medlitГигиена и санитарияHygiene and Sanitation0016-99002412-0650Federal Scientific Center of Hygiene named after F.F. Erisman10.47470/0016-9900-2021-100-11-1236-1243medlit-1840Research ArticleМЕДИЦИНА ТРУДАOCCUPATIONAL HEALTHПсихическое здоровье, связанное с трудом: современное состояние проблемы (обзор литературы)Work-related mental health: current state of the art (literature review)https://orcid.org/0000-0002-8317-2718БухтияровИ. В.BukhtiyarovIgor V.noemail@neicon.ruhttps://orcid.org/0000-0002-2771-1617ДенисовЭ. И.DenisovEduard I.noemail@neicon.ruhttps://orcid.org/0000-0002-7078-7238ЖовнерчукЕ. В.ZhovnerchukEvgeny V.noemail@neicon.ruhttps://orcid.org/0000-0001-7523-4686СериковВасилий ВасильевичSerikovVasiliy V.

Канд. психол. наук, зав. лаб. физиологии и профилактической эргономики ФГБНУ «Научно-исследовательский институт медицины труда им. академика Н.Ф. Измерова», 105275, Москва.

e-mail: vasiliy_serikov@mail.ru

vasiliy_serikov@mail.ruhttps://orcid.org/0000-0003-2491-0204ХатинД. Е.KhatinDmitry E.noemail@neicon.ruhttps://orcid.org/0000-0003-4674-1886МосковенкоА. В.MoskovenkoAlexey V.noemail@neicon.ruФГБНУ «Научно-исследовательский институт медицины труда имени академика Н.Ф. Измерова»РоссияIzmerov Research Institute of Occupational HealthRussian FederationФГБНУ «Научно-исследовательский институт медицины труда имени академика Н.Ф. Измерова»; Академия постдипломного образования ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства»РоссияIzmerov Research Institute of Occupational Health; Academy of Postgraduate Education of the Federal Medical Biological AgencyRussian Federation2021061220211001112361243Copyright © Бухтияров И.В., Денисов Э.И., Жовнерчук Е.В., Сериков В.В., Хатин Д.Е., Московенко А.В., 20212021Бухтияров И.В., Денисов Э.И., Жовнерчук Е.В., Сериков В.В., Хатин Д.Е., Московенко А.В.Bukhtiyarov I.V., Denisov E.I., Zhovnerchuk E.V., Serikov V.V., Khatin D.E., Moskovenko A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rjhas.ru/jour/article/view/1840Введение

Введение. Психическое здоровье – неотъемлемая часть здоровья, а его нарушения чреваты социально-экономическими издержками для личности и общества. По данным Всемирной организации здравоохранения (ВОЗ), наиболее распространённым заболеванием и основной причиной инвалидности в мире является депрессия; от неё страдают 350 млн человек. Актуален анализ новых данных и концепций по этим вопросам.

Цель работы – изучение проблемы стресса на работе и нарушений психического здоровья с анализом концепции аллостаза и аллостатической нагрузки как интегрального показателя стресса.

Поиск литературы проводили до сентября 2020 года с использованием баз данных научной литературы Scopus (https://www.scopus.com/home.uri) и MedLine/PubMed (https://www.ncbi.nlm.nih.gov/PubMed). Ключевые термины поиска включали «mental health problems», «mental health in the workplace», «working condition», «anxiety», «burnout», «depression». Рассматривали полнотекстовые статьи, опубликованные на английском языке в журналах с присвоенными цифровыми идентификаторами объектов (DOI, англ. digital object identifier). 

Рассмотрены связанные с работой факторы, вызывающие стресс, – их также называют психосоциальными рисками. Приведены данные по видам и размерам медико-социального ущерба от нарушений психического здоровья в странах Европы и США, а также детально рассмотрен опыт Италии по ограничению стресса, связанного с работой. Даны примеры законодательства по ограничению психосоциальных рисков на работе в странах Европы, а также схемы признания связи психических расстройств с работой. Проанализирован сдвиг медико-биологической парадигмы – от гомеостаза к аллостазу  – и описаны аллостаз и аллостатическая нагрузка как интегральный показатель хронического стресса на работе. Несмотря на изобилие работ по стрессу и депрессии, в литературе нет единства в понимании механизмов и этапов формирования нарушений психического здоровья от стрессов на работе. Не ясно, что лучше отражает эффект хронического стресса, связанного с работой: аллостатическая нагрузка или метаболический синдром. Стресс, депрессия и выгорание – каково соотношение между ними? Можно говорить о логической цепочке: профессиональный фактор риска – утомление – стресс – депрессия – выгорание – нарушение здоровья и профессиональная деформация. Изложены вопросы появления Международной классификации болезней 11-го пересмотра (МКБ-11), ожидаемого в 2021 году, и, в частности, синдром выгорания. Рассмотрены возможности информационных технологий и Интернета в профилактике и лечении нарушений психического здоровья.

