1 Mental Health Policy Unit, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.
2 Public Health Agency of Barcelona, Barcelona, Spain.
Aust N Z J Psychiatry. 2018 Jan;52(1):47-58. doi: 10.1177/0004867417704506. Epub 2017 Apr 12.
Common mental disorders are the most common reason for long-term sickness absence in most developed countries. Prediction algorithms for the onset of common mental disorders may help target indicated work-based prevention interventions. We aimed to develop and validate a risk algorithm to predict the onset of common mental disorders at 12 months in a working population.
We conducted a secondary analysis of the Household, Income and Labour Dynamics in Australia Survey, a longitudinal, nationally representative household panel in Australia. Data from the 6189 working participants who did not meet the criteria for a common mental disorders at baseline were non-randomly split into training and validation databases, based on state of residence. Common mental disorders were assessed with the mental component score of 36-Item Short Form Health Survey questionnaire (score ⩽45). Risk algorithms were constructed following recommendations made by the Transparent Reporting of a multivariable prediction model for Prevention Or Diagnosis statement.
Different risk factors were identified among women and men for the final risk algorithms. In the training data, the model for women had a C-index of 0.73 and effect size (Hedges' g) of 0.91. In men, the C-index was 0.76 and the effect size was 1.06. In the validation data, the C-index was 0.66 for women and 0.73 for men, with positive predictive values of 0.28 and 0.26, respectively Conclusion: It is possible to develop an algorithm with good discrimination for the onset identifying overall and modifiable risks of common mental disorders among working men. Such models have the potential to change the way that prevention of common mental disorders at the workplace is conducted, but different models may be required for women.
在大多数发达国家,常见精神障碍是导致长期病假的最常见原因。常见精神障碍发病预测算法可能有助于针对特定的基于工作场所的预防干预措施。我们旨在开发和验证一种风险算法,以预测工作人群中常见精神障碍在 12 个月时的发病情况。
我们对澳大利亚家庭、收入和劳动力动态调查(一项在澳大利亚进行的纵向、全国代表性家庭面板调查)进行了二次分析。在基线时不符合常见精神障碍标准的 6189 名工作参与者中,根据居住州,将数据非随机分为训练和验证数据库。使用 36 项简短健康调查问卷的心理成分评分(得分 ⩽45)评估常见精神障碍。风险算法是根据 Transparent Reporting of a multivariable prediction model for Prevention Or Diagnosis 声明中的建议构建的。
对于最终的风险算法,女性和男性的风险因素不同。在训练数据中,女性模型的 C 指数为 0.73,效应量(Hedges'g)为 0.91。在男性中,C 指数为 0.76,效应量为 1.06。在验证数据中,女性的 C 指数为 0.66,男性的 C 指数为 0.73,阳性预测值分别为 0.28 和 0.26。结论:对于常见精神障碍发病的识别,可以开发一种具有良好区分度的算法,用于确定工作人群中常见精神障碍的总体和可改变的风险。这些模型有可能改变在工作场所预防常见精神障碍的方式,但可能需要为女性开发不同的模型。