Bonde Jens Peter E, Munch-Hansen Torsten, Wieclaw Joanna, Westergaard-Nielsen Niels, Agerbo Esben
Occupational and Environmental Medicine, Copenhagen University Hospital Bisbebjerg, Copenhagen, Denmark.
BMC Public Health. 2009 Jul 27;9:262. doi: 10.1186/1471-2458-9-262.
Adverse psychosocial work environments may lead to impaired mental health, but it is still a matter of conjecture if demonstrated associations are causal or biased. We aimed at verifying whether poor psychosocial working climate is related to increase of redeemed subscription of antidepressant medication.
Information on all antidepressant drugs (AD) purchased at pharmacies from 1995 through 2006 was obtained for a cohort of 21,129 Danish public service workers that participated in work climate surveys carried out during the period 2002-2005. Individual self-reports of psychosocial factors at work including satisfaction with the work climate and dimensions of the job strain model were obtained by self-administered questionnaires (response rate 77,2%). Each employee was assigned the average score value for all employees at his/her managerial work unit [1094 units with an average of 18 employees (range 3-120)]. The risk of first-time AD prescription during follow-up was examined according to level of satisfaction and psychosocial strain by Cox regression with adjustment for gender, age, marital status, occupational status and calendar year of the survey.
The proportion of employees that received at least one prescription of ADs from 1995 through 2006 was 11.9% and prescriptions rose steadily from 1.50% in 1996 to the highest level 6.47% in 2006. ADs were prescribed more frequent among women, middle aged, employees with low occupational status and those living alone. None of the measured psychosocial work environment factors were consistently related to prescription of antidepressant drugs during the follow-up period.
The study does not indicate that a poor psychosocial work environment among public service employees is related to prescription of antidepressant pharmaceuticals. These findings need cautious interpretation because of lacking individual exposure assessments.
不良的心理社会工作环境可能导致心理健康受损，但已证实的关联是因果关系还是存在偏差仍存在争议。我们旨在验证不良的心理社会工作氛围是否与抗抑郁药物再购率的增加有关。
获取了1995年至2006年期间在药店购买的所有抗抑郁药物（AD）的信息，这些信息来自于21129名丹麦公共服务人员组成的队列，他们参与了2002年至2005年期间进行的工作氛围调查。通过自填问卷（回复率77.2%）获得了工作中包括对工作氛围的满意度和工作压力模型维度等心理社会因素的个人自我报告。为每位员工分配其所在管理工作单位所有员工的平均得分值[1094个单位，平均每个单位18名员工（范围为3 - 120名）]。通过Cox回归分析，并对性别、年龄、婚姻状况、职业地位和调查年份进行调整，根据满意度和心理社会压力水平检查随访期间首次开具AD处方的风险。
1995年至2006年期间至少接受过一次AD处方的员工比例为11.9%，处方率从1996年的1.50%稳步上升至2006年的最高水平6.47%。AD在女性、中年、职业地位低的员工和独居者中开具得更频繁。在随访期间，所测量的心理社会工作环境因素均未与抗抑郁药物的处方持续相关。
该研究并未表明公共服务员工中不良的心理社会工作环境与抗抑郁药物的处方有关。由于缺乏个体暴露评估，这些发现需要谨慎解读。
