Medicalization of Social Problems: Rising Depression-related Absenteeism in Japan

Abstract

Increasing numbers of people are absent from work with a diagnosis of depression, and this has become a social problem in Japan. This study examines the hypothesis that this rise of depression-related absenteeism in Japan is influenced by social factors that contribute to the medicalization of social problems. Here, “social factors” are corporate systems that affect workers' psychology and mental health, media coverage and disease awareness campaigns by pharmaceutical companies, the intentions of patients' physicians, as well as psychopathological factors such as increased workplace stress. Data were obtained from semi-structured interviews conducted with 50 workers who had a history of taking depression-related leaves of absence, and a re-diagnosis by six physicians of 10 representative cases derived from categorizations based on data from the interviews. The data were analyzed to identify social factors underlying the rise in depression-related absenteeism and the mechanisms of medicalization of social problems. Social factors found to affect the rise of depression-related absenteeism include mentalities whereby patients, seeking to escape from harsh work environments, may wish to receive a diagnosis of depression to take a leave of absence; and the intention of participants' physicians to provide the diagnosis out of sympathy even when official diagnostic criteria are not met. Thus, it would seem that work-related social problems that should normally be addressed by public policy measures are in fact being medicalized. Moreover, this study considers how “self-medicalization” by patients renders the solution to social problems more complex by contributing to the further medicalization of social problems.