Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK.
Psychol Med. 2013 May;43(5):961-73. doi: 10.1017/S0033291712001821. Epub 2012 Aug 21.
The present study aimed to assess the prevalence of common mental disorders (CMDs) by occupation in a representative sample of the English adult population. Another aim was to examine whether the increased risk of CMD in some occupations could be explained by adverse work characteristics. Method We derived a sample of 3425 working-age respondents from the Adult Psychiatric Morbidity Survey 2007. Occupations were classified by Standard Occupational Classification group, and CMD measured by the Revised Clinical Interview Schedule. Job characteristics were measured by questionnaire, and tested as explanatory factors in associations of occupation and CMD.
After adjusting for age, gender, housing tenure and marital status, caring personal service occupations had the greatest risk of CMD compared with all occupations (odds ratio 1.73, 95% confidence interval 1.16-2.58). The prevalence of adverse psychosocial work characteristics did not follow the pattern of CMD by occupation. Work characteristics did not explain the increased risk of CMDs associated with working in personal service occupations. Contrary to our hypotheses, adding work characteristics individually to the association of occupation and CMD tended to increase rather than decrease the odds for CMD.
As has been found by others, psychosocial work characteristics were associated with CMD. However, we found that in our English national dataset they could not explain the high rates of CMD in particular occupations. We suggest that selection into occupations may partly explain high CMD rates in certain occupations. Also, we did not measure emotional demands, and these may be important mediators of the relationship between occupation type and CMDs.
本研究旨在评估常见精神障碍(CMD)在英国成年人群代表性样本中的职业流行率。另一个目的是检验某些职业中 CMD 风险增加是否可以用不良工作特征来解释。
我们从 2007 年成人精神疾病发病率调查中获得了一个由 3425 名工作年龄的受访者组成的样本。职业通过标准职业分类组进行分类,CMD 通过修订后的临床访谈表进行测量。工作特征通过问卷调查进行测量,并作为职业和 CMD 关联的解释因素进行测试。
在调整年龄、性别、住房所有权和婚姻状况后,照顾个人服务职业的 CMD 风险最高,与所有职业相比(比值比 1.73,95%置信区间 1.16-2.58)。不良心理社会工作特征的流行程度并未遵循 CMD 随职业的模式。工作特征并不能解释与个人服务职业相关的 CMD 风险增加。与我们的假设相反,将工作特征单独添加到职业与 CMD 的关联中往往会增加而不是降低 CMD 的几率。
正如其他人所发现的那样,心理社会工作特征与 CMD 相关。然而,我们发现,在我们的英国全国数据集,它们不能解释某些职业中 CMD 率高的原因。我们建议,职业选择可能部分解释了某些职业中 CMD 率高的原因。此外,我们没有测量情感需求,而这些需求可能是职业类型与 CMD 之间关系的重要中介因素。