Netterstrøm Bo, Conrad Nicole, Bech Per, Fink Per, Olsen Ole, Rugulies Reiner, Stansfeld Stephen
Clinic of Occupational Medicine, Hillerød Hospital, Helsevej 2, DK 3400 Hillerød, Denmark.
Epidemiol Rev. 2008;30:118-32. doi: 10.1093/epirev/mxn004. Epub 2008 Jun 27.
This review is based on a literature search made in January 2007 on request by the Danish National Board of Industrial Injuries. The search in PubMed, EMBASE, and PsycINFO resulted in more than 1,000 publications. This was reduced to 14 after the titles, abstracts, and papers were evaluated by using the following criteria: 1) a longitudinal study, 2) exposure to work-related psychosocial factors, 3) the outcome a measure of depression, 4) relevant statistical estimates, and 5) nonduplicated publication. Of the 14 studies, seven used standardized diagnostic instruments as measures of depression, whereas the other seven studies used self-administered questionnaires. The authors found moderate evidence for a relation between the psychological demands of the job and the development of depression, with relative risks of approximately 2.0. However, indication of publication bias weakens the evidence. Social support at work was associated with a decrease in risk for future depression, as all four studies dealing with this exposure showed associations with relative risks of about 0.6. Even if this literature study has identified work-related psychosocial factors that in high-quality epidemiologic studies predict depression, studies are still needed that assess in more detail the duration and intensity of exposure necessary for developing depression.
本综述基于应丹麦国家工伤委员会要求于2007年1月进行的文献检索。在PubMed、EMBASE和PsycINFO数据库中进行检索后得到了1000多篇出版物。在根据以下标准对标题、摘要和论文进行评估后,数量减少至14篇:1)纵向研究;2)接触与工作相关的社会心理因素;3)以抑郁测量作为结果;4)相关统计估计;5)非重复发表。在这14项研究中,7项使用标准化诊断工具作为抑郁测量方法,而其他7项研究使用自行填写的问卷。作者发现有适度证据表明工作的心理需求与抑郁的发生之间存在关联,相对风险约为2.0。然而,发表偏倚的迹象削弱了这一证据。工作中的社会支持与未来患抑郁症风险的降低相关,因为所有四项涉及这种接触的研究均显示关联的相对风险约为0.6。即使这项文献研究已经确定了在高质量流行病学研究中可预测抑郁症的与工作相关的社会心理因素,但仍需要进行更详细评估引发抑郁症所需接触的持续时间和强度的研究。