@article{MuschallaPoguntkeLinden2019, author = {Muschalla, Beate and Poguntke, Kim Joy and Linden, Michael}, title = {Assessment of Capacity Impairment in Patients with Mental Disorders by Routine Clinical Assessment and by Structured Assessment with the Mini-ICF-APP}, series = {Psychopathology}, volume = {52}, journal = {Psychopathology}, number = {4}, publisher = {Karger}, address = {Basel}, issn = {0254-4962}, doi = {10.1159/000502123}, pages = {248 -- 255}, year = {2019}, abstract = {Background: Physicians and therapists are also consulted to give judgments on working ability. Ability to work cannot simply be derived from the patient's symptom status but from the illness-related capacity impairments in relation to the work demands. A structured assessment of capacity impairments has been evaluated and applied internationally: the Mini-ICF-APP Social Functioning Scale. It is currently unclear whether a free-text clinical report (i.e., usual clinical practice: clinical exploration according to clinical standards, but without a standardized documentation form, instead a text is written) and a structured capacity assessment correspond to the overall work ability judgment, i.e., the decision whether a patient is "fit for work" or "unfit for work." Objectives: This investigation assessed, for the first time, whether usual clinical judgment and the additional structured capacity rating support the work ability decision. Methods: A total of 100 medical reports from patients in a psychotherapy hospital were excerpted for psychopathological symptoms and capacity disorders using a checklist. Additionally, a structured assessment of capacity disorders was documented on the Mini-ICF-APP rating for all patients. Results: In the free-text clinical medical report, endurance, flexibility, and contacts to others were the things mainly reported as impaired. This was similar to the structured Mini-ICF-APP rating. However, other capacity impairments were also reported in the Mini-ICF-APP, i.e., adherence to rules and regulations, planning and structuring, assertiveness, and group integration. When the free-text clinical report and the structured Mini-ICF-APP rating were compared, there was a higher rate of stated impairments covering all capacity dimensions in the Mini-ICF-APP rating. Conclusions: The free-text report in the medical report shows the differences between patients who are fit for work and those who are not, and thus speak for the validity of work ability decisions. However, optimization is possible in terms of depth and differentiation of capacity impairment description by adhering to the standard set by the Mini-ICF-APP.}, language = {en} } @article{MuschallaLindenJoebges2016, author = {Muschalla, Beate and Linden, Michael and Joebges, Michael}, title = {Work-Anxiety and Sickness Absence After a Short Inpatient Cognitive Behavioral Group Intervention in Comparison to a Recreational Group Meeting}, series = {Journal of occupational and environmental medicine}, volume = {58}, journal = {Journal of occupational and environmental medicine}, publisher = {American Institute of Physics}, address = {Philadelphia}, issn = {1076-2752}, doi = {10.1097/JOM.0000000000000678}, pages = {398 -- 406}, year = {2016}, abstract = {Objective: The aim of this study was to study the effects of a short-term cognitive behavior therapy on work-anxiety and sickness-absence in patients with work-anxiety. Methods: Three-hundred forty-five inpatients who suffered from cardiologic, neurological, or orthopedic problems and additionally work-anxiety were randomly assigned into two different group interventions. Patients got four sessions of a group intervention, which either focused on cognitive behavior-therapy anxiety-management (work-anxiety coping group, WAG) or unspecific recreational activities (RG). Results: No differences were found between WAG and RG for work-anxiety and subjective work ability. When looking at patients who were suffering only from work-anxiety, and no additional mental disorder, the duration of sickness absence until 6 months follow-up was shorter in the WAG (WAG: 11 weeks, RG: 16 weeks, P = 0.050). Conclusion: A shortterm WAG may help return to work in patients with work-anxieties, as long as there is no comorbid mental disorder.