Institut National d'Etudes Demographiques, Paris, France.
Scand J Public Health. 2010 Jul;38(5):495-501. doi: 10.1177/1403494810371246. Epub 2010 Jun 7.
Various types of musculoskeletal disorders (MSDs) have comorbid mental disorders, which may in turn have a negative influence on disease course and role impairment, but the contribution of social factors to this type of comorbidity is a much under-researched area. This study investigates whether there is a socially patterned association of MSDs with different dimensions of mental malaise.
The sample included 3,368 economically active participants aged 18-64 years, randomly selected from the Lorraine region in north-eastern France. Information was provided through a post-mailed questionnaire on fatigue, sadness/depression (Duke questionnaire) and cognitive disability during the last eight days.
MSDs were significantly more prevalent in manual workers, clerks and other occupations than in upper and intermediate professionals, and similar occupational disparities were found for cognitive disability, fatigue and sadness/ depression. Stratifying the sample, we found the occupational disparities in cognitive disability to be much stronger among participants suffering from MSDs than among participants not suffering from MSDs, and the occupational disparities in fatigue and sadness/depression to be limited to the subsample of subjects suffering from MSDs.
The findings demonstrate that the association of MSDs with mental malaise is much stronger in the lower occupational groups than in the higher groups. Given that psychological factors are implicated in disease prognosis and in the development of disabilities, awareness of the social dimension of the association and treatment of the comorbid mental disorders could open a promising avenue for reducing social inequalities in disability related to MSDs.
各种类型的肌肉骨骼疾病（MSD）与合并精神障碍有关，而这些精神障碍反过来可能对疾病进程和角色障碍产生负面影响，但社会因素对这种合并症的影响是一个研究甚少的领域。本研究调查了 MSD 是否与不同维度的精神不适存在社会模式关联。
该样本包括来自法国东北部洛林地区的 3368 名 18-64 岁的经济活跃参与者，通过邮寄问卷的方式收集他们在过去八天内的疲劳、悲伤/抑郁（杜克问卷）和认知障碍的信息。
MSD 在体力劳动者、办事员和其他职业中比高级和中级专业人员更为普遍，认知障碍、疲劳和悲伤/抑郁在这些职业中也存在类似的职业差异。对样本进行分层后，我们发现患有 MSD 的参与者中认知障碍的职业差异比没有患有 MSD 的参与者更为明显，而疲劳和悲伤/抑郁的职业差异仅局限于患有 MSD 的参与者亚组。
研究结果表明，MSD 与精神不适的关联在较低职业群体中比在较高职业群体中更为强烈。鉴于心理因素与疾病预后和残疾发展有关，了解这种关联的社会层面并治疗合并的精神障碍，可以为减少与 MSD 相关的残疾方面的社会不平等提供一个有前途的途径。
