National Research Centre for the Working Environment, Copenhagen, Denmark.
Eur J Public Health. 2013 Jun;23(3):415-20. doi: 10.1093/eurpub/cks071. Epub 2012 Jun 8.
Depression is a major concern for public health. Both adverse working conditions and low socio-economic position are suspected to increase risk of depression. In a representative sample of the Danish workforce we investigated (i) whether adverse psychosocial working conditions, defined by the effort-reward imbalance (ERI) model, predicted onset of severe depressive symptoms after 5-year follow-up and (ii) whether the effect of ERI was differential across occupational grades.
A cohort of 2701 Danish employees filled in a questionnaire on work and health in 2000 and 2005. ERI was measured with four effort and seven reward items. Depressive symptoms were assessed with the five-item Mental Health Inventory. Participants scoring ≤ 52 points were defined as cases. We used logistic regression to investigate the association of ERI and occupational grade in 2000 with onset of severe depressive symptoms in 2005. Analyses were adjusted for socio-demographics, health behaviours, survey method, self-rated health, sleep disturbances and non-severe depressive symptoms at baseline.
High ERI predicted onset of severe depressive symptoms at follow-up, after adjustment for co-variates and occupational grade (OR = 2.19, 95% CI = 1.12-4.25). Participants with high ERI and low occupational grade showed a considerably higher OR (2.43, 95% CI = 1.07-5.53) compared to participants with low/medium ERI and low grade (OR = 1.45, 95% CI = 0.72-2.92), high ERI and high grade (OR = 1.26, 95% CI = 0.59-2.70) and low/medium ERI and high grade (reference group).
Adverse psychosocial working conditions predicted onset of severe depressive symptoms. The effect was stronger among employees of lower occupational grades compared to those of higher grades.
抑郁是公共卫生的主要关注点。不良的工作条件和较低的社会经济地位都可能增加患抑郁症的风险。在对丹麦劳动力的代表性样本中，我们调查了以下两点：（i）努力-回报失衡（ERI）模型定义的不良心理社会工作条件是否会预测 5 年后严重抑郁症状的发生；（ii）ERI 的影响是否在职业等级之间存在差异。
丹麦的 2701 名员工参加了一项关于工作和健康的问卷调查，时间为 2000 年和 2005 年。ERI 用四个努力和七个回报项来衡量。抑郁症状用五项目心理健康量表来评估。得分≤52 分的参与者被定义为病例。我们使用逻辑回归来研究 2000 年 ERI 和职业等级与 2005 年严重抑郁症状发生之间的关系。分析调整了社会人口统计学因素、健康行为、调查方法、自评健康、睡眠障碍和基线时的非严重抑郁症状。
调整协变量和职业等级后，高 ERI 预测随访时发生严重抑郁症状（OR = 2.19，95%CI = 1.12-4.25）。与低/中 ERI 和低等级（OR = 1.45，95%CI = 0.72-2.92）、高 ERI 和高等级（OR = 1.26，95%CI = 0.59-2.70）和低/中 ERI 和高等级（参考组）相比，高 ERI 和低等级的参与者 OR 值明显更高（OR = 2.43，95%CI = 1.07-5.53）。
不良的心理社会工作条件预测严重抑郁症状的发生。与高职业等级的员工相比，低职业等级的员工受影响更大。
