Inoue Nobutaka, Otsui Kazunori, Yoshioka Takayuki, Suzuki Atsushi, Ozawa Toru, Iwata Sachiyo, Takei Asumi
Department of Cardiovascular Medicine, Kobe Rosai Hospital, Japan.
Intern Med. 2016;55(9):1071-5. doi: 10.2169/internalmedicine.55.5920. Epub 2016 May 1.
Objective Karoshi, which is the Japanese term for death from over-work, is usually the extreme result of cardiovascular diseases, and occupational stress plays a pivotal role in the pathogenesis. Depression is closely associated with atherosclerotic cardiovascular disease. The present study was undertaken to examine the relationship between occupational stress and depression. Methods We enrolled 231 consecutive outpatients with lifestyle-related diseases such as diabetes, hyperlipidemia and hypertension were enrolled. Occupational stress was measured by qualitative constructs assessing job control, job demands, and worksite social support using a job content questionnaire (JCQ). The job strain index measured by the ratio of job demands to job control was used as an indicator of the occupational stress. Depression was evaluated by the Self-rating Depression Scale (SDS). Results A univariate linear regression analysis showed the SDS scores to be positively correlated with job demands and the job strain index and negatively correlated with job control and worksite social support. Multiple regression analyses to predict the SDS scores demonstrated that job demands were positively associated with SDS scores and job control and worksite social support were negatively associated with SDS scores after controlling for other variables. The job strain index was positively related to SDS scores. Conclusion Occupational stress expressed as the job strain index was strongly associated with depression. By simultaneously using the SDS and JCQ, the health conditions of patients could be classified based on occupational stress and mental stress, and this classification could help to promote a healthy work environment and guide individual workers.
目的 “过劳死” 是日语中因过度工作导致死亡的术语,通常是心血管疾病的极端后果,职业压力在其发病机制中起关键作用。抑郁症与动脉粥样硬化性心血管疾病密切相关。本研究旨在探讨职业压力与抑郁症之间的关系。方法 我们纳入了231例连续的门诊患者,他们患有糖尿病、高脂血症和高血压等与生活方式相关的疾病。使用工作内容问卷(JCQ)通过评估工作控制、工作需求和工作场所社会支持的定性结构来测量职业压力。用工作需求与工作控制的比率测量的工作紧张指数作为职业压力的指标。通过自评抑郁量表(SDS)评估抑郁症。结果 单变量线性回归分析显示,SDS得分与工作需求和工作紧张指数呈正相关,与工作控制和工作场所社会支持呈负相关。预测SDS得分的多元回归分析表明,在控制其他变量后,工作需求与SDS得分呈正相关,工作控制和工作场所社会支持与SDS得分呈负相关。工作紧张指数与SDS得分呈正相关。结论 以工作紧张指数表示的职业压力与抑郁症密切相关。通过同时使用SDS和JCQ,可以根据职业压力和精神压力对患者的健康状况进行分类,这种分类有助于促进健康的工作环境并指导个体劳动者。