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工作相关心理社会因素暴露对抑郁和焦虑障碍的影响是短期的、滞后的还是累积的?

Is the effect of work-related psychosocial exposure on depressive and anxiety disorders short-term, lagged or cumulative?

机构信息

Occupational Epidemiology Division, National Research and Safety Institute (INRS), Vandoeuvre-lès-Nancy, France.

General Management, National Research and Safety Institute (INRS), Vandoeuvre-lès-Nancy, France.

出版信息

Int Arch Occup Environ Health. 2020 Jan;93(1):87-104. doi: 10.1007/s00420-019-01466-9. Epub 2019 Aug 3.

Abstract

PURPOSE

To determine the short-term, lagged, and cumulative effects of psychosocial factors (PSF) on the incidence of depression and anxiety.

METHOD

Major depressive disorders (MDD) and generalized anxiety disorders (GAD) were diagnosed in 2006 and 2010 using the Mini International Neuropsychiatric Interview among 5684 workers from the French SIP cohort. The outcome considered here was diagnosis of MDD and/or GAD (MDD/GAD) in 2010. The frequency of 17 PSF, covering labour intensity and working time, emotional demand, autonomy, social relationships, conflict of values, and job insecurity, was self-reported in 2006 and 2010. For each PSF, four groups (A-D) were considered: exposed neither in 2006 nor in 2010 (A as the reference), exposed in 2010 but not in 2006 (B as a short-term association), exposed in 2006 but not in 2010 (C as a lagged association), exposed in both 2006 and 2010 (D as a cumulative association).

RESULTS

In men, short-term and cumulative-and to a lesser extent lagged-associations of four labour-intensity factors with MDD/GAD occurrence were observed (high volume of work, pressure at work, high complexity, and long working hours). In women, the short-term and cumulative associations of five PSF were observed, mostly emotional demand factors, lack of reward and work-family imbalance. Job insecurity had strong, short-term, cumulative and lagged associations in both men and women.

CONCLUSION

According to PSF and gender, the results suggest that the relationships between PSF exposure and MDD/GAD were mostly short-term and cumulative rather than lagged.

摘要

目的

确定心理社会因素(PSF)对抑郁和焦虑发生的短期、滞后和累积影响。

方法

2006 年和 2010 年,在法国 SIP 队列的 5684 名工人中使用 Mini 国际神经精神访谈对主要抑郁障碍(MDD)和广泛性焦虑障碍(GAD)进行了诊断。这里考虑的结果是 2010 年 MDD 和/或 GAD(MDD/GAD)的诊断。2006 年和 2010 年,自我报告了 17 项 PSF 的频率,涵盖劳动强度和工作时间、情绪需求、自主权、社会关系、价值观冲突和工作不安全感。对于每个 PSF,考虑了四个组(A-D):在 2006 年和 2010 年均未暴露(A 作为参考),在 2010 年暴露但在 2006 年未暴露(B 为短期关联),在 2006 年暴露但在 2010 年未暴露(C 为滞后关联),在 2006 年和 2010 年均暴露(D 为累积关联)。

结果

在男性中,观察到四项劳动强度因素与 MDD/GAD 发生的短期和累积关联(工作量大、工作压力大、工作复杂性高和工作时间长),以及累积关联和滞后关联。在女性中,观察到五个 PSF 的短期和累积关联,主要是情绪需求因素、缺乏奖励和工作-家庭失衡。在男性和女性中,工作不安全感都具有强烈的短期、累积和滞后关联。

结论

根据 PSF 和性别,结果表明 PSF 暴露与 MDD/GAD 之间的关系主要是短期和累积的,而不是滞后的。

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