Wang J L, Lesage A, Schmitz N, Drapeau A
Department of Psychiatry and of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
J Epidemiol Community Health. 2008 Jan;62(1):42-7. doi: 10.1136/jech.2006.050591.
[corrected] This analysis estimated the gender-specific associations between work stress, major depression, anxiety disorders and any mental disorder, adjusting for the effects of demographic, socioeconomic, psychological and clinical variables.
Data from the Canadian national mental health survey were used to examine the gender-specific relationships between work stress dimensions and mental disorders in the working population (n = 24,277). Mental disorders were assessed using a modified version of the World Mental Health - Composite International Diagnostic Interview.
In multivariate analysis, male workers who reported high demand and low control in the workplace were more likely to have had major depression (OR 1.74, 95% CI 1.12 to 2.69) and any depressive or anxiety disorders (OR 1.47, 95% CI 1.05 to 2.04) in the past 12 months. In women, high demand and low control was only associated with having any depressive or anxiety disorder (OR 1.39, 95% CI 1.05 to 1.84). Job insecurity was positively associated with major depression in men but not in women. Imbalance between work and family life was the strongest factor associated with having mental disorders, regardless of gender.
Policies improving the work environment may have positive effects on workers' mental health status. Imbalance between work and family life may be a stronger risk factor than work stress for mental disorders. Longitudinal studies incorporating important workplace health research models are needed to delineate causal relationships between work characteristics and mental disorders.
本分析评估了工作压力、重度抑郁症、焦虑症及任何精神障碍之间的性别特异性关联，并对人口统计学、社会经济、心理及临床变量的影响进行了校正。
利用加拿大全国心理健康调查的数据，研究工作人群（n = 24277）中工作压力维度与精神障碍之间的性别特异性关系。使用世界心理健康综合国际诊断访谈的修订版评估精神障碍。
在多变量分析中，报告工作场所需求高且控制低的男性工作者在过去12个月中更有可能患有重度抑郁症（比值比1.74，95%置信区间1.12至2.69）以及任何抑郁或焦虑症（比值比1.47，95%置信区间1.05至2.04）。在女性中，高需求和低控制仅与患有任何抑郁或焦虑症相关（比值比1.39，95%置信区间1.05至1.84）。工作不安全感与男性的重度抑郁症呈正相关，但与女性无关。工作与家庭生活的失衡是与患有精神障碍相关的最强因素，无论性别如何。
改善工作环境的政策可能对工作者的心理健康状况产生积极影响。工作与家庭生活的失衡可能是比工作压力更强的精神障碍风险因素。需要纳入重要工作场所健康研究模型的纵向研究来阐明工作特征与精神障碍之间的因果关系。
