Balancing Work and Schizophrenia: Challenges in Fitness-for-Work Assessment

Résumé

Introduction Assessing medical fitness for work in patients with schizophrenia remains challenging due to the disorder’s complex medical, organizational and social implications for both employees and employers. Objectives The aim of this study was to describe the medical and occupational characteristics of patients with schizophrenia and analyze the determinants of medical fitness for work decisions. Methods A descriptive, retrospective study was conducted on medical records of patients with schizophrenia referred to the occupational health department at Charles Nicolle University hospital in Tunis for fitness-for-work assessment between 2020 and 2024. Results Fifteen cases were analyzed. Most participants were male (86.7%) with a median age of 38 years (range: 24-56) and mean professional seniority of 15.2 ±8 years. The most represented sectors of activity were public health (n=3), public administration (n=3), and electronics (n=2). Most patients (86.7%) had no psychiatric history, and 26.7% had been diagnosed with schizophrenia before starting employment. At assessment, 47% were asymptomatic, 26.7% had active psychotic symptoms, and 20% reported sleep disorders Regarding treatment response, 46.7% were well-controlled, 33.3% partially controlled, and 20% poorly controlled. Fitness outcomes were: 6.7% of patients fit for current work, 46.7% fit with workplace adjustments, 33.3% permanently unfit, and 13.3% temporarily unfit. Required adjustments primarily involved removing night shifts (40%), excluding responsibility roles (33.3%), and driving restrictions (6.7%). Determinants of fitness decisions were primarily job characteristics, working hours, and clinical stability. Conclusions Fitness-for-work evaluations in patients with schizophrenia present significant challenges requiring careful consideration of multiple medical and occupational factors. These findings, despite the small sample size, highlight the need for clear guidelines to assist occupational physicians. Disclosure of Interest None Declared

Citer ce document

Accès au document

Texte intégral en lecture en ligne, réservé aux abonnés SPHAERO et aux membres de l'institution. Se connecter

Auteur(s)

Statistiques

Consultations : 1

Téléchargements : 0