職業性憂鬱症－一例個案報告與職業醫學、精神醫學、與勞動法學剖析

Occupational Depression-A Case Report & Medicolegal Discussion

周碩渠(Shou-Chu Chou) ； 黃百粲(Pai-Tsang Huang)

《中華職業醫學雜誌》 16卷2期 (2009/04) Pp. 83-91

https://doi.org/10.30027/CJOM.200904.0001

摘要

憂鬱症是一種普遍的精神疾病，憂鬱症可能因為人際關係、家庭因素、經濟困境、工作或學業的困擾等諸多壓力事件，情緒無法獲得有效的抒解而引起。本文報告一位特殊案例，可能由於職場上的衝突而引起其病症。然而職業性精神疾病尚未初入各國的職業病種類表中，況且精神醫學界對此多持保留的態度。不可否認地，隨著勞動結構的持續改變，全球化飛躍，各業競爭白熱化，工作者精神心理所承受的負荷遠超過逝去的每一個時代。本文針對目前國際上職業性精神疾病的列表情形、認定補償法理、職業病表的規律與演進，精神疾病的特質，與相關人員的見解等面向加以分析討論。
在員工意識普遍抬頭，相關團體持續的關切，與行政院勞委會的政策性方針之下，目前醫界正與政府合作，全力探討憂鬱症納入勞工保險職業病種類表的可能性，相關配套措施，與將來實務上的標準作業流程。本文期待能夠拋磚引玉，激發各界的思考與回饋，為這一個職業醫學難以抗衡的趨勢貢獻妥善的因應之道。

關鍵字

憂鬱症 ； 職業性精神疾病 ； 職業病 ； 勞工補償

並列摘要

Depression is a common psychiatric disorder which can be caused by stressful events among personal, familial, financial, work or other life milieu. In this article we report a case of depression probably evolved from interpersonal conflict and maladjustment in an occupation setting. Occupational depression, however, has not yet been included in the occupational disease lists in most countries, and many psychiatrists are skeptical of the notion of a disease entity as such, in spite of the fact that working condition has changed a great deal in the past century, the process of globalization keeps advancing, fierce international & domestic competition take place everywhere, thus imposing tremendous mental burden to working population nowadays.
In the face of mounting demands of employees, constant challenge from relevant organizations, and the policy of Council of Labor Affairs for the year 2009, the issue of occupational psychiatric disease is currently under heavy debate and intensive research both among physicians and research institutions, such as IOSH [institute of occupational safety & health]. The focus is placed on the feasibility of including depression in the list of compensable occupational diseases, recognition criteria, and pertinent administrative procedure. Our report aims to initiate brainstorming of all parties involved, bringing forth opinions, feedback, and counter-opinions. It is expected that, by so doing, our society will be able to come out with an appropriate measure to address this irresistible trend in the world of work.

並列關鍵字

depression ； occupational psychiatric disease ； occupation medicine ； workers' compensation