Reviews
21 February 2022
Vol. 44 No. 1 (2022)
https://doi.org/10.4081/gimle.578

[The new Maugeri diagnostic protocol for work-related stress and mobbing (MaSD-2)]

Il nuovo protocollo diagnostico Maugeri per stress lavoro-correlato e mobbing (MaSD-2)

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Alessia Gallozzi
Unità Operativa Ospedaliera di Medicina del Lavoro, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Fabrizio Scafa
Unità Operativa Ospedaliera di Medicina del Lavoro, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Maria Carmela Mongiovì
Unità Operativa Ospedaliera di Medicina del Lavoro, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Claudia Negri
Psichiatria, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Giulia Crisafulli
Unità Operativa Ospedaliera di Medicina del Lavoro, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Giovanni Malgara
Unità Operativa Ospedaliera di Medicina del Lavoro, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Daniela R. Bellini
Unità Operativa Ospedaliera di Medicina del Lavoro, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Stefano M. Candura
stefano.candura@icsmaugeri.it
Unità Operativa Ospedaliera di Medicina del Lavoro, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.

Occupational stress can exceed the workers' individual capacity to adapt, and cause psychopathological conditions, including adjustment disorder (AD) and post-traumatic stress disorder (PTSD), for which medico-legal reporting is mandatory by law. Since the early 2000s, an interdisciplinary diagnostic protocol has been in use at our Institute to address patients towards an appropriate therapeutic path, in order to promote their psychological well-being and work reintegration. In 2017, the protocol was updated and expanded. The current version (MaSD-2) includes: occupational medicine examination, psychological counselling, psychiatric interview, and psychodiagnostic testing: Short-Negative Acts Questionnaire (S-NAQ), Cognitive Behavioral Assessment 2.0 (CBA-2.0), SCID (Structured Clinical Interview for DSM: Diagnostic and Statistical Manual of Mental Disorders), Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), Maugeri Stress Index - Reduced form (MAST-R). Between 2017 and 2019, we used the MasD-2 to assess, for suspected psychopathological work-related problems, 198 patients (120 women and 78 men; mean age I SD: 47.9 ≤ 9.0 years). Nine (4.5%), already examined with the original version of the protocol, received diagnostic confirmation (2 cases of paranoid personality disorder, 7 of work-related anxiety-depressive disorder). Of the other 189 subjects, three (1.6%) were not affected by psychiatric disease, 12 (6.3%) had a psychiatric disorder (e.g., anxiety disorder, mood disorder, personality disorder) independent of work, 160 (84.7%) a work-related anxiety and or depressive disorder. DA was identified in 12 cases (6.3%), and two patients (1.1%) were diagnosed with DA in pre-existent DPTS, for a total of 14 medico-legal reports of occupational disease. Compared to the past, the case record presents a much higher percentage of psychiatric disorders related to occupational stress. This may be due to a greater sensitivity of the new diagnostic protocol, and to a better selection of the patients referred to us. Women and tertiary workers continue to be at greater risk, with significant involvement of health professionals. Diagnoses of DA and DPTS remain rare, confirming the need for a rigorous and cautious interdisciplinary approach, aimed at selecting the cases for which to start medico-legal procedures. Finally, the study calls for adequate preventive measures.

