Anxiety-depressive symptoms in patients in the clinic of occupational diseases
Authors: Zhovnerchuk E. V. , Bukhtiyarov I. V. , Khatin D. E. , Moskovenko A. V. , Serikov V. V. , Zakrevskaya A. A. 
Published: February 2020

Introduction. Depression and anxiety, observed in general medical practice, can lead to maladaptive states that reduce performance, and contributes to the manifestation of various psychosomatic disorders. Therefore, timely diagnosis of these disorders in many cases becomes an important condition for the success of medical care and the patient’s return to work. Clinical manifestations of occupational and work-related diseases are often accompanied by anxiety and depressive symptoms, which can occur as a comorbid mental disorder or be affective inclusion.

The aim of the study is to explore the distribution and severity of secondary anxiety and depression in the provision of special inpatient medical care in the field of occupational pathology by conducting a screening examination and develop practical recommendations for diagnosis.

Materials and methods. The hospital’s HADS anxiety and depression scale and Beck’s depression scale were used to test for indications of secondary anxiety and depression in the incoming patient stream (n=260). Correlation analysis was used to study the dependence of the severity of anxiety values on the severity of depression values and the severity of anxiety and depression on the age of patients. Using the Mann-Whitney criterion, a comparison was made between a sample of respondents with anxiety and depression values and a control group with normal indicators for all disease groups according to ICD–10. Also, in the General sample and separately for a group of men and women, three groups of diseases were compared — professional, production-related, and others.

Results. In the risk group of 94 patients with severe symptoms of anxiety (10.9±2.84) and depression (10.2±1.9), 67% were women. This group has higher rates of anxiety and depression in the HADS survey compared to the group of men (33%, p<0.001). The dependence of the severity of anxiety signs on the severity of depression signs for the joint sample of men and women was 0.337 (p≤0.05). Separately, for a group of women, 0.251 (p≤0.05) and for a group of men, 0.252 (p≤0.05). This suggests that as anxiety increases, the severity of depression may also increase. The relationship between the patient’s age and the severity of his symptoms of anxiety 0.144 (p≤0.05) and depression 0.1199 (p≤0.05) confirms the trend towards this relationship. The distribution of anxiety and depression indicators among patients with occupational and work-related pathology showed a predominance of anxiety values in professional (10.5±2.4) and work-related (11.8±3.2) diseases in the group of women. The prevalence of depression in professional (10.5±2.4) and production-related (10.4±2) diseases was also detected in the group of women. Criterion for the difference between a sample of respondents with anxiety and depression values and a control group with normal indicators for all disease groups according to ICD–10 (p<0.001). Differences in depression indicators between groups of occupational and work-related diseases (p=0.08) indicate that patients with occupational diseases have more pronounced values on the depression scale. Women with occupational and work-related diseases have much higher depression values than women with other diseases (p=0.02). Thus, women with occupational and workrelated diseases have higher indicators of anxiety and depression scales than men.

Conclusions. Screening examination for signs of anxiety and depression in the provision of special inpatient medical care in the profile of occupational pathology, revealed increased indicators of anxiety and depression in the group of women. As the severity of anxiety indicators increases, so does the severity of depression indicators. The dependence of anxiety and depression indicators on the age of patients confirms the tendency to this dependence. The distribution of anxiety and depression indicators among patients with occupational and work-related pathology showed the predominance of the value of anxiety in professional and work-related diseases in the group of women. The predominance of indicators of depression in occupational and work-related diseases was also found in the group of women. In the female group, patients with occupational and work-related diseases have much higher rates of depression than patients with other diseases. Thus, women with occupational and work-related illnesses are more likely to experience anxiety and depression than men. The development of practical recommendations for the diagnosis of signs of anxiety and depression is reduced to psycho-educational work to prevent negative stigmatization of issues related to mental health, conducting timely examinations with elements of bioinformatics modeling and using a system to support medical decision-making.