Niedhammer Isabelle, Chastang Jean-François
INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, 75013, Paris, France.
Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, 75013, Paris, France.
Int Arch Occup Environ Health. 2015 Oct;88(7):835-47. doi: 10.1007/s00420-014-1013-y. Epub 2014 Dec 19.
The objective was to explore the associations between psychosocial work factors and first depressive episode. Additional objectives included the study of the frequency and duration of exposure, and the evaluation of the induction period between exposures and outcome and of the reversibility of the effects.
The study was based on a sample of 13,648 men and women from the 2006 national representative French SIP survey. Retrospective evaluation was performed for depressive episode for the whole life history, for psychological demands, skill discretion, social support, tension with the public, reward and work-life imbalance for each job, and within each job before and after each major change, and for time-varying covariates. The outcome was the first depressive episode. Statistical analysis was performed using weighted discrete time logistic regression model.
High psychological demands and low social support were risk factors for first depressive episode for both genders. The risk increased with the frequency of exposure to these factors. Associations were found with the frequency of exposure to tension with the public among women and to work-life imbalance among men. The risk increased with the duration of exposure to psychological demands and low social support for both genders, however, these associations become non-significant when recent exposure was taken into account. Past exposure older than 2 years was not associated with the outcome.
Associations between psychosocial work factors and first depressive episode were observed, including dose-response associations. However, after removal of the exposure, the risk may be reduced after 2 years.
探讨心理社会工作因素与首次抑郁发作之间的关联。其他目的包括研究暴露的频率和持续时间，评估暴露与结局之间的诱导期以及效应的可逆性。
该研究基于2006年具有全国代表性的法国SIP调查中13648名男性和女性的样本。对整个生命历程中的抑郁发作、每项工作以及每项重大变化前后每项工作中的心理需求、技能自主性、社会支持、与公众的紧张关系、奖励和工作生活失衡情况以及随时间变化的协变量进行回顾性评估。结局为首次抑郁发作。使用加权离散时间逻辑回归模型进行统计分析。
高心理需求和低社会支持是男女首次抑郁发作的危险因素。风险随着暴露于这些因素的频率增加而增加。发现女性暴露于与公众的紧张关系的频率以及男性暴露于工作生活失衡的频率与之有关联。男女暴露于心理需求和低社会支持的持续时间增加时风险都会增加，然而，当考虑近期暴露情况时，这些关联变得不显著。超过2年的既往暴露与结局无关。
观察到心理社会工作因素与首次抑郁发作之间存在关联，包括剂量反应关联。然而，去除暴露因素后，2年后风险可能会降低。
