Work-related mental distress in primary care. Study of prevalence and associated factors ; La souffrance psychique en lien avec le travail vue en consultation de médecine générale. Étude de la prévalence et des facteurs associés

The general practitioner (GP) is often confronted with patients with mental health problems related to work. The objective of this study is to determine the prevalence of work related mental distress in patients consulting their GP and to study the association between mental distress and psychosocial factors at work. This work is based on the Héraclès study conducted among 2,027 patients in professional activity consulting their GP in the Nord - Pas-de-Calais. Mental distress was evaluated with the MINI International Neuropsychiatric Interview, by the patient's statement and the GP’s diagnosis. The association between mental distress objectified by the MINI and psychosocial factors at work was studied using a Poisson regression or a logistic regression model. The prevalence of work related mental distress objectified by the MINI was 25.6%, 24.5% for mental distress reported by the patient and 25.8% for mental distress diagnosed by the GP. In the multivariable analyses significant association was found for depression/anxiety and work intensity, emotional demands and social relations at work. Excessive alcohol consumption was associated with social relations at work and autonomy. For suicidality, there was an association with work intensity in men and emotional demands in women. The prevalence of work related mental distress found in our study was high and emphasize the major role of GPs in the management of these patients. Several psychosocial factors at work were associated with mental distress which shows the impact of those work characteristics on the presence of mental distress. ; Le médecin généraliste (MG), est souvent confronté à des patients avec des problèmes de santé psychique en lien avec le travail. L’objectif de cette thèse est de déterminer la prévalence de la souffrance psychique en lien avec le travail chez les patients consultant leur MG et d’étudier l’association entre la souffrance psychique et les facteurs psychosociaux au travail. Ce travail est basé sur l’étude Héraclès menée auprès de 2 027 ...