Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336, Munich, Germany.
Int Arch Occup Environ Health. 2012 Jul;85(5):559-70. doi: 10.1007/s00420-011-0706-8. Epub 2011 Sep 29.
The study investigates the long-term effects of accumulated working conditions on depressive symptoms in junior doctors. Drawing on the Job Demand-Control-Support model, this study aims to identify personal and job-related determinants for self-reported depression in junior doctors-a professional group that is vulnerable to depression.
We conducted a prospective cohort study with measures of work characteristics and depressive symptoms over three time-points among hospital doctors during postgraduate specialty training in Germany. Participants were 415 junior doctors with full-time contract (47.5% women; mean age, 30.5 years). The outcome was depressive symptoms assessed with the Spielberger State-Depression Scale. Odds ratios (OR) were computed to analyse the cumulative effect of initial depressive symptoms scores, demographic variables, and working characteristics across T1 and T2 on subsequent depressive symptoms at T3.
The percentage of junior doctors reporting depressive symptoms scores above a critical value varied between 12.0% at T1, 10.4% at T2, and 13.3% at T3; N = 34 doctors (8.19%) were classified as incident cases during the observation period. Elevated depressive symptoms at T3 were positively predicted by depressive symptoms scores across T1 and T2 (OR: 1.37; 95% confidence interval: 1.25-1.50) and negatively by professional tenure (0.54; 0.31-0.96), free weekends (0.52; 0.28-0.97), and job autonomy (0.35; 0.18-0.65).
After controlling for demographic and working time influences, findings suggest that junior doctors' perceived job autonomy is negatively associated with future depressive symptoms. Enhancing job control emerges as a promising strategy to lower the risk of depression during first years of professional practice.
本研究旨在探讨长期工作条件对初级医生抑郁症状的影响。本研究以工作需求-控制-支持模型为基础，旨在确定个人和工作相关因素对初级医生（易患抑郁症的职业群体）自我报告抑郁的影响。
我们在德国进行了一项前瞻性队列研究，在研究生专业培训期间，通过三个时间点测量工作特征和抑郁症状。研究对象为 415 名有全职合同的初级医生（47.5%为女性；平均年龄 30.5 岁）。使用 Spielberger 状态抑郁量表评估结局为抑郁症状。计算比值比（OR），以分析初始抑郁症状评分、人口统计学变量和工作特征在 T1 和 T2 对 T3 时随后出现抑郁症状的累积效应。
报告抑郁症状评分高于临界值的初级医生比例在 T1 时为 12.0%，在 T2 时为 10.4%，在 T3 时为 13.3%；在观察期间，34 名医生（8.19%）被归类为新发病例。T3 时出现的抑郁症状与 T1 和 T2 时的抑郁症状评分呈正相关（OR：1.37；95%置信区间：1.25-1.50），与专业工龄（0.54；0.31-0.96）、周末自由（0.52；0.28-0.97）和工作自主性（0.35；0.18-0.65）呈负相关。
在控制人口统计学和工作时间影响后，研究结果表明，初级医生感知到的工作自主性与未来的抑郁症状呈负相关。增强工作控制可能是降低专业实践早期抑郁风险的一种有前途的策略。
