After a survey of the definition and etiopathogenesis of burnout syndrome (BOS) carried out with the support of the most reliable available literature on the subject, the essay focuses on clinical evaluation (psychometric identification and quantification) of burn-out. In accordance with Circular 71/2003 of INAIL, it is assumed to be essential both legally and scientifically knowledge that the syndrome of burnout, knowledge, which involves an analysis of the case conducted with objective strictness and critical sensibility. It is carried out by collecting data on work history, physiological history, remote and proximal pathological history and performing a physical examination including neuro-psychiatric and psycho-diagnostic tests surveys. Only after the ascertainment of an effective existence of a psychiatric syndrome related to burnout phenomenon indeed, it will be possible (and necessary) to quantify the period of illness and the potential temporary biological damage or, more rarely, a permanent one. Given the difficulty of applying the forensic methodology to BOS (among which: the evaluation of the previous state of the person, the assessment of the causal link, the difficulties of nosographic of mental illness, the near impossibility of adequate prognostic evaluation, the difficulty to identify suitable criteria for establishing the importance and nature of limitations of daily living), in order to quantify the damage as objective as possible, it will be necessary to: 1) reconstruct the previous mental state of the subject; 2) assess the psychopathological condition following the event which the action of recognition focuses on; 3) express the clinical severity graduation judgment of the framework as well as a prognosis regarding the mental disorder found. The second part of the analysis focuses on the relationship between BOS and "helping profession"; specific attention is paid, in this section of work, to the analysis of the relationship between a typical BOS work-related stress and suicide.

La combinata osservazione della sindrome da burnout (BOS) quale malattia professionale degli appartenenti alle cosiddette “helping profession”, specie di quelle che operano nell’ambito delle patologie psichiatriche, e dell’elevata frequenza di suicidi in queste stesse categorie professionali, ha evidenziato una correlazione causale tra suicidio e BOS. Tale evento drammatico può essere inquadrato, in termini medico-giuridici, come epifenomeno della malattia professionale, ma anche come vero e proprio infortunio sul lavoro. È stata effettuata una revisione della letteratura con particolare riferimento ai casi di autosoppressione tra gli appartenenti alle specializzazioni mediche che operano nell’ambito delle patologie psichiatriche, conseguenti a eventi stressanti lavoro-correlati acuti e cronici. Il burnout è una sindrome da stress lavoro-correlata che si presenta con maggiore incidenza nelle helping profession, dove la sollecitazione emozionale negativa può essere all’origine di una depersonalizzazione e di una ridotta realizzazione professionale. Clinicamente, la BOS si esprime come un disturbo dell’adattamento o un disturbo post-traumatico da stress acuti che, se l’azione stressante persiste, cronicizzano con un aumentato rischio di suicidio. Nella valutazione della BOS il medico legale deve individuare le valenze nosografiche inducenti lo stato patologico e stimare il conseguente danno biologico. La statistica epidemiologica mostra la diffusione della BOS a tutte le specializzazioni mediche, con un aumento del rischio tra gli psichiatri. Sotto un profilo medico-giuridico la BOS si esprime in forma di malattia professionale, meritevole di un’adeguata tutela INAIL, che deve essere estesa anche ai casi di suicidi burn-indotti. Considerata la lacunosità di voci valutative medico-legali applicabili alle psicopatologie proprie della BOS, si è ritenuto necessario esprimere un nuova proposta valutativa con un’ampia articolazione del danno biologico.

Coluccia, A., Carlini, L., Fidenzi, L., Gualtieri, G., Nucci, G., Fagiolini, A., et al. (2016). Analisi e valutazione medico-legale della sindrome da burnout nell'ambito delle helping profession e della tutela INAIL per i casi di malattia e suicidio. [Burnout syndrome. Legal medicine: analysis and evaluation INAIL protection in cases of suicide induced by burnout within the helping professions]. RIVISTA DI PSICHIATRIA, 51(3), 87-95 [10.1708/2304.24790].

Analisi e valutazione medico-legale della sindrome da burnout nell'ambito delle helping profession e della tutela INAIL per i casi di malattia e suicidio. [Burnout syndrome. Legal medicine: analysis and evaluation INAIL protection in cases of suicide induced by burnout within the helping professions]

Coluccia Anna;Fidenzi Luca;Gualtieri Giacomo;Nucci Giulia;Fagiolini Andrea;Gabbrielli Mario
2016-01-01

Abstract

After a survey of the definition and etiopathogenesis of burnout syndrome (BOS) carried out with the support of the most reliable available literature on the subject, the essay focuses on clinical evaluation (psychometric identification and quantification) of burn-out. In accordance with Circular 71/2003 of INAIL, it is assumed to be essential both legally and scientifically knowledge that the syndrome of burnout, knowledge, which involves an analysis of the case conducted with objective strictness and critical sensibility. It is carried out by collecting data on work history, physiological history, remote and proximal pathological history and performing a physical examination including neuro-psychiatric and psycho-diagnostic tests surveys. Only after the ascertainment of an effective existence of a psychiatric syndrome related to burnout phenomenon indeed, it will be possible (and necessary) to quantify the period of illness and the potential temporary biological damage or, more rarely, a permanent one. Given the difficulty of applying the forensic methodology to BOS (among which: the evaluation of the previous state of the person, the assessment of the causal link, the difficulties of nosographic of mental illness, the near impossibility of adequate prognostic evaluation, the difficulty to identify suitable criteria for establishing the importance and nature of limitations of daily living), in order to quantify the damage as objective as possible, it will be necessary to: 1) reconstruct the previous mental state of the subject; 2) assess the psychopathological condition following the event which the action of recognition focuses on; 3) express the clinical severity graduation judgment of the framework as well as a prognosis regarding the mental disorder found. The second part of the analysis focuses on the relationship between BOS and "helping profession"; specific attention is paid, in this section of work, to the analysis of the relationship between a typical BOS work-related stress and suicide.
2016
Coluccia, A., Carlini, L., Fidenzi, L., Gualtieri, G., Nucci, G., Fagiolini, A., et al. (2016). Analisi e valutazione medico-legale della sindrome da burnout nell'ambito delle helping profession e della tutela INAIL per i casi di malattia e suicidio. [Burnout syndrome. Legal medicine: analysis and evaluation INAIL protection in cases of suicide induced by burnout within the helping professions]. RIVISTA DI PSICHIATRIA, 51(3), 87-95 [10.1708/2304.24790].
File in questo prodotto:
File Dimensione Formato  
Riv Psichiatr 2016; 51(3) 87 _95 Analisi e valutazione medico-legale della sindrome da burnout.pdf

non disponibili

Descrizione: Free full-text sul sito dell'editore
Tipologia: PDF editoriale
Licenza: NON PUBBLICO - Accesso privato/ristretto
Dimensione 126.69 kB
Formato Adobe PDF
126.69 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/1225876