Recurrent Depressive Disorder, Severe Episode without Psychotic Symptoms in Lawyer: A Case Report

Background. Depression, a global disability cause, negatively impacts work productivity and can be aggravated by work-related stress, making it crucial to differentiate between causes to prevent workplace mental disorders. Methods. Utilizing a case report methodology, we applied a seven-step approach to analyze the diagnosis of an occupational disease. Results. A 26-year-old, a private law firm corporate lawyer, was brought to the emergency room by colleagues due to worsening suicidal ideation over the past three weeks. The clinical diagnosis revealed a severe recurrent episode of depressive disorder without psychotic symptoms, supported by a MADRS score of 40 and previous depression history during thesis work. Work-related exposures - handling difficult clients, time constraints, and frequent overtime - were consistent with similar reports from coworkers. The relationship between exposure and disease was evident, with lawyers facing a 3.6 times higher prevalence of depression based on literature, influenced by factors such as work overcommitment and lack of work-life balance. The results of the assessment by SDS & NBJSQ showed severe stress related to quantitative and qualitative workload; lack of appreciation and support from superiors. Despite work-related stress, there were individual external triggers for her medical condition. The diagnosis of occupational disease was not conclusive. Discussion. Through the seven-step analysis, it became apparent that the patient experienced work-related stress, but external factors were also significant in triggering her medical condition. Conclusion. This case is not classified as an occupational disease but a condition aggravated by work. Thus, a holistic approach to addressing mental health issues in the workplace is important.