Siegrist Johannes
Department of Medical Sociology, Faculty of Medicine, Heinrich-Heine-University of Duesseldorf, Universitätsstrasse 1, Düsseldorf, Germany.
Eur Arch Psychiatry Clin Neurosci. 2008 Nov;258 Suppl 5:115-9. doi: 10.1007/s00406-008-5024-0.
Due to their high prevalence and severe consequences depressive disorders provide a primary challenge to medicine and public health. Improving our understanding of modifiable risk factors may help to advance preventive efforts. Chronic psychosocial stress at work, as defined by two theoretical models, demand-control and effort-reward imbalance, is one such modifiable risk factor. This paper reviews and discusses current evidence of associations between work-related psychosocial stress and depression based on a systematic review of prospective cohort studies of these two models, published within the last 10 years. Findings from 12 reports indicate a rather consistently elevated odds ratio of about 1.8 of depression among men and women who were exposed to high demand and low control at work or who spent high efforts in combination with low rewards received in turn. Findings are substantiated by results from experimental investigations that explored psychobiological mechanisms underlying this association. In conclusion, there is solid evidence of a prospectively established moderate association of chronic psychosocial stress at work, as defined by theoretical models, with depression. Despite open research questions the implications of these findings for prevention should be addressed.
由于抑郁症的高患病率及其严重后果，它对医学和公共卫生构成了主要挑战。增进我们对可改变风险因素的理解可能有助于推进预防工作。工作中的慢性心理社会压力，根据需求控制和努力回报失衡这两种理论模型的定义，就是这样一种可改变的风险因素。本文基于对过去10年内发表的这两种模型的前瞻性队列研究的系统综述，回顾并讨论了工作相关心理社会压力与抑郁症之间关联的现有证据。12份报告的研究结果表明，在工作中面临高需求和低控制或付出高努力却得到低回报的男性和女性中，患抑郁症的比值比相当一致地升高，约为1.8。探索这种关联背后心理生物学机制的实验研究结果证实了这些发现。总之，有确凿证据表明，根据理论模型定义，工作中的慢性心理社会压力与抑郁症之间存在前瞻性确立的中度关联。尽管存在尚未解决的研究问题，但这些发现对预防工作的影响仍应予以关注。