Заключение

Заключение. Отмечается всё возрастающая роль проблемы стресса в жизни современного общества. Необходима разработка методов ограничения психосоциальных факторов риска и критериев ранней диагностики нарушений психического здоровья работников. Перспективны программы сохранения и укрепления психического здоровья (e-MentalHealth – электронное психическое здоровье), основанные на онлайн-консультациях с помощью Интернета.

Участие авторов

Участие авторов: Бухтияров И.В. — утверждение окончательного варианта статьи;Денисов Э.И. — концепция и дизайн исследования, сбор и обработка данных литературы, материала, написание текста; Жовнерчук Е.В. — написание текста, редактирование, ответственность за целостность всех частей статьи;Сериков В.В. — написание текста, редактирование;Хатин Д.Е. — написание текста, редактирование, сбор данных литературы;Московенко А.В. — редактирование. 

Конфликт интересов

Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов в связи с публикацией данной статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Поступила

Поступила: 13.05.2020 / Принята к печати: 28.09.2021 / Опубликована: 30.11.2021

Introduction

Introduction. Mental health is an integral part of health, and its disorders are fraught with social and economic costs for the individual and society. According to WHO, depression is the most common disease and the leading cause of disability globally; it affects 350 million people. The analysis of new data and concepts on these issues is relevant. 

The aim of the work is to study the problem of stress at work and mental health disorders with an analysis of the concept of allostasis and allostatic load as an integral indicator of stress.

A literature search was conducted through September 2020 using the Scopus (https://www.scopus.com/home.uri) and MedLine/PubMed (https://www.ncbi.nlm.nih.gov/PubMed) scientific literature databases. Key search terms included “mental health problems,” “mental health in the workplace,” “working condition,” “anxiety,” “burnout,” and “depression. Full-text articles published in English in journals with DOIs were reviewed.

There are considered work-related stressors, also called psychosocial risks. Data on the types and amounts of medico-social damage from mental health disorders in European countries and the United States are presented. The Italian experience in limiting work-related stress is reviewed in detail. There are given examples of legislation to restrict psychosocial risks at work in European countries, as well as patterns of recognition of the connection between mental disorders and work. The biomedical paradigm shift — from homeostasis to allostasis — is analyzed, and allostasis and allostatic load is described as integral indicator of chronic work stress. Despite an abundance of work on anxiety and depression, there is no unity in the literature in understanding the mechanisms and stages of mental health disorders from stress at work. It is not clear what better reflects the effects of chronic work-related stress: allostatic stress or metabolic syndrome. Stress, depression and burnout — what is the relation between them? We can discuss a logical chain: occupational risk factors — fatigue, stress — depression, burnout, health disorder, and occupational deformity. The questions of ICD-11, expected to appear in 2021, and, in particular, burnout syndrome, are outlined. The possibilities of information technologies and the Internet in preventing and treating mental health disorders are considered.

Conclusions

Conclusions. The increasing role of stress problems in the life of modern society is noted. The methods of psychosocial risk factors limitation and mental health disorders diagnostics need to be developed. Internet-based programs for the preservation and promotion of mental health (e-MentalHealth) are promising.

Contribution

Contribution: Bukhtiyarov I.V. — editing the text;Denisov E.I. — concept, research design, literature data collection, text writing, material collection and data processing; Zhovnerchuk E.V. — text writing, editing, responsibility for the integrity of all parts of the article; Serikov V.V. – text writing, editing;Khatin D.E. — text writing, editing, collection of literature data;Moskovenko A.V. — editing.All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement

Acknowledgement. The study had no sponsorship.

Received

Received: May 13, 2021 / Accepted: September 28, 2021 / Published: November 30, 2021

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The authors declare that there are no conflicts of interest present.