}, language = {en} } @article{MuschallaLinden2014, author = {Muschalla, Beate and Linden, Michael}, title = {Workplace phobia, workplace problems, and work ability among primary care patients with chronic mental disorders}, series = {Journal of the American Board of Family Medicine}, volume = {27}, journal = {Journal of the American Board of Family Medicine}, number = {4}, publisher = {American Board of Family Medicine}, address = {Lexington}, issn = {1557-2625}, doi = {10.3122/jabfm.2014.04.130308}, pages = {486 -- 494}, year = {2014}, abstract = {Purpose: Work-related anxieties are frequent and have a negative effect on the occupational performance of patients and absence due to sickness. Most important is workplace phobia, that is, panic when approaching or even thinking of the workplace. This study is the first to estimate the prevalence of workplace phobia among primary care patients suffering from chronic mental disorders and to describe which illness-related or workplace-specific context factors are associated with workplace phobia. Methods: A convenience sample of 288 primary care patients with chronic mental disorders (70\% women) seen by 40 primary care clinicians in Germany were assessed using a standardized diagnostic interview about mental disorders and workplace problems. Workplace phobia was assessed by the Workplace Phobia Scale and a structured Diagnostic and Statical Manual of Mental Disorders-based diagnostic interview. In addition, capacity and participation restrictions, illness severity, and sick leave were assessed. Results: Workplace phobia was found in 10\% of patients with chronic mental disorders, that is, approximately about 3\% of all general practice patients. Patients with workplace phobia had longer durations of sick leave than patients without workplace phobia and were impaired to a higher degree in work-relevant capacities. They also had a higher degree of restrictions in participation in other areas of life. Conclusions: Workplace phobia seems to be a frequent problem in primary care. It may behoove primary care clinicians to consider workplace-related anxiety, including phobia, particularly when patients ask for a work excuse for nonspecific somatic complaints.}, language = {en} } @article{MuschallaKesslerSchwantesetal.2013, author = {Muschalla, Beate and Kessler, U. and Schwantes, U. and Linden, M.}, title = {Rehabilitationsbedarf bei Hausarztpatienten mit psychischen St{\"o}rungen}, series = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation}, volume = {52}, journal = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation}, number = {4}, publisher = {Thieme}, address = {Stuttgart}, issn = {0034-3536}, doi = {10.1055/s-0032-1327587}, pages = {252 -- 257}, year = {2013}, abstract = {Hintergrund: Rehabilitationsmedizin ist nach \S 2 und \S 26 SGB IX die medizinische Spezialdisziplin zur Vorbeugung, Diagnostik und Behandlung chronischer Erkrankungen. Dies betrifft in besonderem Maße psychische Erkrankungen. Die Behandlung chronischer Erkrankungen erfordert in der Regel eine komplexe und multimodale Langzeitbetreuung, bei der niedergelassenen {\"A}rzten eine zentrale Rolle zukommt. Allerdings gibt es bislang nur wenig ausgearbeitete Konzepte zu den rehabilitationsmedizinischen Aufgaben niedergelassener {\"A}rzte und den ihnen zur Verf{\"u}gung stehenden diesbez{\"u}glichen Behandlungsoptionen. Methoden: Zur Kl{\"a}rung der Frage, welche Rolle rehamedizinische Aspekte in der Hausarztpraxis haben, wurden im ersten Schritt 40 niedergelassene {\"A}rzte zum gesch{\"a}tzten Anteil chronisch psychisch kranker Patienten in ihrer Praxis befragt. Im zweiten Schritt wurden 1 451 Patienten im Alter von 18 bis 60 Jahren mittels des WHO-5-Screenings zum psychischen Wohlbefinden, dem IMET-Fragebogen zu Teilhabest{\"o}rungen, der Burvillskala zur Multimorbidit{\"a}t und Fragen zum psychischen Erkrankungsstatus und Arbeitsstatus untersucht. Ergebnisse:Im Durchschnitt sch{\"a}tzten die Haus{\"a}rzte den Anteil ihrer Patienten mit psychischen Erkrankungen auf 41,9\% (SD=18,2; Range 15-90\%).Von den Patienten gaben 46,5\% an, unter psychischen Beschwerden zu leiden. 