Book Review:"Work-Linked Depression" Author: Satoshi Kato
- かゆかわクリニック院長 粥川裕平
- 5 days ago
- 3 min read
Updated: 2 days ago
Monthly Hodanren
No. 1230, January 2017
Essential Reading for Every Physician
Caring for Working People
The very title, Work-Linked Depression, is striking. For many years, the vast majority of psychiatrists subscribed to the theory that depression was closely associated with a depressive-prone personality. Bipolar disorder (formerly manic-depressive illness) was regarded as an endogenous psychosis, based on the a priori assumption that environmental factors played no role in its development. Drawing on his own clinical experience, Dr. Kato demonstrates that mood disorders attributable to occupational factors do indeed exist. This is the first book in Japan to present such evidence systematically.
The book consists of a preface, three main sections comprising ten chapters—Part I: Work-Linked Mood Disorders: Work-Linked Depression and Bipolar Disorder; Part II: Neurasthenia, Panic Disorder, and Depression; and Part III: The Pathology of Contemporary Society—followed by references and an afterword.
In the preface, the author explains that Jichi Medical University, being under the administrative authority of the Ministry of Internal Affairs and Communications, was required to provide tertiary emergency medical services. He also notes that many of Japan's leading corporations are concentrated in the surrounding area. He characterizes the book as "a collection of descriptions of clinical practice arising from encounters with patients suffering from depression in the workplace."
Professor Kato spent many years in academia, serving as Professor of Psychiatry at Jichi Medical University. He is well versed in European and American psychiatric literature and has made numerous contributions in the fields of psychopathology and psychoanalysis. At the same time, while serving as a member of the Tochigi Prefectural Workers' Compensation Committee, he established himself as a principled clinician who spoke candidly about the mental health problems of working people. Throughout his career in psychiatric hospitals, he was actively involved in occupational therapy for patients with severe mental illness as well as their rehabilitation and reintegration into society. It is no coincidence that his grandfather, Fusajiro Kato, was one of the pioneers of occupational therapy in Japan. One cannot help but sense a family tradition—and a driving force—that challenges accepted wisdom and conventional theories in pursuit of workers' health.
According to the author, excessive workload in the workplace is the principal precipitating factor for work-linked depression and bipolar disorder. Patients do not exhibit evident personality disorders. Cases of work-linked bipolar disorder, along with work-linked depression, have increased rapidly in the era of globalization. In this sense, they may be regarded as diseases characteristic of modern corporate society, which increasingly favors the so-called melancholic personality type. The author also offers a critical examination of the widely discussed concept of "new-type depression." Although some aspects remain exploratory from an academic standpoint, this is the only book that presents a truly persuasive alternative perspective on the theory of modern-type depression.
Following the enactment of the Act on Promotion of Preventive Measures against Karoshi (Death from Overwork), Overwork Prevention Promotion Centers have been established in every prefecture in Japan. Remaining an overwhelming minority voice independent of government policy, the author has also been actively involved in the Japanese Society for the Prevention of Death from Overwork.
The book is particularly groundbreaking in arguing for the existence of work-linked bipolar disorder, a condition that workers' compensation authorities have traditionally dismissed as purely endogenous. It is essential reading not only for occupational physicians but for every physician who provides medical care to working people.
