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Abstract Background Mental health issues are gaining in importance in society and the economic system. At the same time, the accessibility and stigmatisation of the mental health care system in Germany can obstruct help-seeking behavior and delay early psychotherapeutic interventions. Therefore, new models of care are being established at the interface of company-supported health promotion and conventional health insurance sponsored outpatient care for people developing mental illnesses. Two large industrial companies, in cooperation with two psychosomatic clinics, have recently established a model of “psychosomatic consultation in the workplace“. This new model of care offers the opportunity for a first psychotherapeutic door to door consultation with occupational medicine within the industrial workplace. The main empirical goals of this study are: 1) Describing the differences between patients who use this new diagnostic and therapeutic offer within the industrial workplace vs. patients who visit a conventional regional outpatient clinic, especially in regard to symptom duration and severity, work ability, and demographic characteristics, and 2) A first evaluation of how patients may benefit more from this new model of care compared to those first seen by standard outpatient care. In the qualitative part of the study, occupational physicians, psychosomatic therapists, involved personnel and select employees of the involved companies will be asked to comment on their experiences with this new approach. Methods/Design The implementation study will take place in Ulm and in Stuttgart, with each site looking at one regional conventional psychosomatic outpatient clinic and one psychosomatic consultation offer within the workplace. 70 consecutive patients in each setting will be recruited (overall n = 280). For the cross-sectional study and pre-post comparison we will use established and validated survey instruments (PHQ, SF-12, WAI, MBI, IS) as well as standardized questions about health care use. For data analysis, we will use uni- and multivariate analytical methods. Qualitative data analysis (expert interviews) will be carried out using Mayring’s content analysis method. Discussion The results of this study have the potential to provide evidence-based knowledge about an innovative model of psychotherapeutic outpatient care and to further promote tailored solutions for early psychotherapeutic interventions within the worksite. Trial Registration DRKS00003184

Introduction: A good relationship quality between leaders and staff members promotes mental health and prevents stress. To improve the relationship quality, it is important to identify variables which determine relationship quality at the workplace. Therefore, this study aims to identify specific leadership characteristics which support the development of a positive relationship between hospital leaders and staff members. Methods: A cross-sectional study design was applied. A total number of 1,137 leaders (n = 315) and staff members (n = 822) of different professions (physicians, nursing staff, therapeutic professionals, administration staff, IT staff, clinical services, office assistants, scientists, others) working at a tertiary hospital in Germany assessed transformational leadership style as a staff-oriented leadership style and leader–member relationship quality by self-report questionnaires [integrative leadership questionnaire (FIF), leader–member exchange (LMX-7) questionnaire]. The data were statistically analyzed by mean comparisons and a multiple linear regression analysis. Results: Leaders rated their own transformational leadership style (M = 3.98, SD = 0.43) systematically higher than staff members assessed their leader (M = 2.86, SD = 1.04). Evaluation of relationship quality showed similar results: leaders evaluated their relationship quality to one exemplary staff member higher (M = 4.06, SD = 0.41) than staff members rated their relationship quality to their direct leader (M = 3.15, SD = 0.97). From the staff members' perspective, four sub-dimensions of transformational leadership, that is, "individuality focus," "being a role model," "fostering innovations," and "providing a vision" showed large effect sizes in the regression analysis of relationship quality (R 2 = 0.79, F (14,690) = 189.26, p < 0.001, f = 1.94). Discussion: The results of our study are in line with previous investigations in other working contexts and point to a profession-independent association as the professional group of participants did not contribute to the variance explanation of the regression analysis. The exploration of potential determinants of relationship quality at work can, for example, support the development of leadership training programs with a focus on transformational leadership style. This might be an opportunity to foster high relationship quality between leaders and staff members and consequently might represent one strategy to prevent stress in the health care sector. [ABSTRACT FROM AUTHOR]

This study investigates the role of body image self‐appraisal in predicting the outcomes of outpatient psychotherapy in patients with anorexia nervosa (AN). Multiple linear regression analyses and a path‐analysis model were applied to test the study hypotheses that body image at baseline predicts treatment outcomes of outpatient psychotherapy in patients with AN at follow‐up measurement. The analyses were conducted as secondary analyses in a subgroup (n = 148) of the anorexia nervosa treatment of outpatient‐cohort (ANTOP‐study) (N = 242) of patients with AN. The results show that Negative Evaluation of the Body at baseline predicts perceived stress during psychotherapy, which in turn predicts depressive symptoms at the end of therapy which in turn predicts the outcomes body mass index and EDI‐2 sum score at 12 months follow‐up. The results underline the importance of body image disturbance in the course of AN and call for body image as a central target of psychotherapeutic interventions in patients with AN. [ABSTRACT FROM AUTHOR]

