method Kuan-Han Lin1, Nai-Wen Guo3, Shi-Cheng Liao4, Yun-Chan Hsieh5, Chun-Ya Kuo4, Yaw-Huei Hwang1, Yue-Liang Leon Guo1,2 1. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University School of Public Health. 2. Department of Environmental & Occupational Medicine, National Taiwan University Hospital. 3. Institute of Behavioral Medicine, National Cheng Kung University. 4. Department of Psychiatry, National Taiwan UniversityHospital 5. Taiwan Public Health Association This study found that 139 injured workers who had interviewed with MINI, their rates of PTSD, major depression, and comorbid PTSD and major depression were 19.4% (27/139),18.7% (26/139), and 10.8% (15/139, respectively (Table2). And, the estimated rates of PTSD, major depression, and comorbid PTSD and major depression of 1424 injured workers were 4.2% (21.6% x 19.4%), 4.0% (21.6% x 18.7%), and 2.3% (21.6% x 10.6%), respectively (Table3). Sex (female), marital status (divorced/separated), coma after occupational injury, injury affecting physical appearance, past traumatic experience, psychiatric medicine taking before injury, and post traumatic experience were important factors that increased the likelihood of psychiatric morbidity and PTSD. (Table4) Results *P<.05 ; **P<.01; ***P<.001 Discussion and Conclusion The results showed that the estimated rates of PTSD, major depression, and comorbid PTSD and major depression of 1424 injured workers were 4.2% , 4.0% , and 2.3%, respectively. In conclusion, this study showed that occupational injury can cause psychological impact in the injured workers. Moreover, PTSD and depression are commonly observed following occupational injury. The findings of risk factors suggest avenues for targeting posttraumatic interventions. This study was supported by grants IOSH98-M315 from the Institute of Occupational Safety & Health, Taiwan, ROC. Acknowledgements (+) severity score (-) non-severity score First author’s e-mail: okonkio@yahoo.com.tw