Pikhart Hynek, Bobak Martin, Pajak Andrzej, Malyutina Sofia, Kubinova Ruzena, Topor Roman, Sebakova Helena, Nikitin Yuri, Marmot Michael
Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
Soc Sci Med. 2004 Apr;58(8):1475-82. doi: 10.1016/S0277-9536(03)00350-2.
Psychosocial factors at work have been found to predict a range of health outcomes but their effect on mental health outcomes has not been extensively studied. This paper explores the relationship between psychosocial factors at work and depression in three countries of Central and Eastern Europe. The data come from a cross-sectional study of working men (n = 645) and women (n = 523) aged 45-64 years, randomly selected from population registers in Novosibirsk (Russia), Krakow (Poland) and Karvina-Havirov (Czech Republic). The questionnaire included questions on the effort and reward at work, job control, the full CES-D scale of depression, and a range of other characteristics. Linear regression was used to estimate the association between depression score and work characteristics: the logarithm of the effort-reward ratio, and continuous job control score. The means of the depression score were 10.5 for men and 14.2 for women. After controlling for age, sex and country, effort-reward ratio (logarithmically transformed) was strongly related to depression score; a 1 SD increase in the log transformed effort-reward ratio was associated with an increase in the depression of 2.0 points (95% CI 1.5; 2.4), and further adjustment did not materially change the effect. Job control was inversely associated with depression score in Poland and the Czech Republic (not in Russia) but the association was largely eliminated by controlling for socioeconomic characteristics. This study suggests that the effort-reward imbalance at work is related to prevalence of depression in these central and eastern European populations.
研究发现,工作中的社会心理因素能够预测一系列健康结果,但它们对心理健康结果的影响尚未得到广泛研究。本文探讨了中欧和东欧三个国家工作中的社会心理因素与抑郁症之间的关系。数据来自一项横断面研究,研究对象为年龄在45 - 64岁之间的在职男性(n = 645)和女性(n = 523),他们是从新西伯利亚(俄罗斯)、克拉科夫(波兰)和卡尔维纳 - 哈维若夫(捷克共和国)的人口登记册中随机选取的。调查问卷包括有关工作中的努力与回报、工作控制、完整的抑郁症CES - D量表以及一系列其他特征的问题。采用线性回归来估计抑郁评分与工作特征之间的关联:努力 - 回报比的对数以及连续的工作控制评分。男性抑郁评分的均值为10.5,女性为14.2。在控制了年龄、性别和国家因素后,努力 - 回报比(对数转换后)与抑郁评分密切相关;对数转换后的努力 - 回报比每增加1个标准差,抑郁评分就会增加2.0分(95%置信区间为1.5;2.4),进一步调整并没有实质性改变这种影响。在波兰和捷克共和国,工作控制与抑郁评分呈负相关(在俄罗斯则不然),但通过控制社会经济特征,这种关联在很大程度上被消除了。这项研究表明,工作中的努力 - 回报失衡与这些中欧和东欧人群中抑郁症的患病率有关。