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Background: The "International Classification of Diseases 11th Revision" (ICD-11) introduces complex post-traumatic stress disorder (CPTSD) as a separate diagnosis to account for the effects that persistent or repetitive trauma can have. In CPTSD, disorders of self-organization are added to the core symptoms of PTSD. It can be assumed that those affected are impaired in their professional lives as a result. The aim of this paper is to provide an overview of the effects of CPTSD on work-related functioning and to present possible consequences for therapeutic and rehabilitative treatment., Method: A scoping review with a literature search in the MEDLINE, APA PsycArticles, and APA PsycInfo databases was conducted in February 2024., Results: Of 2378 studies on KPTBS, five studies were included, of which only three dealt more specifically with the impact on the world of work. Those affected appear to have a poorer prognosis for maintaining their ability to work and are therefore to be regarded as a socio-medical risk group with regard to long-term maintenance of participation in working life., Discussion: The current state of research on the effects of the CPTSD symptom complex on the world of work is surprisingly limited. In comparison, the results indicate that CPTSD has a greater negative impact on the ability to function in the world of work than PTSD and other mental disorders. It is still unclear which psychopathological mechanisms mediate the connection. Only basic findings on the psychopathology of CPTSD are available. Treatment approaches that address the disorders of self-organization in addition to PTSD symptoms appear necessary., (© 2024. Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature.)

Background: Service use among employees with mental health problems and the associated costs for the health and social system have not yet been systematically analysed in studies or have only been recorded indirectly. The aim of this article is to report the service use in this target group, to estimate the costs for the health and social system and to identify possible influencing factors on the cost variance., Methods: As part of a multicentre study, use and costs of health and social services were examined for a sample of 550 employees with mental health problems. Service use was recorded using the German version of the Client Sociodemographic Service Receipt Inventory (CSSRI). Costs were calculated for six months. A generalized linear regression model was used to examine influencing cost factors., Results: At the start of the study, the average total costs for the past six months in the sample were € 5227.12 per person (standard deviation € 7704.21). The regression model indicates significant associations between increasing costs with increasing age and for people with depression, behavioural syndromes with physiological symptoms, and other diagnoses., Discussion: The calculated costs were similar in comparison to clinical samples. It should be further examined in longitudinal studies whether this result changes through specific interventions., (© 2024. The Author(s).)

Background: Risk factors for mental health can be found in socio-economic-, gender- and migration-specific inequalities. These factors and the extent of depression, anxiety, and somatization among employees were examined in the present study., Methods: As part of the Early Intervention in the Workplace Study (friaa), mentally burdened employees at five locations in Germany were surveyed on socio-demographic-, work-, migration-, and health-related content. Regression analyses were used to examine the relationship between these factors and depression (Patient-Health-Questionnaire-9, PHQ-9), anxiety (Generalized Anxiety Disorder-2, GAD-2), and somatization (Somatic Symptom Scale-8, SSS-8) in the entire sample and in people with migration background (MB). For the latter, acculturation (Frankfurt Acculturation Scale, FRACC) and the perception of burden in terms of demands of immigration (Demands of Immigration Scale, DIS) were also taken into account., Results: On average, the 550 employees (12% with MB) showed clinically relevant depression (M = 13.0, SD = 5.1) (PHQ-9 ≥ 10), anxiety (M = 3.5, SD = 1.7) (GAD ≥ 3) and somatization (M = 13.0, SD = 5.8) (SSS-8 ≥ 12). Female gender was associated with higher anxiety and somatization. Older age and night shift work were associated with higher somatization., Discussion: The results confirm the high level of mental burden among this sample of employees in Germany. In order to maintain their mental health, support measures should be offered, especially for vulnerable groups such as women, older employees, and night shift workers., (© 2024. The Author(s).)

Background: Psychosomatic consultation in the workplace (PSIW) is an offer for employees who are under mental and psychosomatic strain. Core elements are early diagnosis and short-term psychotherapy with the aim of improving the care for mentally stressed employees. This article provides a characterization of patients and presents initial data on the effects of short-term psychotherapy., Materials and Methods: From 05/2016 to 12/2019, basic data were collected from all employees seeking help. Socio-demographic data, previous treatments, work ability, depression (PHQ-9), anxiety (GAD-7), somatic symptoms (PHQ-15), assessment of psychological state and attitudes towards treatment options were collected by self-report before and (if applicable) after a short-term intervention., Results: A total of 672 employees from 20 companies (49% male) were mostly referred to PSIW by the company physician. Adjustment disorders and depressive disorders each accounted for almost one-third of diagnoses. A quarter of the employees presenting at PSIW were on sick leave at the time of referral. The most frequent recommendations were short-term intervention at PSIW, followed by outpatient psychotherapy. A total of 343 (51%) employees completed the questionnaires, of which 187 (55%) of them received short-term psychotherapy. The symptoms improved significantly across all scales. Satisfaction with PSIW was very high., Conclusions: PSIW is an innovative care concept in the work context, which is well accepted and effective in various sectors. Close cooperation with company stakeholders such as occupational health physicians is important for a successful outcome., Competing Interests: Die Autorinnen/Autoren geben an, dass sie für eine Klinik arbeiten, die auch eine psychosomatische Sprechstunde betreibt. Sie erhalten aber keine vom Erfolg der Sprechstunde abhängige Vergütung., (Thieme. All rights reserved.)

