Burns Richard A, Butterworth Peter, Anstey Kaarin J
Centre for Research on Ageing, Health and Wellbeing, The Research School of Population Health, The Australian National University, Building 54, Mills Road, Canberra, ACT, 0200, Australia.
Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2016 May;51(5):725-33. doi: 10.1007/s00127-016-1192-9. Epub 2016 Feb 13.
Job strain has been implicated in a range of employee health outcomes including psychiatric health. Much of the literature is drawn from studies that utilise cross-sectional designs, whilst the long-term follow-up of participants is limited. We examine the short and long-term risks of job strain for depression and wellbeing over a 12-year period. In particular, we utilise measures of wellbeing to emphasise the importance of discriminating between indices of subjective and psychological wellbeing that complement measures of mental health.
Participants (n = 2530) were aged between 40 and 44 years at baseline and were drawn from the Personality and Total Health (PATH) Through Life Project. Participants were observed once every 4 years for 12 years.
A high strain job was associated with an increased risk of reporting sub-syndromal [RRR = 1.66 (95 % CI 1.23; 2.25), p < 0.001], minor [RRR = 1.92 (95 % CI 1.19; 3.10), p < 0.001] and major depression [RRR = 2.19 (95 % CI 1.30; 3.67), p < 0.001], but strain was not a long-term risk for depression 4 years later. In contrast, strain was a risk for both cross-sectional and longitudinal wellbeing outcomes. Moving into a high strain job was a risk for developing depression [RRR = 1.81 (95 % CI 1.26; 2.59), p < 0.001], but the cumulative exposure to a high strain job was not associated with poorer outcomes in adjusted models.
Overall, our results emphasise the importance of current job strain, and the risk of moving into a high strain job, on adverse mental health and wellbeing outcomes. Effects were not consistent between indices of mental health, subjective or psychological wellbeing, supporting the need to dedifferentiate between wellbeing and mental health.
工作压力已被认为与一系列员工健康结果相关，包括精神健康。大部分文献来自采用横断面设计的研究，而对参与者的长期随访有限。我们研究了12年期间工作压力对抑郁和幸福感的短期和长期风险。特别是，我们使用幸福感测量方法来强调区分主观幸福感和心理幸福感指标的重要性，这些指标可补充心理健康测量方法。
参与者（n = 2530）在基线时年龄在40至44岁之间，来自贯穿一生的人格与总体健康（PATH）项目。参与者在12年中每4年观察一次。
高压力工作与报告亚综合征[相对风险比（RRR）= 1.66（95%置信区间1.23；2.25），p < 0.001]、轻度[RRR = 1.92（95%置信区间1.19；3.10），p < 0.001]和重度抑郁[RRR = 2.19（95%置信区间1.30；3.67），p < 0.001]的风险增加相关，但4年后压力不是抑郁的长期风险。相比之下，压力是横断面和纵向幸福感结果的风险因素。转入高压力工作是患抑郁症的风险因素[RRR = 1.81（95%置信区间1.26；2.59），p < 0.001]，但在调整模型中，累积暴露于高压力工作与较差结果无关。
总体而言，我们的结果强调了当前工作压力以及转入高压力工作对不良心理健康和幸福感结果的重要性。心理健康、主观或心理幸福感指标之间的影响不一致，支持了区分幸福感和心理健康的必要性。
