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工作要求、控制和社会支持对抑郁症状轨迹的预测作用。

Job demands, control and social support as predictors of trajectories of depressive symptoms.

机构信息

Stress Research Institute, Stockholm University, Stockholm, Sweden.

Stress Research Institute, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies, Stockholm University, Karolinska Institute, Stockholm, Sweden.

出版信息

J Affect Disord. 2018 Aug 1;235:535-543. doi: 10.1016/j.jad.2018.04.067. Epub 2018 Apr 16.

DOI:10.1016/j.jad.2018.04.067
PMID:29689506
Abstract

BACKGROUND

Job demands, job control and social support have been associated with depressive symptoms. However, it is unknown how these work characteristics are associated with different trajectories of depressive symptoms, which this study aimed to examine.

METHODS

We included 6679 subjects in the Swedish Longitudinal Occupational Survey of Health (SLOSH), who completed biennial questionnaires in 2006-2016. Group-based trajectory models identified groups with similar development of depressive symptoms. Multinomial logistic regression estimated associations between baseline demands, control, social support and trajectories of depressive symptoms.

RESULTS

We identified six depression trajectories with varying severity and stability across four measurements. High job demands and low social support, but not low control, were associated with higher probability of belonging to subsequent trajectories with higher symptom level compared to very low symptom level. Adjusted risk ratios ranged from 1.26, 95% CI = 1.06-1.51 (low symptom trajectory) to 2.51, 95% CI = 1.43-4.41 (persistent severe symptom trajectory). Results also indicated that onset of high demands, low control and low social support increases depressive symptoms over time.

LIMITATIONS

The results were based on self-reported data and all individuals did not have complete data in all waves.

CONCLUSIONS

The results indicated that especially perceptions of high job demands and low social support are associated with higher or increasing levels of depressive symptoms over time. This support the supposition that high job demands, and low social support may have long-term consequences for depressive symptoms and that interventions targeting job demands and social support may contribute to a more favourable course of depression.

摘要

背景

工作需求、工作控制和社会支持与抑郁症状有关。然而,目前尚不清楚这些工作特征与抑郁症状的不同轨迹有何关联,本研究旨在对此进行探讨。

方法

我们纳入了瑞典纵向职业健康调查(SLOSH)中的 6679 名受试者,他们在 2006-2016 年期间完成了两年一次的问卷调查。基于群组的轨迹模型确定了具有相似抑郁症状发展轨迹的群组。使用多项逻辑回归估计基线需求、控制、社会支持与抑郁症状轨迹之间的关联。

结果

我们确定了六个具有不同严重程度和稳定性的抑郁轨迹,在四次测量中表现出不同的程度和稳定性。高工作需求和低社会支持,而不是低控制,与后续具有更高症状水平的轨迹相关联的可能性更高,而与非常低症状水平相比。调整后的风险比范围从 1.26(95%CI=1.06-1.51)(低症状轨迹)到 2.51(95%CI=1.43-4.41)(持续严重症状轨迹)。结果还表明,高需求、低控制和低社会支持的出现会随着时间的推移增加抑郁症状。

局限性

结果基于自我报告数据,并非所有个体在所有波次都有完整的数据。

结论

结果表明,尤其是高工作需求和低社会支持的感知与随着时间推移抑郁症状水平升高或增加有关。这支持了这样一种假设,即高工作需求和低社会支持可能对抑郁症状产生长期影响,而针对工作需求和社会支持的干预措施可能有助于改善抑郁症状的发展。

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