38,3\% der Patienten sagten, dass die Probleme bereits seit 6 Monaten oder l{\"a}nger bestehen (chronisch), und 26,9\% erkl{\"a}rten, dass sie die Beschwerden in den letzten 6 Monaten durchg{\"a}ngig erlebt haben (persistierend). Insgesamt litten 29,7\% der 18- bis 60-j{\"a}hrigen Hausarztpatienten unter chronischen psychischen Beschwerden mit zus{\"a}tzlich relevanten Teilhabest{\"o}rungen. Schlussfolgerungen: Patienten mit chronischen psychischen Problemen und Teilhabest{\"o}rungen sind in Praxen niedergelassener {\"A}rzte h{\"a}ufig anzutreffen. Niedergelassene {\"A}rzte und insbesondere Haus{\"a}rzte sind demnach zu einem wesentlichen Teil ihrer T{\"a}tigkeit als Rehabilitationsmediziner anzusehen. In ihren H{\"a}nden liegt die Diagnostik, Behandlung, Koordinierung und Langzeitf{\"u}hrung der chronisch Kranken, wie auch die sozialmedizinische Betreuung, von der Feststellung einer Arbeitsunf{\"a}higkeit bis hin zur Einleitung station{\"a}rer Rehamaßnahmen. Die Bedeutung der niedergelassenen {\"A}rzte im Rehaprozess verdient organisatorisch wie wissenschaftlich mehr Aufmerksamkeit.}, language = {de} } @article{MuschallaJoebges2017, author = {Muschalla, Beate and J{\"o}bges, Michael}, title = {Prevalence and Characteristics of Work Anxiety in Medical Rehabilitation Patients}, series = {Archives of Physical Medicine and Rehabilitation}, volume = {99}, journal = {Archives of Physical Medicine and Rehabilitation}, number = {1}, publisher = {Elsevier}, address = {Philadelphia}, issn = {0003-9993}, doi = {10.1016/j.apmr.2017.06.017}, pages = {57 -- 64}, year = {2017}, abstract = {Objective: To investigate frequency, type, and characteristics of work anxieties in patients with somatic illness. Design: Cross-sectional observation study. Setting: Neurology, orthopedic, and cardiology rehabilitation clinics. Participants: Patients (N=4610; age, 18-65y) with work anxieties. Interventions: Not applicable. Main Outcome Measures: Patients who scored high on at least 2 of 9 items in the work-anxiety screening questionnaire and who reported impairment were investigated with a differential diagnostic interview on work anxieties and with the Mini-International Neuropsychiatric Interview on non work-related common mental disorders. Patients also filled out a self-rating questionnaire on their subjective symptom load and sociodemographic data. Results: Approximately 20\% to 27\% of the investigated inpatients in somatic rehabilitation (altogether n=393) received a work-anxiety diagnosis. Patients with orthopedic illness report highest work anxiety and have previous longest sick leave (20.6wk in the past 12mo). Patients with orthopedic illness suffer from work-related adjustment disorder with anxiety, social anxieties, and workplace phobias, whereas patients with cardiac illness are more often affected by hypochondriac anxieties. Anxieties of insufficiency and worrying occur equally in all indications. Conclusions: About a quarter of patients in somatic rehabilitation are in need of additional diagnostic attention owing to work anxieties. Differential diagnostic of work anxiety is needed for initiating adequate therapeutic action. Somatic rehabilitation physicians should be aware of work anxieties in their patients, especially in patients with orthopedic illness with previous long-term sick leave. (c) 2017 by the American Congress of Rehabilitation Medicine}, language = {en} } @article{MuschallaHenningHaakeetal.2018, author = {Muschalla, Beate and Henning, Anne and Haake, Tim Woody and Cornetz, Kathrin and Olbrich, Dieter}, title = {Mental health problem or workplace problem or something else}, series = {Disability and rehabilitation : an international, multidisciplinary journal}, volume = {42}, journal = {Disability and rehabilitation : an international, multidisciplinary journal}, number = {4}, publisher = {Routledge, Taylor \& Francis Group}, address = {Abingdon}, issn = {0963-8288}, doi = {10.1080/09638288.2018.1501099}, pages = {502 -- 509}, year = {2018}, abstract = {Purpose: Work perception is an important predictor for work ability and, therefore, of interest for rehabilitation. Until now it is unclear to which extent different psychological aspects