[Early detection and intervention for adjustment disorder and depression in the work place]

Work-related adjustment disorder and depression are frequently work-related mental problems. Over 60% of employees feel job stress in the work place in Japan. The number of employees who become psychiatric disorders such as depressive state and depression, and lead to the suspension of jobs is increasing. It is an important issue for Japanese government is planning to introduce a new rule for mental examinations for workers using a self-check questionnaire. However, it is quite skeptical to detect depressive employees using such methods. It is well known that the sensitivity and specificity in self-rating questionnaire for depression is very low, because depression is not homogeneous disorder and patients reveals various symptoms. It is quite questionable that workers who required receiving a mental interview go to meet occupational health physicians or psychiatrists or workers answer the questionnaire in precise, because of stigma of the mental disorders or afraid of worsening evaluations to themselves by their superiors. Moreover it is actually very difficult for psychiatrist to deal with the subjects including false positive cases as well as true depressed patients. Therefore, more realistic and useful methods should be reconsidered. I think enhancing cooperation or interaction between occupational health physicians and psychiatrists is one of important issues.