Sinokki Marjo, Hinkka Katariina, Ahola Kirsi, Koskinen Seppo, Kivimäki Mika, Honkonen Teija, Puukka Pauli, Klaukka Timo, Lönnqvist Jouko, Virtanen Marianna
Finnish Institute of Occupational Health, Lemminkäisenkatu 14-18 B, FI-20520 Turku, Finland.
J Affect Disord. 2009 May;115(1-2):36-45. doi: 10.1016/j.jad.2008.07.009. Epub 2008 Aug 21.
Social support is assumed to protect mental health, but it is not known whether low social support at work increases the risk of common mental disorders or antidepressant medication. This study, carried out in Finland 2000-2003, examined the associations of low social support at work and in private life with DSM-IV depressive and anxiety disorders and subsequent antidepressant medication.
Social support was measured with self-assessment scales in a cohort of 3429 employees from a population-based health survey. A 12-month prevalence of depressive or anxiety disorders was examined with the Composite International Diagnostic Interview (CIDI), which encompasses operationalized criteria for DSM-IV diagnoses and allows the estimation of DSM-IV diagnoses for major mental disorders. Purchases of antidepressants in a 3-year follow-up were collected from the nationwide pharmaceutical register of the Social Insurance Institution.
Low social support at work and in private life was associated with a 12-month prevalence of depressive or anxiety disorders (adjusted odds ratio 2.02, 95% CI 1.48-2.82 for supervisory support, 1.65, 95% CI 1.05-2.59 for colleague support, and 1.62, 95% CI 1.12-2.36 for private life support). Work-related social support was also associated with subsequent antidepressant use.
This study used a cross-sectional analysis of DSM-IV mental disorders. The use of purchases of antidepressant as an indicator of depressive and anxiety disorders can result in an underestimation of the actual mental disorders.
Low social support, both at work and in private life, is associated with DSM-IV mental disorders, and low social support at work is also a risk factor for mental disorders treated with antidepressant medication.
社会支持被认为能保护心理健康，但工作中社会支持水平低是否会增加常见精神障碍或抗抑郁药物使用风险尚不清楚。这项于2000年至2003年在芬兰开展的研究，考察了工作中和私人生活中社会支持水平低与《精神疾病诊断与统计手册》第四版（DSM-IV）中抑郁和焦虑障碍以及后续抗抑郁药物使用之间的关联。
在一项基于人群的健康调查中，用自我评估量表对3429名员工进行社会支持水平测量。采用复合国际诊断访谈（CIDI）检查抑郁或焦虑障碍的12个月患病率，该访谈包含DSM-IV诊断的操作性标准，并能对主要精神障碍进行DSM-IV诊断估计。从社会保险机构的全国药品登记处收集3年随访期内抗抑郁药物的购买情况。
工作中和私人生活中社会支持水平低与抑郁或焦虑障碍的12个月患病率相关（监督支持方面，调整优势比为2.02，95%置信区间为1.48 - 2.82；同事支持方面，调整优势比为1.65，95%置信区间为1.05 - 2.59；私人生活支持方面，调整优势比为1.62，95%置信区间为1.12 - 2.36）。与工作相关的社会支持也与后续抗抑郁药物使用相关。
本研究对DSM-IV精神障碍采用横断面分析。将抗抑郁药物购买情况用作抑郁和焦虑障碍指标可能会低估实际精神障碍情况。
工作中和私人生活中社会支持水平低均与DSM-IV精神障碍相关，工作中社会支持水平低也是接受抗抑郁药物治疗的精神障碍的一个风险因素。