Work and mental health are closely interrelated. Sick leave rates due to mental illness have constantly been rising for years. Thus, not only companies but also the society as a whole have become more and more aware of the relevance of this topic.At first, various work stress models are outlined in this article. This is followed by an overview of how to classify work-related mental disorders in the ICD and DSM systems. Burnout is explained with regard to terminology, origin and adequate use in clinical practice. Furthermore, the ILO (International Labour Organization) classification of work-related mental disorders is presented. Possible intervention models for the prevention and therapy of work-related mental health problems are discussed. In addition, the most essential components of work-related psychotherapy are pointed out. Finally, corresponding guidelines are put into an international context., Competing Interests: Erklärung zu finanziellen InteressenForschungsförderung erhalten: nein; Honorar/geldwerten Vorteil für Referententätigkeit erhalten: nein; Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an Firma: nein.Erklärung zu nichtfinanziellen InteressenDie Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Within the framework of psychosomatic consultation in the workplace (PSIW), external expert psychotherapists offered consultation sessions for employees at the company premises in order to establish a first contact. In contrast to the first contact usually established in regular care, PSIW explicitly focuses on the workplace and enables in-company actors to get closely involved, if the patient's consent is provided. The new model of care helps to identify mental problems at an early stage and is clinically effective. Reliable data considering the user's point of view is missing., Objectives: How satisfied are users of the new model of care compared to users of regular care?, Material and Methods: A total of 189 people from in-company (n = 91) or regular medical consultations (n = 98) made statements before first contact (t1) and 12 weeks (t2) after the initial contact. They reported satisfaction with the offer (t2), further treatment (t2), and depressiveness (t1, t2) by means of self-assessment tools. On the basis of an OLS (ordinary least squares) regression analysis, we investigated how treatment quality (clinical improvement, further treatment) and the place of treatment influenced user satisfaction (dependent variable), while controlling for selection bias and the different degrees of depression at baseline., Results: Higher clinical improvement predicted more satisfaction with the received treatment in both (b = 1.2, CI 0.802-1.548). The mean value (MV) of satisfaction was 1.6 points higher if further treatment took place (CI 0.236-2.909). PSIW users showed a 1.8 points higher MV of satisfaction than people in regular care (CI 0.322-3.302)., Conclusions: PSIW users consider PSIW as positive in terms of treatment success and service quality.

Psycho-mental stressors and increased perceived stress in workplace settings may determine the onset and course of stress-related mental and psychosomatic disorders. For the description of psycho-mental stressors three distinct models have widely been used in the analyses of the matter: the Demand-Control-Model by Karasek and Theorell, the Effort-Reward-Imbalance Model by Siegrist, and the Model of Organisational Justice.The interactional or social dimension in work-place settings can be seen as a cross-sectional dimension to the above mentioned models. Here, social conflicts and mobbing, as specific forms of interactional problems, are of importance.Besides measures of primary prevention which can be derived from applying the above mentioned models, attention is paid increasingly to secondary and tertiary preventive measures in work-place settings. Concepts such as the psychosomatic consultation-hour within the context of workplace showed to be effective measures for the early detection of people at risk or early stages of e. g. stress-related psychosomatic disorders.Furthermore, step-wise reintegration of members of the work-force play an important role within the effort to retain the ability to work and the workplace of individuals who suffered from stress-related mental disorders, as it has to be stressed that working and social interactions at the workplace may well be a resource that enhances and stipulates psycho-mental well-being and mental health.This CME-Article describes the above mentioned models and discusses selected perspectives of preventive measures to avoid stress-related mental disorders in members of the work-force., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objectives: Psychosomatic symptoms often present within the vocational context. The unmet need for easily accessible and early interventions led to the development of a variety of offers in this area. From a scientific point of view, the question of how such a "psychosomatic consultation in the workplace" (PCIW) is best conceptualized remains open., Methods: We analysed treatment documentation for all patients of two recently established PCIW from January 2011 to January 2012 both descriptively and by qualitative content analysis., Results: A total of 67 patients were seen, 75% of whom were male. For 75% of users PCIW constituted the first contact with psychosomatic-psychotherapeutic-psychiatric services. For about 80%of the patients a work-related aetiology could be considered. 40%of patients were recommended to outpatient psychotherapeutic care., Conclusions: PCIW represents an easily accessible therapeutic offer in the vocational context. There often is a mix of work-related and personal problems that suggests the cooperation of occupational and psychosomatic physicians.