Wang Jianli
Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
Psychol Med. 2005 Jun;35(6):865-71. doi: 10.1017/s0033291704003241.
Major depression is a prevalent mental disorder in the general population, with a multi-factorial etiology. However, work stress as a risk factor for major depression has not been well studied.
Using a longitudinal study design, this analysis investigated the association between the levels of work stress and major depressive episode(s) in the Canadian working population, aged 18 to 64 years. Data from the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were used (n = 6663). The NPHS participants who did not have major depressive episodes (MDE) at baseline (1994-1995 NPHS) were classified into four groups by the quartile values of the baseline work stress scores. The proportion of MDE of each group was calculated using the 1996-1997 NPHS data.
The first three quartile groups had a similar risk of MDE. Those who had a work stress score above the 75th percentile had an elevated risk of MDE (7.1%). Using the 75th percentile as a cut-off, work stress was significantly associated with the risk of MDE in multivariate analysis (odds ratio = 2.35, 95% confidence interval 1.54-3.77). Other factors associated with MDE in multivariate analysis included educational level, number of chronic medical illnesses and child and adulthood traumatic events. There was no evidence of effect modification between work stress and selected sociodemographic, clinical and psychosocial variables.
Work stress is an independent risk factor for the development of MDE in the working population. Strategies to improve working environment are needed to keep workers mentally healthy and productive.
重度抑郁症是普通人群中普遍存在的一种精神障碍,其病因是多因素的。然而,工作压力作为重度抑郁症的一个风险因素尚未得到充分研究。
采用纵向研究设计,本分析调查了18至64岁加拿大工作人群中工作压力水平与重度抑郁发作之间的关联。使用了加拿大国家人口健康调查(NPHS)纵向队列的数据(n = 6663)。在基线(1994 - 1995年NPHS)时没有重度抑郁发作(MDE)的NPHS参与者,根据基线工作压力得分的四分位数分为四组。使用1996 - 1997年NPHS数据计算每组的MDE比例。
前三个四分位数组的MDE风险相似。工作压力得分高于第75百分位数的人群MDE风险升高(7.1%)。以第75百分位数为临界值,在多变量分析中工作压力与MDE风险显著相关(优势比 = 2.35,95%置信区间1.54 - 3.77)。多变量分析中与MDE相关的其他因素包括教育水平、慢性疾病数量以及儿童期和成年期创伤事件。没有证据表明工作压力与选定的社会人口统计学、临床和心理社会变量之间存在效应修正。
工作压力是工作人群中发生MDE的一个独立风险因素。需要采取改善工作环境的策略来保持员工的心理健康和工作效率。