Bullying at Workplace and Brain-Imaging Correlates.

The relationship between psychosocial stress at work and mental health outcome is well-known. Brain-imaging studies hypothesize morphological brain modifications connected to work-related stress. To our knowledge this is the first study describing the link between work characteristics and brain imaging in a sample of work-related psychiatric patients assessed according to standardized clinical and diagnostic criteria. The aims of the study are: (1) to evaluate hippocampal and whole brain volumes in work-related psychiatric disturbances; (2) to verify the relationship between brain changes and the anxious and/or depressive symptoms; (3) to observe the relationship between the brain changes and the degree of the bullying at workplace. The hippocampus and whole brain volumes of 23 patients with work-related adjustment-disorders were compared with 15 controls by means of MRI. MR images highlight a smaller hippocampal volume in patients compared with controls. Significant reduction in the patients' gray matter was found in three brain areas: right inferior temporal gyrus, left cuneus, left inferior occipital gyrus. The reduction of the hippocampi volumes was related to work distress and, above all, to bullying at workplace. The results confirm that the morphological brain abnormalities could be involved in work-related psychiatric disturbances.

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.

[Mobbing, organizational dysfunction and bio-psycho-social effects: an integrated assessment. Preliminary data for the validation of the Questionnaire in the Neapoletan dialect on Distress at Work(Qn-DL)]. / Mobbing, costrittività organizzative ed effetti bio-psico-sociali: una valutazione integrata. Dati preliminari di validazione del Questionario-napoletano sul Disagio Lavorativo (Qn-DL).

The aim of this study is to produce preliminary data about the validation of the "Naples-Questionnaire of Distress at Work" (nQ.DW). This inventory is a new assessment tool in order to evaluate the distress perceived in the working environment by means of the differentiation of the conditions linked to the mobbing from which related to organizational disfunction. The nQ-DW also measures the bio-psycho-social global effects of these two phenomena. The questionnaire has been administered to workers suffering of a psychopathological disturbance related to work distress and to a control group matched for the sociodemographic and working variables. The statistical analysis demonstrated a significant validity and reliability. The degree of internal coherence was satisfactory. The ROC curves allow the determination of a threshold value which allows to separate the workers subjected to mobbing and/or organizational stress from control-workers with an optimal reliability degree. The values of the area under the ROC curves show that the inventory has a high discriminating capacity. Future studies, based on a greater sample size, will be oriented to the analysis of the questionnaire by means of multivariate techniques like the factorial analysis.

Obsessive-compulsive symptoms in schizophrenia: their relationship with clinical features and pharmacological treatment.

OBJECTIVES: The aim of this study was to evaluate (1) the frequency of obsessive-compulsive symptoms (OCS) in patients with schizophrenia, (2) the impact of OCS on clinical features of schizophrenia, and (3) the association between type of antipsychotic treatment and presence of OCS. METHODS: OCS were evaluated using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) in 70 patients with schizophrenia. The patients were then divided into two subgroups: those with at least a moderate level of OCS and those with mild or absent OCS. The two subgroups were compared using scores on the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), and the Global Assessment of Functioning Scale (GAF). RESULTS: Of the 70 patients with schizophrenia who were evaluated, 36 (51.4%) had at least moderate OCS (Y-BOCS score >16). SAPS subscale scores for hallucinations and delusions and GAF scores were found to be significantly higher among patients with at least moderate OCS, compared with those with mild or absent OCS. A significant relationship between at least moderate OCS and treatment with conventional antipsychotics was also observed. CONCLUSIONS: The presence of OCS seems to have the potential to affect clinical outcomes in schizophrenia and treatment with conventional antipsychotics appears to be correlated with the presence of OCS.

Association between bullying at work and mental disorders: gender differences in the Italian people.

BACKGROUND: In the last few years the international literature has shown an increasing attention for the work as life-event stressor, for its organizational characteristics as well as for job insecurity and interpersonal conflicts. METHODS: We have studied 707 subjects who approached the Work Psychopathology Medical Centre of Naples to evaluate the DSM IV diagnoses and the degree of bullying at the workplace according to Leymann's definition. Two groups, with high and with low severity of bullying, were compared, mainly in relation to gender differences. RESULTS: The more frequent diagnoses were anxiety disorders (8.7% of the total), mood disorders (31.5%) and adjustment disorders (58.3%). The patients with higher degree of bullying were 55.7% among the subjects with anxiety disorders, 51.4% among the patients with adjustment disorders and 81.25% in the group with mood disorders. The odds of patients with severe bullying was 1.602 times higher for males than for females. Independently by the gender, the odds of patients being in the group with severe bullying were more than three times higher for subjects with mood disorders than for patients suffering from anxiety and adjustment disorders. DISCUSSION: In the male gender, the psychiatric disturbances are more correlated to bullying at the workplace and this datum is especially linked to the gender differences found in the relationship between severity of bullying and adjustment disorders. Among female employees the psychopathological dimensions could be linked with a more multifactorial genesis in relation to their psychosocial role in the cultural context we examined (Southern Italy).