S'abonner

Prévention de la dépression en milieu professionnel : du dépistage à la psychoéducation - 01/09/16

Doi : 10.1016/j.jtcc.2016.06.005 
Marc Willard a, , Elie Wertenschlag b, Carine Bontemps b
a Formacat, 6, rue des Arquebusiers, 67000 Strasbourg, France 
b Alsace santé au travail, 3, rue de Sarrelouis, 67080 Strasbourg, France 

Auteur correspondant.

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

pages 5
Iconographies 0
Vidéos 0
Autres 0

Summary

The management of psychosocial risks is at the centre of the social debate in France. Having focused on stress, it is now burnout which is most often cited by the media and politicians. A recent report from the French Medical Academy highlights the difficulty in defining professional exhaustion. This concept appears to be more sociological than medical, and even its existence is a subject of debate. There are no scientific diagnostic criteria nor validated evaluation scale (Olié and Légeron, 2016). However, the role of depression as a causal factor in suffering in the workplace is neglected, yet it is a common and serious illness. The frequency of depression, lack of knowledge about its symptomatology and denial of diagnosis mean that many depressed patients work without being treated (Kessler, 2003). Behavioral and cognitive disorders related to this illness can easily induce a sense of overwork, the inability to cope and a feeling of harassment (Raffaitin and Raffaitin-Bodin, 2008). This is not a new problem, and the history of acedia, considered as the work of the devil in the Middle Ages, is a good illustration of the startling psychopathological hypotheses put forward in the case of suffering related to mood disorders. Workplace interventions linking screening and psychoeducation are essential to improve the situation. A diagnosis based on the Centre for Epidemiological Studies-Depression scale (CESD) is recommended. This is a 20-item self-report measure, scored between 0 and 3, widely used in the field of psychiatric epidemiology. Its advantage is that it can be used with the general population contrary to other scales more commonly used in psychiatry. The threshold of positivity is controversial: Rouillon selected 24 for women and 17 for men (Fuhrer and Rouillon, 1989). It should be noted that a free downloadable CESD smartphone application is available at AppStore and GoogleStore (Fuhrer and Rouillon, 1989). The questions are non-intrusive and the acceptability of this test is excellent. This evaluation should be systematic during check-ups with the occupational physician. In the case of a positive result, a clinical examination, ideally including a MADRS, will confirm or refute the diagnosis (Montgomery and Asberg, 1979). Given the lack of knowledge about symptomatology and treatment of mood disorders, it is desirable to train and inform employees. Depressed patients are rarely recognized as being truly ill, treatment is criticized and there are a number of preconceived ideas about the illness. In the business world, there are the additional problems of simulation fantasies and manipulation of patients (Willard, 2013). It may be unrealistic to consider training all employees in a company, however, it is pertinent to offer psychoeducation modules to managers and members of health and safety committees. This information should cover the epidemiology of mood disorders, symptomatology, warning signals and aggravating factors, pharmacological and psychotherapeutic therapies, difficulties in diagnosis, suicide risks and the phenomenon of stigmatization. It is also necessary to define the legal context highlighting the current difficulties in obtaining recognition of depression as a professional illness, but also the economic consequences for the company. Less than 20% of French employees would be willing to inform their employers if they were suffering from depression (European Depression Association, 2012). The benefits of this type of intervention to employees, the company and the health service are obvious. In fact, a European study showed that for each pound invested in the diagnosis and treatment of depression in the workplace, the health service saved five pounds (European Commission 2011). It is also important to differentiate between exclusively medical psychosocial risks (prevention of depression and adjustment disorders), those related to legal matters (problems of violence and harassment) and those related to social dialogue (negotiations about working conditions). It is important to calm the debate. The real problem is not to decide if depression is the cause or consequence of problems in the workplace, but to treat patients effectively.

Le texte complet de cet article est disponible en PDF.

Plan


© 2016  Publié par Elsevier Masson SAS.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 26 - N° 3

P. 139-143 - septembre 2016 Retour au numéro
Article précédent Article précédent
  • Évaluation de l’efficacité d’une thérapie comportementale et cognitive (TCC) de groupe auprès de patients souffrant de lombalgies chroniques liées au travail
  • Margaux Le Borgne, Abdel Halim Boudoukha, Audrey Petit, Yves Roquelaure
| Article suivant Article suivant
  • Erratum à l’article : « The relationship between negative and positive cognition and psychopathological states in adults aged 18 to 20 » [J. Ther. Comport. Cogn. (26) (2016) 79–90]
  • Muaweah Alsaleh, Romain Lebreuilly, Joelle Lebreuilly, Manuel Tostain

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’achat d’article à l’unité est indisponible à l’heure actuelle.

Déjà abonné à cette revue ?

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.


Tout le contenu de ce site: Copyright © 2024 Elsevier, ses concédants de licence et ses contributeurs. Tout les droits sont réservés, y compris ceux relatifs à l'exploration de textes et de données, a la formation en IA et aux technologies similaires. Pour tout contenu en libre accès, les conditions de licence Creative Commons s'appliquent.