Melchior Maria, Berkman Lisa F, Niedhammer Isabelle, Zins Marie, Goldberg Marcel
MRC Centre for Social, Genetic and Developmental Psychiatry, Institute of Psychiatry, King's College, London, UK.
Soc Psychiatry Psychiatr Epidemiol. 2007 Jul;42(7):573-82. doi: 10.1007/s00127-007-0203-2. Epub 2007 May 24.
Individuals who experience work stress or heavy family demands are at elevated risk of poor mental health. Yet, the cumulative effects of multiple work and family demands are not well known, particularly in men.
We studied the association between multiple work and family demands and sickness absence due to non-psychotic psychiatric disorders in a longitudinal study conducted among members of the French GAZEL cohort study (8,869 men, 2,671 women) over a period of 9 years (1995-2003). Work stress and family demands were measured by questionnaire. Medically certified psychiatric sickness absence data were obtained directly from the employer. Rate ratios (RRs) of sickness absence were calculated using Poisson regression models, adjusting for age, marital status, social support, stressful life events, alcohol consumption, body mass and depressive symptoms at baseline.
Participants simultaneously exposed to high levels of work and family demands (> or =2 work stress factors and > or =4 dependents) had significantly higher rates of sickness absence due to non-psychotic psychiatric disorders than participants with lower levels of demands (compared to participants exposed to 0-1 work stress factors and with 1-3 dependents, age-adjusted rate ratios were 2.37 (95% CI 1.02-5.52) in men and 6.36 (95% CI 3.38-11.94) in women. After adjusting for baseline socio-demographic, behavioral and health characteristics, these RRs were respectively reduced to 1.82 (95% CI 0.86-3.87) in men, 5.04 (95% CI 2.84-8.90) in women. The effect of multiple work and family demands was strongest for sickness absence due to depression: age-adjusted RRs among participants with the highest level of work and family demands were 4.70 (1.96-11.24) in men, 8.57 (4.26-17.22) in women; fully adjusted RRs: 3.55 (95% CI 1.62-7.77) in men, 6.58 (95%CI 3.46-12.50) in women.
Men and women simultaneously exposed to high levels of work stress and family demands are at high risk of experiencing mental health problems, particularly depression.
经历工作压力或繁重家庭负担的个体心理健康状况较差的风险较高。然而，多种工作和家庭负担的累积影响尚不清楚，尤其是在男性中。
在一项对法国GAZEL队列研究（8869名男性，2671名女性）成员进行的为期9年（1995 - 2003年）的纵向研究中，我们研究了多种工作和家庭负担与非精神病性精神障碍导致的病假之间的关联。通过问卷调查来衡量工作压力和家庭负担。经医学认证的精神病病假数据直接从雇主处获得。使用泊松回归模型计算病假的率比（RRs），并对年龄、婚姻状况、社会支持、应激性生活事件、饮酒量、体重和基线时的抑郁症状进行调整。
同时面临高水平工作和家庭负担（≥2个工作压力因素且≥4个受抚养人）的参与者因非精神病性精神障碍导致的病假率显著高于负担水平较低的参与者（与暴露于0 - 1个工作压力因素且有1 - 3个受抚养人的参与者相比，年龄调整后的率比在男性中为2.37（95%可信区间1.02 - 5.52），在女性中为6.36（95%可信区间3.38 - 11.94）。在对基线社会人口统计学、行为和健康特征进行调整后，这些RRs在男性中分别降至1.82（95%可信区间0.86 - 3.87），在女性中降至5.04（95%可信区间2.84 - 8.90）。多种工作和家庭负担对因抑郁症导致的病假影响最强：工作和家庭负担水平最高的参与者中，年龄调整后的RRs在男性中为4.70（1.96 - 11.24），在女性中为8.57（4.26 - 17.22）；完全调整后的RRs：男性为3.55（95%可信区间1.62 - 7.77），女性为6.58（95%可信区间3.46 - 12.50）。
同时面临高水平工作压力和家庭负担的男性和女性有出现心理健康问题的高风险，尤其是抑郁症。
