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Although increasingly recognized as a source of emotional distress, social malfunctioning, and physical illness, the pathologic need of some people to invest all their energy in goal-directed and intensive labor has not been deeply studied, nor is it named or defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The workaholic may engage in physical or mental work or a combination of the two, and may work for an individual or a company, be self-employed, or engage in volunteer activities without remuneration. The typical workaholic seems incapable of relaxing and uses work not only as a source of livelihood but also as a form of recreation, substituting it for leisure pastimes such as socialization, hobbies, sports, and artistic and cultural pursuits. In this sense, work assumes the function of an addictive drug. Workaholics tend to postpone or omit meals, stay at work after others have gone home and even keep working until late at night, put in excessive amounts of overtime (sometimes failing to claim due compensation), and abuse nicotine, caffeine, alcohol, and other agents to assuage stress and withstand fatigue. The workaholic lifestyle is a common feature of various personality disorders, including a compulsion to achieve success, recognition, or advancement in one's chosen field of endeavor; a morbid absorption in the acquisition of wealth; and a need to immerse oneself in work as a distraction from the stresses or dissatisfactions of daily life. Some workaholic behavior is driven by family, social, or cultural expectations. Many workaholics manifest a compulsion to work even in childhood; some seem to be influenced by the example of a successful, driving parent, relative, family friend, or public figure. A workholic mentality may be engendered or fostered by an unduly demanding employer, or by one who makes overtime work either compulsory or highly rewarding as a means of limiting the total work force and thus curtailing the expense of fringe benefits. Long-term health effects of overwork include chronic fatigue, a decline in general health, increased incidence of illnesses and injuries, weight gain, increased use of tobacco and alcohol, deterioration of cognitive performance, emotional lability and depression, and increased mortality. In Japan, death from overwork (karoshi) is formally recognized as a compensable form of occupational disorder. Japanese courts have ruled that deaths from heart failure, stroke, and even suicide are examples of karoshi.