[Medico-legal problems in the relationship between psychopathology and work]

The Author treats the relationship between work and mental health from a legal medical viewpoint and referring to two different opposite situations: work as a pathogenic factor and work as a therapeutic factor. In the first case, the problem concerns the acknowledgment of the connection between work and mental disorders. It includes the need of a careful estimate of the causation and the meaning that it could assume during the damage evaluation process, the peculiar psycopathological question of the relationship between disturb and damage, and the difficulties in the estimation of this latter. Finally, it concerns the setting peculiarity, essential to a correct methodological approach during the evaluation. In the second case, the focus is the safeguard of both the subject with a psychiatric disorder and his environment, with the need to insert the occupational physician in a "net" of supportive interventions aimed at avoiding that the work became an aggravating agent or an additional risk factor. The Author emphasizes the implicit ethical component of the choice to introduce the psychiatric patient in the "working life"; this choice belongs both to the single practitioner and to the collectivity, and it is supported by the Constitution.