Work-related psychopathology: rates in different work activities and relationship between subjective perception of work distress and psychiatric disturbances.

BACKGROUND: The link between work distress and negative mental health outcome is an emergent topic in the scientific literature. The studies that evaluated the risk of work-related psychopathologies in the different job sectors have obtained so far controversial and inconclusive results. The identification, by means of standardized evaluation tools, of the work activities at higher risk of poor mental health is a relevant target for the occupational psychiatry and medicine. OBJECTIVE: To evaluate the relationship between the psychosocial work conditions and work related psychiatric disturbances and to verify the relationship between the higher pathogenic effect of work and specific job activities. PARTICIPANTS: A six-month diagnostic trial was conducted on 234 patients (35.4% women and 64.6% men). METHODS: Psychiatric diagnoses were according to DSM-IV criteria; anxious and depressive dimensions were studied by means of Hamilton-Anxiety-Scale and Hamilton Scale for Depression; psychosocial work environments and bio-psycho-social features were measured by Naples-Questionnaire of Work Distress. Groups with higher and lower work-related pathogenesis were compared and their distribution among specific job activities was evaluated. RESULTS: Mood disorders were strongly linked to negative work environment. Patients with severe bullying obtained higher scores on Hamilton-Anxiety-Scale and Hamilton Scale for Depression than those with lower work-pathogenesis. The highest scores on Naples-Questionnaire of Work Distress were related to mood disorders, to poorer bio-psycho-social functioning and to higher work etiology. No significant relationship between work activities and work-related psychopathologies was found. CONCLUSION: Workplace bullying is predictive of work-related psychiatric disturbances with more severe clinical features and bio-psycho-social consequences. No significant differences were found about the relationship between work-related psychopathologies and work activities.

Congenital asymptomatic diaphragmatic hernias in adults: a case series.

INTRODUCTION: Congenital diaphragmatic hernia is a major malformation occasionally found in newborns and babies. Congenital diaphragmatic hernia is defined by the presence of an orifice in the diaphragm, more often to the left and posterolateral, that permits the herniation of abdominal contents into the thorax. The aim of this case series is to provide information on the presentation, diagnosis and outcome of three patients with late-presenting congenital diaphragmatic hernias. The diagnosis of congenital diaphragmatic hernia is based on clinical investigation and is confirmed by plain X-ray films and computed tomography scans. CASE PRESENTATIONS: In the present report three cases of asymptomatic abdominal viscera herniation within the thorax are described. The first case concerns herniation of some loops of the large intestine into the left hemi-thorax in a 75-year-old Caucasian Italian woman. The second case concerns a rare type of herniation in the right side of the thorax of the right kidney with a part of the liver parenchyma in a 57-year-old Caucasian Italian woman. The third case concerns herniation of the stomach and bowel into the left side of the chest with compression of the left lung in a 32-year-old Caucasian Italian man. This type of hernia may appear later in life, because of concomitant respiratory or gastrointestinal disease, or it may be an incidental finding in asymptomatic adults, such as in the three cases featured here. CONCLUSIONS: Patients who present with late diaphragmatic hernias complain of a wide variety of symptoms, and diagnosis may be difficult. Additional investigation and research appear necessary to better explain the development and progression of this type of disease.