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男性的工作强度和女性的工作相关情绪需求与接受初级保健人群的自杀意念增加有关。

Work intensity in men and work-related emotional demands in women are associated with increased suicidality among persons attending primary care.

机构信息

EA 40-47 University of Versailles Saint-Quentin, Versailles, France; Academic Unit of Psychiatry for Adults, Versailles Hospital, Versailles, France.

Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013 Paris, France; Department of Infectious Diseases, Centre Hospitalier Régional, Orléans, France.

出版信息

J Affect Disord. 2018 Aug 1;235:565-573. doi: 10.1016/j.jad.2018.04.075. Epub 2018 Apr 14.

Abstract

BACKGROUND

A large proportion of persons died by suicide are employed at the time of death and work-related factors partly contribute to suicide risk. Our aim was to examine the association between multiple aspects of work organization and suicidal ideation in a study conducted in primary care.

METHODS

Data came from a study of 2027 working patients attending a GP representative of patients in the Nord Pas-de-Calais region in France (April-August 2014). Suicidality was assessed using the MINI (Mini International Neuropsychiatric Interview). Six emergent worked-related factors were explored (work intensity, emotional demands, autonomy, social relationships at work, conflict of values, insecurity of work). Several covariates were considered: patient's and GP's characteristics, and area-level data (material and social deprivation, psychiatrist and GPs' density, suicide attempts and suicide rates).

RESULTS

8.0% of participants reported suicidal ideation in the preceding month (7.5% of men and 8.6% of women, p = .03). In multivariate analyses adjusted for covariates, suicidality was significantly associated with work intensity (OR = 1.65; 95%CI [1.18-2.31]) in men and with work-related emotional demands (OR = 1.35; 95%CI [1.01-1.80]) in women. Area-level data were not associated.

LIMITATIONS

Our cross-sectional study cannot assess the direction of the relationships under study.

CONCLUSION

Our results emphasise a central role for GPs in suicide prevention among workers and highlight the importance of work-related factors with regard to suicidality in primary care.

摘要

背景

很大比例的自杀者在死亡时都有工作,工作相关因素部分导致了自杀风险。我们的目的是在一项在基层医疗中进行的研究中,检验工作组织的多个方面与自杀意念之间的关系。

方法

数据来自于一项对 2027 名在法国北部加来海峡地区(2014 年 4 月至 8 月)就诊的 GPs 的代表性工作患者的研究。使用 MINI(国际神经精神访谈微型版)评估自杀倾向。探索了六个新兴的与工作相关的因素(工作强度、情绪需求、自主性、工作中的社会关系、价值观冲突、工作保障不足)。考虑了几个协变量:患者和 GPs 的特征以及区域水平的数据(物质和社会剥夺、精神科医生和 GPs 的密度、自杀企图和自杀率)。

结果

8.0%的参与者报告在前一个月有自杀意念(男性为 7.5%,女性为 8.6%,p=0.03)。在调整了协变量的多变量分析中,男性自杀意念与工作强度(OR=1.65;95%CI [1.18-2.31])显著相关,女性与工作相关的情绪需求(OR=1.35;95%CI [1.01-1.80])显著相关。区域水平的数据没有相关性。

局限性

我们的横断面研究不能评估研究中关系的方向。

结论

我们的结果强调了 GPs 在预防工人自杀方面的核心作用,并强调了与初级保健中的自杀意念相关的工作相关因素的重要性。

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