Trastorno de adaptación. Análisis de la Incapacidad Laboral por contingencias comunes en Ibermutuamur, Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social

Abstract

[ES] Las enfermedades mentales constituyen una importante causa de Incapacidad Temporal y absentismo laboral en los países industrializados, con la consiguiente carga socio-sanitaria e impacto económico que conllevan. Una de las causas más importante de estas enfermedades son los Trastornos de Adaptación. La predisposición o vulnerabilidad individual que da lugar a su aparición y manifestaciones, junto con la dificultad de aplicar criterios diagnósticos determinantes y cuantificables, hacen que muchos pacientes sean encuadrados en este diagnóstico y no reciben un tratamiento adecuado a la patología que realmente padecen, con el consiguiente desajuste temporal en la duración de su situación de Incapacidad Laboral. Por este motivo se inicia la revisión del comportamiento de la Incapacidad Temporal de los trabajadores controlados por contingencias comunes en Ibermutuamur con el diagnóstico de Trastorno de Adaptación durante los años 2008 al 2010, valorar los resultados y concluir si alguna variable permitirá mejorar el control y seguimiento de estos procesos, ajustando su duración en beneficio del paciente, su empresa, la Mutua y la sociedad en general. [EN] Mental illnesses are a major cause of sick leave and absenteeism in industrialized countries, resulting in a burden of socio-sanitary and economic impact. One of the most important related-causes are Adjustment Disorders. Individual predisposition or vulnerability leading to their appearance and symptoms, along with the difficulty of applying diagnostic criteria and quantifiable determinants, means that many patients are misclassified in the same diagnosis. Therefore, they do not receive adequate treatment for the disease that really suffer from, generating temporary mismatch in the duration of sick leave. Due to all this, we started a review of the sick leave behavior from this disease in workers monitored for non-work-related diseases at Ibermutuamur between 2008 and 2010 in order to evaluate the results and to conclude whether some of the variables will improve the management and control of these processes by adjusting the length on behalf of the patients, their company, the mutual insurance company and the society in general. Following the completion of the observational epidemiological study according to the data recorded in the processes in our own health program system during the period of time mentioned, we can conclude that, except for some key data for management, as the fact of their higher frequency in women, and in them, the relapses and progression to total disability or the fact that besides the generic diagnostic, subtypes “Adjustment reaction with mixed emotional features” and “Adjustment disorder with mixed anxiety and depressed mood” are the most common and frequently observed in almost all the assessment results of the other study variables, there is no variable itself which could determine the decision-making to improve the management of sickness absence from this disease. It is essential to note that one of the major drawback found was the lack of coding of this disease in their diagnostic subtypes, which can determine a key information deficit to proper assignment of the pathology and the posterior treatment, thus affecting the evolution and the duration of sick leave and absenteeism.