Ángel Martínez-Hernáez
Professor titular de Antropologia Médica da Universitat Rovira i Virgili, Tarragona, Espanha
Leticia Medeiros-Ferreira
Médica-psiquiatra da CSMA Nou Barris, Barcelona, Espanha.
Abstract:
Background: Several studies point out the high risk of misdiagnosing delusional disorder and paranoid personality disorder in victims of mobbing or workplace harassment (WPH). Objective: To analyze the extent to which the symptoms attributable to mobbing are misidentified with criteria for two paranoid spectrum nosologies (delusional disorder and paranoid personality disorder). Methods: Literature review of PubMed and SciELO from 1990 to June 2009. Results: The identification of paranoid spectrum symptoms in victims of mobbing is not consistent with the literature, which, by contrast, shows a notable presence of symptoms in the post-traumatic stress spectrum (as much as 92%), although they do not meet the A1 criterion for this nosology. Some of the causes of wrong diagnosis are noted, such as a tendency to confuse hypervigilance (D4 criterion for post-traumatic stress disorder in DSM-IV-TR) with paranoid ideation, the existence of a defensive profile in victims of WPH, and lack of recognition on the part of clinicians of the stressful and traumatizing impact of mobbing. Discussion: Longitudinal and mixed methodology (qualitative and quantitative) studies are necessary in order to establish robust differential diagnosis criteria that clearly distinguish the clinical manifestations attributable to workplace harassment from paranoid spectrum symptoms.
Keywords:Mobbing, workplace harassment, delusional disorder, paranoid personality disorder, post-traumatic stress disorder