Capacity Limitations and Work Ability in Patients With Neurological Conditions With and Without Work Phobic Anxiety

Abstract

Objective: Work phobic anxiety can occur as an additional problem in any somatic illness and is often associated with work capacity limitations and sick leave. This study investigates work-related capacity limitations in patients with and without work phobic anxiety who are undergoing neurological rehabilitation. It was conducted in the rehabilitation facility Brandenburgklinik Berlin-Brandenburg in Germany.

Methods: Work phobic anxiety was assessed with the Workplace Phobia Scale (WPS). The response rate was 69.51%. Capacity limitations (Mini-ICF-APP) were compared between 19 patients with neurological conditions and work phobic anxiety and 209 patients with neurological conditions without work phobic anxiety. Work participation restrictions were examined and compared using the self- and observer rated Index for Measuring Participation (IMET, IMEP-O). The work ability assessments regarding the patients’ last occupation as well as the general labor market were conducted by the treating physicians as part of their medical reports and compared between the subgroups. The work ability was rated as less than 3 h, 3 to less than 6 h, or 6 h or more a day for more than 6 months, with the latter being an indication for prognostic work ability and potential reintegration into the labor market. This is a common classification in sociomedical assessments in Germany.

Results: Independent t-tests showed that patients with work phobic anxiety were significantly more limited in their planning and structuring of tasks (t[20.104] = 2.310, p = 0.032, d = 0.68), flexibility (t[217] = 3.586, p < 0.001, d = 0.86), assertiveness (t[19.613] = 2.151, p = 0.044, d = 0.70), group integration (t[19.534] = 2.274, p = 0.034, d = 0.76), and mobility capacities (t[16.616] = 2.198, p = 0.042, d = 0.76) and significantly more restricted in participating in work compared to patients without work phobic anxiety (IMEP-O: t[23.549] = 2.298, p = 0.031, d = 0.40; IMET: t[27.191] = 4.581, p < 0.001, d = 0.78). Chi-squared tests revealed no significant differences in the physicians’ work ability assessments between patients with and without work phobic anxiety.

Conclusions: While work phobic anxiety seems to not be decisive concerning early retirement assessments, it is associated with greater capacity limitations and work participation restrictions. The results highlight the need for identifying work phobic anxiety and associated capacity limitations in clinical practice.