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抑郁症状作为男性和女性失业的因果关系:来自瑞典健康纵向职业调查中组织裁员背景下的证据。

Depressive symptoms as a cause and effect of job loss in men and women: evidence in the context of organisational downsizing from the Swedish Longitudinal Occupational Survey of Health.

作者信息

Andreeva Elena, Magnusson Hanson Linda L, Westerlund Hugo, Theorell Töres, Brenner M Harvey

机构信息

FG Epidemiologie, Fakultät VII, Technische Universität Berlin, Berlin, Germany.

Centre for Applied Rehabilitation Research, Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany.

出版信息

BMC Public Health. 2015 Oct 12;15:1045. doi: 10.1186/s12889-015-2377-y.

Abstract

BACKGROUND

Few studies have examined depression as both a cause and effect of unemployment, but no prior work investigated these relationships in the context of organisational downsizing. We explored whether the exposure to downsizing is associated with subsequent depression (social causation), and whether pre-existing depression increases the risk of being laid off when organisations downsize (health selection).

METHODS

Two successive waves of the nationally representative Swedish Longitudinal Occupational Survey of Health represented the baseline (2008) and follow-up (2010) of this study. Analyses included 196 workers who lost their jobs through downsizing, 1462 layoff survivors remaining in downsized organisations and 1845 employees of non-downsized workplaces. The main outcomes were: (1) Depressive symptoms at follow-up, assessed with a brief subscale from the Symptom Checklist 90, categorised by severity levels ("major depression", "less severe symptoms" and "no depression") and analysed in relation to earlier downsizing exposure; (2) Job loss in persons with downsizing in relation to earlier depressive symptoms. The associations were assessed by means of multinomial logistic regression.

RESULTS

Job loss consistently predicted subsequent major depression among men and women, with a somewhat greater effect size in men. Surviving a layoff was significantly associated with subsequent major depression in women but not in men. Women with major depression have increased risks of exclusion from employment when organisations downsize, whereas job loss in men was not significantly influenced by their health.

CONCLUSIONS

The evidence from this study suggests that the relative importance of social causation and health selection varies by gender in the context of organisational downsizing. Strategies for handling depression among employees should be sensitive to gender-specific risks during layoffs. Policies preventing social exclusion can be important for female workers at higher risk of depression.

摘要

背景

很少有研究将抑郁症视为失业的原因和后果,但此前没有研究在组织裁员的背景下探讨这些关系。我们探究了经历裁员是否与随后的抑郁症相关(社会因果关系),以及在组织裁员时,先前存在的抑郁症是否会增加被解雇的风险(健康选择)。

方法

具有全国代表性的瑞典纵向职业健康调查的连续两波数据代表了本研究的基线(2008年)和随访(2010年)。分析包括196名因裁员失去工作的工人、1462名留在裁员组织中的裁员幸存者以及1845名未裁员工作场所的员工。主要结果如下:(1)随访时的抑郁症状,用症状自评量表90的一个简短子量表进行评估,按严重程度分类(“重度抑郁症”、“症状较轻”和“无抑郁症”),并分析与早期裁员经历的关系;(2)在经历裁员的人群中,失业与早期抑郁症状的关系。通过多项逻辑回归评估这些关联。

结果

失业始终预示着男性和女性随后会患重度抑郁症,男性的效应量略大。在女性中,经历裁员后存活与随后的重度抑郁症显著相关,而在男性中则不然。患有重度抑郁症的女性在组织裁员时被排除在就业之外的风险增加,而男性的失业情况并未受到其健康状况的显著影响。

结论

本研究的证据表明,在组织裁员的背景下,社会因果关系和健康选择的相对重要性因性别而异。处理员工抑郁症的策略应关注裁员期间特定性别的风险。预防社会排斥的政策对抑郁症风险较高的女性员工可能很重要。

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