Work-related mental health: current state of the art (literature review)

Abstract

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. 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.