Magnusson Hanson Linda L, Westerlund Hugo, Chungkham Holendro Singh, Vahtera Jussi, Sverke Magnus, Alexanderson Kristina
From the aStress Research Institute, Stockholm University, Stockholm, Sweden; bDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; cIndian Statistical Institute, North-East Centre, Tezpur, India; d Finnish Institute of Occupational Health, Turku, Finland; eDepartment of Public Health, University of Turku, Turku, Finland; fTurku University Hospital, Turku, Finland; gDepartment of Psychology, Stockholm University, Stockholm, Sweden; and hNorthwest University, Potchefstroom, South Africa.
Epidemiology. 2016 Mar;27(2):257-64. doi: 10.1097/EDE.0000000000000414.
Organizational downsizing may be a risk factor for morbidity among both the displaced and those who remain in work. However, the knowledge is limited regarding its impact on clinically relevant mental health problems. Our objective was to investigate purchases of prescription antidepressants across 5 years in relation to workplace downsizing. We studied all Swedish residents 2004 throughout 2010, 22-54 years old in 2006, gainfully employed, and with a stable labor market position up to 2006. People primarily employed at a workplace with ≥18% staff reduction were considered exposed to major downsizing (in 2006-2007, 2007-2008, or 2008-2009). We applied repeated measures regression analyses through generalized estimating equations, calculating odds of any purchase of prescription antidepressants (inferred from the prescribed drug register) within five 12-month periods from 2 years before to 2 years after the period of major downsizing and compared the trends for newly exposed (n = 632,500) and unexposed (n = 1,021,759) to major downsizing. The odds of purchasing prescription antidepressants for exposed increased more than for nonexposed, mainly peridownsizing (1 year before to 1 year after), and postdownsizing (1 year after to 2 years after) for survivors (odds ratio 1.24 vs. 1.14 peridownsizing and 1.12 vs. 1.00 postdownsizing) and those changing workplace (odds ratio 1.22 vs. 1.14 peridownsizing and 1.10 vs. 1.00 postdownsizing) with no previous sickness absence or disability pension (≥7% more than unexposed peri- and postdownsizing). This large-scale study indicates that downsizing is associated with a slight increase in the odds of purchasing prescription antidepressants among people without previous sickness absence or disability pension.
组织精简可能是被裁员工和留任员工患病的一个风险因素。然而，关于其对临床相关心理健康问题的影响，相关知识有限。我们的目标是调查5年期间与职场精简相关的处方抗抑郁药购买情况。我们研究了2004年至2010年期间所有2006年年龄在22至54岁、有工作收入且截至2006年劳动力市场地位稳定的瑞典居民。主要受雇于员工裁减比例≥18%的工作场所的人员被视为经历了重大精简（在2006 - 2007年、2007 - 2008年或2008 - 2009年）。我们通过广义估计方程应用重复测量回归分析，计算在重大精简期前2年至后2年的五个12个月期间内购买任何处方抗抑郁药的几率（从处方药登记册推断），并比较新经历重大精简的人群（n = 632,500）和未经历重大精简人群（n = 1,021,759）的趋势。经历精简的人群购买处方抗抑郁药的几率比未经历精简的人群增加得更多，主要是在精简期间（前1年至后1年）和精简后（后1年至后2年），对于幸存者（精简期间优势比为1.24对1.14，精简后为1.12对1.00）以及更换工作场所的人（精简期间优势比为1.22对1.14，精简后为1.10对1.00），且这些人之前没有病假或残疾抚恤金（精简期间和精简后比未经历精简的人群高出≥7%）。这项大规模研究表明，精简与之前没有病假或残疾抚恤金的人群购买处方抗抑郁药的几率略有增加有关。
