Stress Research Institute, Stockholm University, SE-106 91, Stockholm, Sweden.
Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
Int Arch Occup Environ Health. 2018 Apr;91(3):263-272. doi: 10.1007/s00420-017-1277-0. Epub 2017 Nov 11.
Depression is a global health concern. High job demands, low job control, and the combination (high strain) are associated with depression. However, few longitudinal studies have investigated changed or repeated exposure to demands and control related to depression. We investigated how trajectories of exposure to job demands and control jointly influence subsequent depression.
We included 7949 subjects from the Swedish Longitudinal Occupational Survey of Health, who completed questionnaires of perceived job demands and control, and depressive symptoms from 2006 to 2014. None of them were depressed between 2006 and 2012. Univariate and joint group-based trajectory models identified groups with similar development of demands and control across 2006-2012. Logistic regression estimated the risk for symptoms of major depression in 2014 according to joint trajectory groups.
The joint trajectory model included seven groups, all with fairly stable levels of demands and control over time. Subjects in the high strain and active (high demands and high control) trajectories were significantly more likely to have subsequent major depressive symptoms compared to those having low strain, controlling for demographic covariates (OR 2.15; 95% Cl 1.24-3.74 and OR 2.04; 95% CI 1.23-3.40, respectively). The associations did not remain statistically significant after adjusting for previous depressive symptoms in addition to demographic covariates.
The results indicate that the levels of job demands and control were relatively unchanged across 6 years and suggest that long-term exposure to a high strain or active job may be associated with increased risk for subsequent depression.
抑郁症是全球关注的健康问题。高工作要求、低工作控制以及两者的结合(高压力)与抑郁症有关。然而,很少有纵向研究调查过与抑郁相关的需求和控制的变化或重复暴露。我们调查了暴露于工作需求和控制的轨迹如何共同影响随后的抑郁。
我们纳入了来自瑞典职业健康纵向调查的 7949 名受试者,他们在 2006 年至 2014 年期间完成了感知工作需求和控制以及抑郁症状的问卷。在 2006 年至 2012 年期间,他们都没有抑郁。单变量和联合群组基于轨迹模型确定了 2006-2012 年需求和控制发展相似的群体。逻辑回归根据联合轨迹组估计了 2014 年主要抑郁症状的风险。
联合轨迹模型包括七个群体,所有群体在需求和控制方面的水平在整个时间内都相当稳定。与低压力组相比,高压力和积极(高需求和高控制)轨迹组发生随后的重度抑郁症状的可能性显著更高,控制了人口统计学协变量(OR 2.15;95%Cl 1.24-3.74 和 OR 2.04;95%CI 1.23-3.40)。在调整人口统计学协变量和以前的抑郁症状后,这些关联不再具有统计学意义。
结果表明,6 年内工作需求和控制水平相对不变,并表明长期暴露于高压力或积极的工作环境可能与随后抑郁风险增加有关。