Recognition and assessment of shift work disorder.

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Recognition and assessment of shift work disorder.

机译：对轮班工作障碍的认识和评估。

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It is estimated that almost 15% of full-time wage and salary workers (over 14 million workers) work evening, night, or rotating shifts and that 10% of these individuals suffer from shift work disorder. This disorder can cause serious impairments in individuals' ability to function at work and at home and to drive safely, and can place great stress on personal relationships. Yet this disabling disorder is frequently missed by clinicians. This article provides guidance for clinicians on how to recognize and assess shift work disorder in their day-to-day practices. It begins with an overview of the human circadian rhythm, its anatomy and genetics, and the important effects it has on sleep, wakefulness, and overall health. This is followed by an overview of circadian rhythm sleep disorders, with a detailed focus on one of the most common types, shift work disorder, and its diagnostic criteria, clinical features, and health consequences. Shift work disorder is associated with increased rates of gastrointestinal disorders (eg, ulcers, functional bowel disorders), hypertension, depression, on-the-job and automobile accidents, and decreased productivity. The article concludes with practical guidance for clinicians on how to recognize and assess shift work disorder in clinical settings, including clinical clues that suggest a circadian rhythm problem, how to take a sleep history, tools for assessing sleep disturbances, practical strategies to help patients shift their biological clocks, and when to consider more aggressive treatment and/or a referral for a specialized sleep consultation.

机译：据估计，几乎有15％的全职工资工人（超过1400万名工人）在晚上，晚上或轮班工作，而这些人中有10％患有轮班工作障碍。这种疾病会严重损害个人在工作和在家中的功能以及安全驾驶的能力，并可能给人际关系带来很大压力。然而，这种残疾疾病经常被临床医生遗漏。本文为临床医生提供了有关如何在日常实践中认识和评估轮班工作障碍的指南。它首先概述了人类昼夜节律，其解剖结构和遗传学，以及对睡眠，清醒和整体健康的重要影响。接下来是对昼夜节律性睡眠障碍的概述，重点是最常见的一种类型，轮班工作障碍及其诊断标准，临床特征和健康后果。轮班工作障碍与胃肠道疾病（例如溃疡，功能性肠病），高血压，抑郁症，在职和汽车事故的发生率增加以及生产力下降相关。本文最后为临床医生提供了有关如何识别和评估临床环境中轮班工作障碍的实用指南，包括提示昼夜节律问题的临床线索，如何记录睡眠史，评估睡眠障碍的工具，帮助患者转变的实用策略他们的生物钟，以及何时考虑采用更积极的治疗方法和/或转介进行专门的睡眠咨询。

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《The journal of clinical psychiatry》 |2011年第2期|共10页
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Recognition and assessment of shift work disorder.

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