近年來心理疾病逐漸成為職場益受重視的健康問題，我國勞委會參考國際間對於精神
疾病之職業疾病認定制度較為明確的日本，於2009年11月19日發布「工作相關心理壓力事件
引起精神疾病認定參考指引」。本研究目的在藉由文獻與網際網路資訊的蒐集，回顧日本制
訂「判斷壓力造成的精神障礙等，起因是否為工作的判斷指南」的時空背景、理論概念、壓
力強度判定工具與運作流程，並了解日本近年持續審視修訂該類指南的方向與考量，以及
其使用美國Holmes等所提出的「社會再適應量表」中職場內外生活壓力事件表協助評估個案
心理壓力強度的方式。本文最後總結日本「業務引起之精神疾病」認定制度的發展趨勢，並
簡介勞委會勞工安全衛生研究所近年相關政策回顧、精神科就診勞工和一般職場勞工研究
方面的進展，期使此參考指引在考量台灣狀況進一步加以修訂與充分討論，並逐步累積工
作者心理壓力強度之實證證據之後，未來能成為認定職業相關精神疾病的重要參考基礎。

Recently, psychiatric illness, as a health problem, has received increasing focus in workplaces.
When the Council of Labor Affairs announced the “Evaluation Guidelines for Psychiatric
Diseases Induced by Work-related Mental Stress” on November 19, 2009, the council referenced
Japan, which possesses a clearer occupational disease identification system for mental
illnesses than other countries worldwide. This study collects literature and Internet materials to
review the spatial and temporal background for Japan’s “Guidelines about Mental Disorder
Caused from Working Stress” as well as the theoretical concepts, stress determination tools
and operational processes adopted in these guidelines. This review is then employed to understand
Japan’s directions and considerations when examining and revising the guidelines in recent
years as well as Japan’s adoption of Holmes’s “Social Readjustment Rating Scale” to assess
the intensity of individual psychological stress. Finally, the study also summarizes developmental
trends in the “Mental Illness Induced by Professional Work” identification system employed
in Japan and briefly introduces the Taiwanese Institute of Occupational Safety and
Health’s review of related policies in recent years and the progress in research of the laborers
under psychological treatment and general laborers. It is hoped that Japan’s guidelines can
become an essential reference for the identification of work-related mental illness after considerations
of Taiwan’s status are revised and discussed and empirical evidence on the intensity
of psychological stress in laborers is obtained.