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1) Selye H. Stress in health and disease. London, Butterworths, 1976. 2) Stavroula L, Aditya J. Impact of psychosocial hazards at work: an overview. Genève, World Health Organization (WHO), 2013.
3) Cecchini F. Dal mobbing al disagio allo stress correlati al lavoro. Roma, NeP edizioni Sris, 2016.
4) Perbellini L, Romeo L, Goio I, et al. Patologie da stress. In Alessio L, Franco G, Tomei F (curatori) Trattato di Medicina del Lavoro. Padova, Piccin, 2015: 1743-56.
5) Leymann H. Mobbing and psychological terror at workplaces. Violence Vict 1990; 5(2): 119-26. DOI: https://doi.org/10.1891/0886-6708.5.2.119
6) Einarsen S, Hoel H, Zapf D, et al. Bullying and emotional abuse in the workplace. London-New York, Taylor & Francis, 2003. DOI: https://doi.org/10.4324/9780203278734
7) Fiabane E, Flachi D, Giorgi I, et al. Esiti professionali e salute psicologica a seguito di vessazioni sul luogo di lavoro: uno studio esplorativo di follow-up. Med Lav 2015; 106(4): 271-83.
8) World Health Organization. ICD-11 for Mortality and Morbidity Statistics (ICD-11 MMS) - 2018 version. Genève, World Health Organization WHO, 2018.
") American Psychiatric Association. Diagnostic and statistical manua of mental disorders (5th ed.). Arlington (Virginia, USA), Americar Psychiatric Publishing, 2013.
10) Bachem R, Casey P. Adjustment disorder: A diagnosis whose time has come. J Affect Disord 2018; 227: 243-53. DOI: https://doi.org/10.1016/j.jad.2017.10.034
11) Campbell SB, Renshaw KD. Posttraumatic stress disorder and relationship functioning: A comprehensive review and organizational framework. Clin Psychol Rev 2018; 65: 152-62. DOI: https://doi.org/10.1016/j.cpr.2018.08.003
12) Bonsignore A, Molinelli A. Attualità sugli aspetti giuridici, sociali e medico legali del fenomeno mobbing. Lavoro e Medicina 2008; 3: 31-42.
13) Candura SM, Dondi E, Tonini S, et al. Mobbing. Case record, gender differences, medico-legal issues. Prevention & Research 2014; 3(2):
14) Buselli R, Gonnelli C, Moscatelli M, et al. Esperienza di un centro per lo studio dei disturbi da disadattamento lavorativo in tema di patologie mobbing correlate. Med Lav 2006; 97(1): 5-12.
15) Nolfe G, Petrella C, Blasi F, et al. Disturbi psichiatrici e patogenesi lavorativa: osservazioni sull'epidemiologia del mobbing. G Ital Psicopat 2007; 13: 187-195.
16) Punzi S, Cassitto MG, Castellini G, et al. Le caratteristiche del mobbing ed i suoi effetti sulla salute. L'esperienza della "Clinica del Lavoro Luigi Devoto" di Milano. Med Lav 2007; 98(4): 267-83. 17) Romeo L, Rocchetto A, Quintarelli E, et al. Follow up di lavoratori vittime di molestie morali protratte e costrittività organizzativa: valutazione dell'efficacia degli interventi messi in atto. G Ital Med Lav Erg 2007; 29(3): 696-8.
18) Giorgi I, Argentero P, Zanaletti W, et al. Un modello di valutazione psicologica del mobbing. G Ital Med Lav Erg 2004; 26(2): 127-32. 19) Lettini G, Scafa F, Tedeschi N, et al. Stress lavoro-correlato e mobbing: diagnosi multidisciplinare e casistica clinica. G. Ital. Med. Lav. Erg. 2017; 39(3), suppl.: 77-8.
20) Wise EA, Beck JG. Work-related trauma, PTSD, and workers compensation legislation: implications for practice and policy. Psychol Trauma 2015; 7(5): 500-6. DOI: https://doi.org/10.1037/tra0000039
21) Vianello L, Berto D, Fasciglione M, et al. La valutazione del nesso di causa tra psicopatologia e lavoro: attività presso l'AULSS 6 Euganea di Padova. G Ital Med Lav Erg 2017; 39, 3(3), suppl.: 78-9. 22) Jarreta BM, Garcia-Campayo J, Gascon S, et al. Medico-legal implications of mobbing. A false accusation of psychological harassment at the workplace. Forensic Sci Int 2004; 146, suppl.: S17-8. DOI: https://doi.org/10.1016/j.forsciint.2004.09.010
23) D'Orsi F, Narda R, Scarlini F, et al. Lo stress lavoro-correlato. In: La sorveglianza sanitaria dei lavoratori, V edizione. Roma, EPC Editore, 2015: 159-82.
24) Argentero P, Candura SM. La valutazione obiettiva dei fattori di rischio stress lavoro-correlati: prime esperienze applicative del metodo OSFA (Objective Stress Factors Analysis). G Ital Med Lav Erg 2009; 31(2): 221-6.
25) Rasario GM. Manuale di semeiotica medica, Napoli, Idelson, 1950. 26) Candura SM. Anamnesi lavorativa. In: Tomei F, Candura SM, Sannolo N, et al. (curatori) Manuale di Medicina del Lavoro. Padova, Piccin, 2019: 17-21.
