Abstract
BackgroundThe long-term effects of occupational injury (OI) on psychiatric diseases are unclear. This study assessed and compared the effects of OI, no injury (control), and non-OI (NOI) on the development of psychiatric diseases.MethodsWe used Taiwan’s National Health Insurance Research Database to investigate the incidence of psychiatric disorders in OI, NOI, and control groups. The subjects were aged 20–50 years, actively employed in 2000, and did not have history of injury or psychiatric disorders. All subjects were followed from 2000 and were classified into OI, NOI, and control groups according to occurrence of target injury later on. Individuals in each group were matched by age, sex, insurance premium before the index date, and year of the index date. Psychiatric disease-free days were compared among the groups using survival analysis and Cox regression.ResultsWe included a total of 12,528 patients for final analysis, with 4,176 in each group. Compared with the control group, the OI group had an increased occurrence of trauma and stress-related disorder, depressive disorders, anxiety disorders, and alcohol and other substance dependence. These increases were similar to those in the NOI group. Elevated cumulative incidence rate of any psychiatric disorders was observed among those with OI or NOI up to 10 years after injury.ConclusionWe confirmed that OI and NOI induced psychiatric disorders. These findings highlight the need for workers’ compensation mechanisms to consider long-term psychological care among injured workers.
Highlights
IntroductionThe Global Burden of Disease study by World Health Organization estimated that the total disability-adjusted life years (DALYs) caused by occupational injury (OI) decreased by 0.6% between 2006 and 2016, with more than 22 million DALYs being observed in 2016.1 In addition to experiencing physical impairment, 5.2–7.5% of injured workers have been reported to develop either posttraumatic stress disorder (PTSD)=partial PTSD or major depression within 1 year after OI.[2,3] the findings of previous surveys conducted in Taiwan and the United States have shown that the risk of psychiatric disorders was higher in patients with OI than in those without injury.[4,5] these two studies had follow-up periods of no longer than 2 years.Several studies have suggested that traumatic events or natural disasters may result in long-term psychiatric disorders.[6,7,8,9] little is known about long-term psychiatric consequences occurring after OI
The National Health Research Institutes (NHRI) confirmed that the LHID2005 is a representative cohort of the Taiwanese population and that there is no significant difference in the distribution of age, sex, and insurance premium between individuals in the LHID2005 and those in the original National Health Insurance Research Database (NHIRD).[13]
After the selection of the NOI and control groups by matching for age, sex, insurance premium at the index date, year of the index date, 4,176 subjects were included in each group
Summary
The Global Burden of Disease study by World Health Organization estimated that the total disability-adjusted life years (DALYs) caused by occupational injury (OI) decreased by 0.6% between 2006 and 2016, with more than 22 million DALYs being observed in 2016.1 In addition to experiencing physical impairment, 5.2–7.5% of injured workers have been reported to develop either posttraumatic stress disorder (PTSD)=partial PTSD or major depression within 1 year after OI.[2,3] the findings of previous surveys conducted in Taiwan and the United States have shown that the risk of psychiatric disorders was higher in patients with OI than in those without injury.[4,5] these two studies had follow-up periods of no longer than 2 years.Several studies have suggested that traumatic events or natural disasters may result in long-term psychiatric disorders.[6,7,8,9] little is known about long-term psychiatric consequences occurring after OI. In Taiwan, Chin and her colleagues discovered that, in contrast to general belief, time did not attenuate psychiatric conditions up to 6 years after OI.[10] Prior surveys have recruited only workers who scored high in psychological symptoms in the first stage of the questionnaire survey and diagnosed workers’ mental disorders through telephone interviews. This could lead to potential bias in the selection of subjects for interview and underestimate the results. This study assessed and compared the effects of OI, no injury (control), and non-OI (NOI) on the development of psychiatric diseases
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