Mobbing at work: a five yers clinical experience

Mobbing at the workplace, i.e. reiterated psychological harassment by a person or a group of people against one or few workers, is an emerging problem in occupational medicine. The number of reported cases has increased dramatically worldwide during the last years, attracting the attention of the media, and calling for accurate diagnostic strategies, as well as for effective preventive and rehabilitative measures. Currently, both the ICD-10 and DSM-IV individuate two psychopathological conditions that may be caused by stressing situations, including mobbing: Post-Traumatic Stress Disorder (PTSD) and Adjustment Disorder (AD). This study proposes a method for assessing mobbing in the clinical setting. We present 135 outpatients (59 males, 76 females; mean age: 40 years) who asked medical assistance, during the last five years, for psychopathological problems by them ascribed to mobbing in the working environment. 37 subjects were employed in public institutions, 98 in private companies. All patients underwent occupational health visit, psychological counselling (including personality tests administration), and psychiatric evaluation. A clinical picture probably due to mobbing was diagnosed in 25 workers (19% of the cases): 2 cases of PTSD, 22 of AD, and 1 of anxiety disorder. Three cases of AD were work-related but not due to mobbing. In 4 patients the correlation with the working activity was possible but difficult to demonstrate, due to concomitant (non-occupational) stressing situations. A pre-existing psychiatric disorder was identified in 55 subjects (41%). Altered interpersonal relationships with the colleagues were present in 42 cases (31%). Six patients did not complete the diagnostic protocol. In conclusion, a pure “mobbing syndrome” was diagnosed in a lower proportion than that reported by other investigators. This difference probably depends on patients preselection criteria. The described interdisciplinary approach appears useful for the diagnostic assessment of suspect mobbing cases, that in turn is crucial for prognosis and treatment, as well as in relation to medico-legal issues and work-related compensation claims.