explain work perception. This study investigates in which way workplace problems on the one hand, and mental health and coping on the other hand, contribute to work perception. Methods: A heterogeneous sample of 384 persons in working age with and without mental health problems was recruited. Participants gave self-reports on workplace problems, mental health problems, work-coping, work-anxiety, and work perception. Results: Persons with mental health problems and workplace problems (M + W) perceive the highest degree of work demands, followed by persons with workplace problems but without mental health problems (NM + W). Work-anxiety appeared as the strongest factor explaining perception of high work demands, whereas general mental health problems did not contribute significantly to variance explanation. Conclusions: Persons with specific mental health problems in terms of work-anxiety may be expected to perceive higher work demands. They may be detected when asking for work perception, e.g., within the frame of return-to-work interventions in rehabilitation, or in occupational health settings by mental hazard analysis.}, language = {en} } @article{MuschallaHeldmannFay2013, author = {Muschalla, Beate and Heldmann, Madleen and Fay, Doris}, title = {The significance of job-anxiety in a working population}, series = {Occupational medicine}, volume = {63}, journal = {Occupational medicine}, number = {6}, publisher = {Oxford Univ. Press}, address = {Oxford}, issn = {0962-7480}, doi = {10.1093/occmed/kqt072}, pages = {415 -- 421}, year = {2013}, abstract = {Background Job-anxiety, as distinguished from trait-anxiety, is associated with long-term sickness absence. The prevalence of job-anxiety within a working population is not known. Identifying individuals who would benefit from intervention might be useful. Aims To investigate job-anxiety in employees not undergoing treatment for mental health illness, firstly by assessing the level of job-anxiety and work-related avoidance tendencies in a working sample, and secondly by testing whether job-anxiety is distinguishable from trait-anxiety. Methods Cross-sectional survey of a convenience sample obtained through personal contact distribution. Employees from different professional settings completed an anonymous questionnaire and provided information on their employment status. The State-Trait-Anxiety Inventory (STAI-T) was used to measure trait-anxiety and the Job-Anxiety-Scale (JAS) was used to assess job (state) anxiety. Results There was a 69\% response rate (240 responses); 188 responses were available for analysis of whom 62\% were women. There were no employees with high trait-anxiety. Ten employees (5\%) reported increased job-anxiety and of these nine employees reported high 'tendencies of avoidance and workplace absence'. Avoidance was most often accompanied by the comorbid job-anxieties 'job-related social anxiety', 'fear of changes at work' and 'fears of existence', 'anticipatory' and 'conditioned' job-anxiety and 'panic symptoms'. Conclusions In this sample, self-reported job-anxiety appeared as a specific type of anxiety as opposed to trait-anxiety. In the workplace job-anxiety can present as job-avoidance and sickness absence and should be distinguished from trait-anxiety. In practice, employers and occupational health practitioners should be aware of those employees prone to sickness absence.}, language = {en} } @article{MuschallaFaySeemann2016, author = {Muschalla, Beate and Fay, Doris and Seemann, Anne}, title = {Asking for work adjustments or initiating behavioural changes - what study on the reactions towards colleagues with a personality disorder}, series = {Fundamenta informaticae}, volume = {21}, journal = {Fundamenta informaticae}, publisher = {IOS Press}, address = {Abingdon}, issn = {1354-8506}, doi = {10.1080/13548506.2015.1109671}, pages = {856 -- 862}, year = {2016}, abstract = {People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick leave, because it impedes reintegration into the former workplace. This study explores colleagues' reactions towards a problematic worker dependent on the returning person's reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study, 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes, the co-worker was depicted as having previously caused problems in the work team. In the first vignette, the co-worker did not change anything (control condition) when she returned to work; in the second, she asked for workplace adjustments; in the third vignette she initiated efforts to change her own behaviour; and the fourth vignette combined both workplace adjustments and behavioural change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes.