Madsen Ida E H, Hanson Linda L Magnusson, Rugulies Reiner, Theorell Töres, Burr Hermann, Diderichsen Finn, Westerlund Hugo
The National Research Centre for the Working Environment, Lerso Park Allé 105, 2100, Copenhagen, Denmark,
Soc Psychiatry Psychiatr Epidemiol. 2014 Aug;49(8):1209-18. doi: 10.1007/s00127-014-0836-x. Epub 2014 Feb 20.
Emotionally demanding work has been associated with increased risk of common mental disorders. Because emotional demands may not be preventable in certain occupations, the identification of workplace factors that can modify this association is vital. This article examines whether effects of emotional demands on antidepressant treatment, as an indicator of common mental disorders, are buffered by good leadership.
We used data from two nationally representative work environment studies, the Danish Work Environment Cohort Study (n = 6,096) and the Swedish Longitudinal Occupational Survey of Health (n = 3,411), which were merged with national registers on antidepressant purchases. All individuals with poor self-reported baseline mental health or antidepressant purchases within 8.7 months before baseline were excluded, and data analysed prospectively. Using Cox regression, we examined hazard ratios (HRs) for antidepressants in relation to the joint effects of emotional demands and leadership quality. Buffering was assessed with Rothman's synergy index. Cohort-specific risk estimates were pooled by random effects meta-analysis.
High emotional demands at work were associated with antidepressant treatment whether quality of leadership was poor (HR = 1.84, 95 % CI 1.32-2.57) or good (HR = 1.70, 95 % CI 1.25-2.31). The synergy index was 0.66 (95 % CI 0.34-1.28).
Our findings suggest that good leadership does not substantially ameliorate any effects of emotional demands at work on employee mental health. Further research is needed to identify possible preventive measures for this work environment exposure.
情感要求高的工作与常见精神障碍风险增加有关。由于在某些职业中情感要求可能无法避免，因此识别能够改变这种关联的工作场所因素至关重要。本文探讨作为常见精神障碍指标的情感要求对抗抑郁治疗的影响是否会因良好的领导而得到缓冲。
我们使用了两项具有全国代表性的工作环境研究的数据，即丹麦工作环境队列研究（n = 6,096）和瑞典健康纵向职业调查（n = 3,411），这些数据与全国抗抑郁药物购买登记册合并。所有自我报告基线心理健康状况不佳或在基线前8.7个月内购买过抗抑郁药物的个体均被排除，并对数据进行前瞻性分析。使用Cox回归，我们研究了抗抑郁药物的风险比（HR）与情感要求和领导质量的联合效应之间的关系。使用Rothman协同指数评估缓冲作用。通过随机效应荟萃分析汇总特定队列的风险估计值。
无论领导质量是差（HR = 1.84，95%CI 1.32 - 2.57）还是好（HR = 1.70，95%CI 1.25 - 2.31），工作中高情感要求都与抗抑郁治疗有关。协同指数为0.66（95%CI 0.34 - 1.28）。
我们的研究结果表明，良好的领导并不能显著改善工作中情感要求对员工心理健康的任何影响。需要进一步研究以确定针对这种工作环境暴露的可能预防措施。
