Department of Public Health, Dokkyo Medical University School of Medicine, Shimotsugagun-Mibu, Japan.
BMC Public Health. 2011 Apr 1;11:205. doi: 10.1186/1471-2458-11-205.
The ability to predict future onset of depression is required for primary prevention of depression. Many cross-sectional studies have reported a correlation between sense of coherence (SOC) and the presence of depressive symptoms. However, it is unclear whether SOC can predict future onset of depression. Therefore, whether measures to prevent onset of depression are needed in for persons with low SOC is uncertain. Thus, the aim of this cohort study was to determine whether SOC could predict onset of depression and to assess the need for measures to prevent onset of depression for persons with low SOC.
A total of 1854 Japanese workers aged 20-70 years in 2005 who completed a sense of coherence (SOC) questionnaire were followed-up until August 2007 using their sick-pay records with medical certificates. Depression was defined as a description of "depression" or "depressive" as a reason for sick leave on the medical certificates. The day of incidence of depression was defined as the first day of the sick leave. Risk ratios of SOC for onset of depression were calculated using a multivariate Cox proportional hazards model.
Of the 1854 participants, 14 developed depression during a mean of 1.8 years of follow-up. After adjustment for gender and age, the risk ratio of high SOC compared with low SOC for sick leave from depression was 0.18 (95% confidence interval [CI], 0.04 to 0.79). The area under the receiver operating characteristic curve of SOC was 0.70 (95% CI, 0.58 to 0.82).
The SOC may be able to predict onset of depression in Japanese workers. Measures to prevent onset of depression for persons with low SOC might be required in Japanese workplaces. Thus, SOC could be useful for identifying persons at high risk for future depression.
为了对抑郁症进行一级预防，我们需要具备预测抑郁症未来发病的能力。许多横断面研究报告称，领悟社会支持能力（SOC）与抑郁症状的存在之间存在相关性。但是，SOC 是否可以预测未来的抑郁发病尚不清楚。因此，对于 SOC 较低的个体，是否需要采取预防抑郁发病的措施尚不确定。因此，本队列研究的目的是确定 SOC 是否可以预测抑郁发病，并评估对于 SOC 较低的个体是否需要采取预防抑郁发病的措施。
我们对 2005 年完成 SOC 问卷的 1854 名 20-70 岁的日本在职人员进行了随访，随访时间截至 2007 年 8 月，随访依据是他们的带有医疗证明的病假记录。将病假单上注明的“抑郁”或“抑郁状态”作为请病假的理由来定义为抑郁。将抑郁发病的日期定义为第一次请病假的日期。采用多变量 Cox 比例风险模型计算 SOC 对抑郁发病的风险比。
在 1854 名参与者中，14 名在平均 1.8 年的随访期间患上了抑郁症。在校正性别和年龄后，高 SOC 与低 SOC 相比，因抑郁请病假的风险比为 0.18（95%可信区间，0.04 至 0.79）。SOC 的受试者工作特征曲线下面积为 0.70（95%可信区间，0.58 至 0.82）。
SOC 可能能够预测日本在职人员的抑郁发病。对于 SOC 较低的日本在职人员，可能需要采取预防抑郁发病的措施。因此，SOC 可用于识别未来抑郁风险较高的个体。
