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Saúde mental e trabalho: uma reflexão sobre o nexo com o trabalho e o diagnóstico, com base na prática Mental health and work: a discussion of the connection between work and diagnosis based on daily practice
Débora Miriam Raab Glina 1 Lys Esther Rocha 2 Maria Lucia Batista 3 Maria Goretti Vieira Mendonça

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1 Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, sala 217, São Paulo, SP 01246-904, Brasil. [e-mail] 2 Departamento de Medicina Legal, Ética Médica, Medicina Social e do Trabalho, Faculdade de Medicina LIM-40, Universidade de São Paulo. Rua Teodoro Sampaio 115, São Paulo, SP 05405-000, Brasil. [e-mail] 3 Centro de Referência de Saúde do Trabalhador André Gabois, Secretaria Municipal da Saúde, Prefeitura Municipal de São Paulo. Rua Frederico Alvarenga 259, 5 o andar, São Paulo, SP 01020-030, Brasil.

Abstract Seven cases of workers selected among 150 who had undergone psychiatric treatment at the Workers’ Health Reference Centers in Santo Amaro and André Gabois from 1994 to 1997 were presented for a detailed analysis characterizing work situations and discussing definition of the diagnosis and causal connections with work. The qualitative case study provides a thematic analysis of the patient history and files. Work situations are characterized by: unhealthy working conditions, problems related to work organization, inadequate human resources management, and urban violence. Symptoms included: fear, anxiety, depression, nervousness, tension, fatigue, malaise, loss of appetite, sleep disorders, and psychosomatic disorders (gastritis, hypertension); in addition, workers were unable to forget about work while off the job. Diagnosis varied. Three cases involved post-traumatic syndrome. Two cases involved organic psychosis linked to accidents or exposure to neurotoxic chemical products. Cases also included neurotic syndromes of fatigue, depression,