Melchior Maria, Caspi Avshalom, Milne Barry J, Danese Andrea, Poulton Richie, Moffitt Terrie E
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK.
Psychol Med. 2007 Aug;37(8):1119-29. doi: 10.1017/S0033291707000414. Epub 2007 Apr 4.
Rates of depression have been rising, as have rates of work stress. We tested the influence of work stress on diagnosed depression and anxiety in young working adults.
Participants were enrolled in the Dunedin study, a 1972-1973 longitudinal birth cohort assessed most recently in 2004-2005, at age 32 (n=972, 96% of 1015 cohort members still alive). Work stress (psychological job demands, work decision latitude, low work social support, physical work demands) was ascertained by interview. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) were ascertained using the Diagnostic Interview Schedule (DIS) and diagnosed according to DSM-IV criteria.
Participants exposed to high psychological job demands (excessive workload, extreme time pressures) had a twofold risk of MDD or GAD compared to those with low job demands. Relative risks (RRs) adjusting for all work characteristics were: 1.90 [95% confidence interval (CI) 1.22-2.98] in women, and 2.00 (95% CI 1.13-3.56) in men. Analyses ruled out the possibility that the association between work stress and disorder resulted from study members' socio-economic position, a personality tendency to report negatively, or a history of psychiatric disorder prior to labour-market entry. Prospective longitudinal analyses showed that high-demand jobs were associated with the onset of new depression and anxiety disorder in individuals without any pre-job history of diagnosis or treatment for either disorder.
Work stress appears to precipitate diagnosable depression and anxiety in previously healthy young workers. Helping workers cope with work stress or reducing work stress levels could prevent the occurrence of clinically significant depression and anxiety.
抑郁症的发病率一直在上升，工作压力的发生率亦是如此。我们测试了工作压力对年轻在职成年人确诊的抑郁症和焦虑症的影响。
参与者被纳入达尼丁研究，这是一个始于1972 - 1973年的纵向出生队列，最近一次评估是在2004 - 2005年，当时参与者32岁（n = 972，占1015名队列成员的96%，这些成员仍在世）。通过访谈确定工作压力（心理工作需求、工作决策自由度、低工作社会支持、体力工作需求）。使用诊断访谈表（DIS）确定重度抑郁症（MDD）和广泛性焦虑症（GAD），并根据《精神疾病诊断与统计手册》第四版（DSM - IV）标准进行诊断。
与低工作需求的参与者相比，面临高心理工作需求（工作量过大、极端时间压力）的参与者患MDD或GAD的风险高出两倍。针对所有工作特征进行调整后的相对风险（RRs）为：女性为1.90 [95%置信区间（CI）1.22 - 2.98]，男性为2.00（95% CI 1.13 - 3.56）。分析排除了工作压力与疾病之间的关联是由研究成员的社会经济地位、负面报告的人格倾向或劳动力市场进入之前的精神疾病史导致的可能性。前瞻性纵向分析表明，高需求工作与在入职前没有任何一种疾病诊断或治疗史的个体中新发抑郁症和焦虑症的发作有关。
工作压力似乎会促使原本健康的年轻员工出现可诊断的抑郁症和焦虑症。帮助员工应对工作压力或降低工作压力水平可以预防具有临床意义的抑郁症和焦虑症的发生。