27) Hall RCW (editor) Psychiatric presentations of medical illness: somatopsychic disorders. New York - London, SP Medical and Scientific Books, 1980. DOI: https://doi.org/10.1007/978-94-011-7677-4
28) Notelaers G, Van der Heijden B, Hoel H, et al. Measuring bullying at work with the short-negative acts questionnaire: identification of targets and criterion validity. Work Stress 2019; 33(1): 58-75. DOI: https://doi.org/10.1080/02678373.2018.1457736
29) Bertolotti G, Zotti AM, Michielin P, et al. A computerized approach to cognitive behavioural assessment: an introduction to CBA-2.0 primary scales. J Behav Ther Exp Psychiatry 1990; 21(1): 21-7. 30) Sanavio E, Bertolotti G, Michielin P, et al. CBA-2.0, Cognitive Behavioural Assessment 2.0, Scale Primarie, Manuale (II ed.). Firenze, Giunti Psychometrics, 1997.
31) Sirigatti S, Faravelli C. MMPI-2-RF: adattamento italiano (Il ed.). Firenze, Giunti O.S. Organizzazioni Speciali, 2016.
32) Giorgi I, Baiardi P, Tringali S, et al. Il Maugeri Stress Index questionnaire per la valutazione dello stress lavoro correlato. G Ital Med Lav Erg 2011; 33(3), suppl. B: B78-84.
33) Giorgi I, Mainetti P, Fiabane E, et al. Validità discriminante del MASI-R nella percezione di stress lavoro-correlato. G Ital Med Lav Erg 2014; 36(3): 175-80.
34) Massidda D, Giorgi I, Vidotto G, et al. The Maugeri Stress Indexreduced form: a questionnaire for job stress assessment. Neuropsychiatr Dis Treat 2017; 13: 917-26. DOI: https://doi.org/10.2147/NDT.S107030
35) World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310(20): 2191-4. DOI: https://doi.org/10.1001/jama.2013.281053
36) Perbellini L, Tisato S, Quintarelli E, et al. Disturbi psichici associabili a condizioni di lavoro negative persistenti. Med Lav 2012; 103(6): 437-48. 37) Varhama LM, Báguena MJ, Toldos MP, et al. Dysfunctional workplace behavior among municipal employees in Spanish and Finnish cities: a cross-national comparison. Percept Mot Skills 2010; 110(2): 463-8. 38) Min JY, Park SG, Kim SS, et al. Workplace injustice and selfreported disease and absenteeism in South Korea. Am J Ind Med 2014; 57(1): 87-96. DOI: https://doi.org/10.1002/ajim.22233
39) Salin D. Risk factors of workplace bullying for men and women: the role of the psychosocial and physical work environment. Scand J Psychol 2015; 56(1): 69-77. DOI: https://doi.org/10.1111/sjop.12169
40) Gray P, Senabe S, Naicker N, et al. Workplace-based organizational interventions promoting mental health and happiness among healthcare workers: a realist review. Int J Environ Res Public Health 2019; 16, 4396; doi: 10.3390/jerph16224396. DOI: https://doi.org/10.3390/ijerph16224396
41) Bohlken J, Schömig F, Lemke MR, et al. COVID-19-Pandemie: Belastungen des medizinischen Personals. Ein kurzer aktueller Review [COVID-19 Pandemic: Stress Experience of Healthcare Workers - A Short Current Review]. Psychiatr Prax 2020; 47(4): 190-7. DOI: https://doi.org/10.1055/a-1159-5551
42) Wise EA, Beck JG. Work-related trauma, PISD, and workers compensation legislation: implications for practice and policy. Psychol Trauma 2015; 7: 500-506. DOI: https://doi.org/10.1037/tra0000039
43) Buselli R, Veltri A, Baldanzi S Work-related stress disorders: variability in clinical expression and pitfalls in psychiatric diagnosis. Med Lav 2016; 107(2): 92-101.
44) Pettenuzzo E, Scafa F, Neri L, et al. Disturbo post-traumatico da stress lavoro-correlato: descrizione di cinque casi clinici. G Ital Med Lav Erg 2018; 40(3, suppl.): 91-2.
45) Bollinger AR, Riggs DS, Blake DD, et al. Prevalence of personality disorders among combat veterans with posttraumatic stress disorder. J Trauma Stress 2000; 13(2): 255-70. DOI: https://doi.org/10.1023/A:1007706727869
46) Wiegner L, Hange D, Björkelund C, Prevalence of perceived stress and associations to symptoms of exhaustion, depression and anxiety in a working age population seeking primary care - an observational study. BMC Fam Pract. 2015; 16:38; doi: 10.1186/s12875-015-0252-7. DOI: https://doi.org/10.1186/s12875-015-0252-7

How to Cite



[The new Maugeri diagnostic protocol for work-related stress and mobbing (MaSD-2)]: Il nuovo protocollo diagnostico Maugeri per stress lavoro-correlato e mobbing (MaSD-2). (2022). Giornale Italiano Di Medicina Del Lavoro Ed Ergonomia, 44(1), 22-31. https://doi.org/10.4081/gimle.578
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