Kim T J, von dem Knesebeck O
Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Int Arch Occup Environ Health. 2016 May;89(4):561-73. doi: 10.1007/s00420-015-1107-1. Epub 2015 Dec 29.
It was shown that both job insecurity and unemployment are strongly and consistently associated with depressive symptoms. It is, however, less clear whether perceived job insecurity and unemployment constitute a comparable risk for the onset of depressive symptoms. A meta-analysis was conducted to explore this issue.
In December 2014, relevant records were identified through the databases MEDLINE, Embase and PsychINFO. Articles were included if they had been published in the last 10 years and contained a quantitative analysis on the prospective link between job insecurity and unemployment with depressive symptoms.
In 20 cohort studies within 15 articles, job insecurity and unemployment were significantly related to a higher risk of depressive symptoms, with the odds ratio (OR) being modestly higher for job insecurity (1.29, 95% CI 1.06-1.57) than for unemployment (1.19, 95% CI 1.11-1.28). Sensitivity analyses revealed that the effects were strongest in studies that examined younger respondents (<40 years) and used an unadjusted statistical model. By considering the length of the observational period, it was shown that unemployment ORs were higher in shorter time lags (under 1 year), while ORs for job insecurity were increased in longer exposure-outcome intervals (3-4 years). Specifically for unemployment, ORs were highest in studies that did not control for potential health selection effects and that ascertained enduring unemployment. A statistically significant publication bias was found for studies on unemployment, but not for job insecurity.
The analyses revealed that both perceived job insecurity and unemployment constitute significant risks of increased depressive symptoms in prospective observational studies. By comparing both stressors, job insecurity can pose a comparable (and even modestly increased) risk of subsequent depressive symptoms.
研究表明，工作不安全感和失业都与抑郁症状密切且持续相关。然而，对于感知到的工作不安全感和失业是否构成抑郁症状发作的可比风险，目前尚不清楚。为此进行了一项荟萃分析来探讨这个问题。
2014年12月，通过MEDLINE、Embase和PsychINFO数据库识别相关记录。纳入过去10年内发表的、包含对工作不安全感和失业与抑郁症状之间前瞻性联系进行定量分析的文章。
15篇文章中的20项队列研究表明，工作不安全感和失业与抑郁症状风险增加显著相关，工作不安全感的优势比（OR）（1.29，95%CI 1.06 - 1.57）略高于失业（1.19，95%CI 1.11 - 1.28）。敏感性分析显示，在研究年轻受访者（<40岁）且使用未调整统计模型的研究中，效应最强。考虑观察期长度后发现，失业的OR在较短时间滞后（1年以内）较高，而工作不安全感的OR在较长暴露 - 结果间隔（3 - 4年）增加。具体而言，对于失业，在未控制潜在健康选择效应且确定为长期失业的研究中，OR最高。在关于失业的研究中发现了具有统计学意义的发表偏倚，但在工作不安全感的研究中未发现。
分析表明，在前瞻性观察研究中，感知到的工作不安全感和失业均构成抑郁症状增加的显著风险。通过比较这两种压力源，工作不安全感可能带来相当（甚至略有增加）的后续抑郁症状风险。