}, language = {en} } @article{MuschallaFayLinden2016, author = {Muschalla, Beate and Fay, Doris and Linden, M.}, title = {Self-reported workplace perception as indicators of work anxieties}, series = {Occupational medicine}, volume = {66}, journal = {Occupational medicine}, publisher = {Oxford Univ. Press}, address = {Oxford}, issn = {0962-7480}, doi = {10.1093/occmed/kqv160}, pages = {168 -- 170}, year = {2016}, abstract = {Work anxiety is a potentially disabling mental health problem, which can cause (long-term) sickness absence. In many cases patients do not openly report their anxieties and tend to give externalizing explanations of inner problems. Therefore people with work anxiety may perceive their workplace more negatively than those without such anxiety. To investigate the relation between subjective work description and work anxiety. There were 148 inpatient participants and 8015 general population controls. Patients with work anxiety described their workplace significantly more negatively than patients without work anxiety and employees in the general population, with no differences in workplace descriptions between psychosomatic patients without work anxiety and the general population sample. The type of complaint about work conditions was related to the specific type of work anxiety. Reports about workplace burdens can be indicative of work anxiety and should prompt further in-depth assessments. The content of complaints about work conditions may point to the type of underlying work anxiety.}, language = {en} } @article{MuschallaFayHoffmann2016, author = {Muschalla, Beate and Fay, Doris and Hoffmann, Karin}, title = {Inventory for Job Coping and Return Intention (JoCoRi)}, series = {Diagnostica}, volume = {62}, journal = {Diagnostica}, publisher = {Frontiers Research Foundation}, address = {G{\"o}ttingen}, issn = {0012-1924}, doi = {10.1026/0012-1924/a000146}, pages = {143 -- 156}, year = {2016}, abstract = {Ein großer Anteil der Erwerbst{\"a}tigen ist aufgrund gesundheitlicher Einschr{\"a}nkungen einmalig oder mehrfach in seiner Berufsbiografie l{\"a}ngere Zeit arbeitsunf{\"a}hig. Auf Grundlage etablierter psychologischer Konstrukte und empirischer Befunde wurde ein spezifisch arbeitsbezogenes Inventar f{\"u}r Job-Coping und R{\"u}ckkehrintention (JoCoRi) entwickelt. Der Selbsteinsch{\"a}tzungsfragebogen wurde an drei unabh{\"a}ngigen Stichproben (N = 243, N = 337, N = 111) von Rehabilitationspatienten aus Psychosomatik, Orthop{\"a}die, Kardiologie und Neurologie gepr{\"u}ft. Faktorenanalytische Ergebnisse der ersten Stichprobe best{\"a}tigen eine mehrfaktorielle Struktur. Das Inventar enth{\"a}lt 30 Items in 7 Skalen: 1. Arbeitsbezogene R{\"u}ckkehrintention und -planung, 2. Arbeitsbezogene Selbstwirksamkeitserwartung, 3. Arbeitsbezogene Selbstberuhigung und Selbstinstruktion, 4. Arbeitsbezogene externale Kontroll{\"u}berzeugung, 5. Aktives Coping am Arbeitsplatz, 6. Bedeutung der Arbeit, 7. Kontroll{\"u}berzeugung bzgl. der Arbeitsaufnahme. Die Varianzaufkl{\"a}rung liegt bei 68 \%. 25 Items haben Hauptladungen > .60. Interne Konsistenzen und Trennsch{\"a}rfen sind {\"u}berwiegend zufriedenstellend. Die Modellg{\"u}te der konfirmatorischen Faktorenanalyse ist {\"u}berzeugend. Das Modell ist in einer unabh{\"a}ngigen Stichprobe stabil (N = 337). Die Skalen wurden mit inhaltlich analogen Globalkonstrukten validiert. Die mehrfaktorielle Struktur kann in der zweiten Stichprobe repliziert werden. Eine l{\"a}ngsschnittliche Analyse der dritten Stichprobe pr{\"u}ft die pr{\"a}diktive Validit{\"a}t der R{\"u}ckkehrintentionsskala; sie wird hinsichtlich Arbeitsunf{\"a}higkeitsdauer und Arbeitsf{\"a}higkeitsstatus best{\"a}tigt.}, language = {de} }