A leading article in Newsweek magazine recently described stress as “the dirty little secret of the office age” (Miller, 1988). The deleterious effects of stress are both widespread and diverse, to the extent that many people would regard stress as the principal threat to human well-being in the advanced industrialized societies. A partial list of conditions which are widely considered to be stress-related is given in Table 7.1. The list includes both “symptomatic conditions” (some of which are vague) and clinical entities of a more specific nature (some of which are life-threatening). I have not attemped to differentiate between the two categories. Many of the conditions in the list have a multiple aetiology, in which stress is one contributory factor amongst many. The relative importance of stress, in any individual case, will depend upon the presence or absence of other risk factors.
Headache: tension headache, migraine
Musculoskeletal disorders: pain and dysfunction at many sites but particularly the back and neck
Cardiovascular disorders: symptomatic conditions, arrhythmias, hypertension, coronary heart disease (angina pectoris, myocardial infarction, cardiac arrest), stroke
Gastrointestinal disorders: dyspepsia, peptic ulcer, constipation, colitis, “irritable bowel syndrome”
Amenorrhoea, dysmenorrhoea, premenstrual tension, sexual dysfunction (impotence, frigidity)
Allergies, asthma, skin rash, “sick building syndrome”
Suppression of immune function: increased susceptibility to infections, cancer (?)
Sleep disorders: insomnia, nightmares, “non-restorative sleep”
Chronic fatigue effects: lethargy, tremor, dizziness, faintness, palpitations, “effort syndromes”, “post-viral syndrome”, “sick building syndrome”
Disorders of mood state: impaired concentration, emotional lability, suppressed anger, anxiety, depression, lack of self-esteem, apathy, “nervous breakdown”, burn out
Behavioural effects: smoking, escapist drinking, drug abuse, aggression and antisocial acts, accident- and error-proneness, risk-taking, errors of judgement
Organizational effects: absenteeism, labour turnover, accidents and errors, labour relations problems, the SNAFU syndrome
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