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Zur fachärztlichen Treffsicherheit im Rahmen (arbeits-)psychologischer Diagnostik

Aim: Changes in workplace organisation and the associated increase in psychophysiological problems pose new challenges for occupational physicians. The aim of the present study was to investigate the awareness and willingness of occupational physicians to recognize psychological problems as the cause of disorders of well-being in outpatients of the Department of Occupational Medicine at the General Hospital in Vienna. Subjects and Methods: Between 2002 and 2004 eighty-nine outpatients who attended our clinic because of workplace-associated health problems were examined by a psychologist because the anamnesis and clinical examination had suggested a psychophysiological disorder. The psychological diagnosis suggested by the occupational physician and the diagnosis of the occupational psychologist were compared by means of t-tests and variance analysis. Gender and age were used as covariants. Results: 39.1% of patients who were examined by the psychologist had a psychological problem. However,over a period of time there was a reduction in the clarity of the diagnoses accompanying the referral by the occupational physicians. In 2004, physicians diagnosed primarily stress-associated disorders. But this is not an explicitly psychological diagnosis such as depression, burnout syndrome or panic-related symptoms. The incidence of affective disorders increased during the course of this study. Conclusions: Our data show that occupational physicians achieve a high level of correct answers to the question as to whether work-associated health disorders are caused at least in part by psychological problems. Although the kind of psychological disorder cannot usually be identified precisely by the occupational physician in the preliminary medical examination, the preliminary diagnosis and resulting referral set the patient on the right path for therapy. Aiming for a higher score than 40% is not realistic because a higher risk of not diagnosing psychological problems could result if the criteria for the referral to a psychologist were too restricted.

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