Prior psychiatric problems in rehabilitation clients with work-related injuries.

Psychiatric histories were obtained in 56 patients beginning rehabilitation following a work-related injury in order to establish the temporal relationship between the onset of psychiatric problems and the date of the work injury. The presence of major depression and alcohol abuse was determined using structured, directed interviews and the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders. A history of either alcohol abuse or depression was found in 36 (64.3%) of the 56 subjects. Of these 36 subjects, 32 (88.9%) reported a history of psychiatric problems that antedated the work injury. These data suggest that, in injured workers, the conceptualization of psychiatric problems solely as reactive illnesses in otherwise psychiatrically healthy persons is often inaccurate. Furthermore, these data suggest the hypothesis that the presence of clinical depression or alcohol abuse may increase the risks of a work-related injury.