Niedhammer Isabelle, Coindre Kylian, Memmi Sarah, Bertrais Sandrine, Chastang Jean-François
INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, ESTER Team, Angers, France.
INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, ESTER Team, Angers, France.
J Psychiatr Res. 2020 Apr;123:178-186. doi: 10.1016/j.jpsychires.2020.01.003. Epub 2020 Jan 22.
The objectives were to explore the associations between various types of occupational exposures and depression in the French national working population, most of the studies in the literature focussing on a limited number of exposures and on symptom scales.
The study was based on a nationally representative sample of 25 977 employees, 14 682 men and 11 295 women. Depression was measured using the PHQ-9 instrument and algorithm. Occupational exposures included factors related to both the psychosocial and physical work environment. Weighted logistic regression analyses were performed to study the associations between exposures and outcome with adjustment for covariates among men and women separately.
The prevalence of depression was higher for women than for men (5.70% versus 3.78%). The final models showed that low decision latitude, low reward, bullying, work-family and ethical conflicts for both genders, and high psychological demands, low social support, and long working hours among women were risk factors for depression. No occupational exposure of physical, biomechanical, chemical and biological nature was associated with depression. Sensitivity analyses confirmed the robustness of the results.
Significant associations were found between psychosocial work exposures and depression, and there were some differences in these associations between genders. This study is one of the first to provide a comprehensive overview of occupational exposures in association with depression. More prevention towards the psychosocial work environment is needed to improve mental health of working populations.
本研究旨在探究法国全国劳动人口中各类职业暴露与抑郁症之间的关联，而文献中的大多数研究仅聚焦于有限的几种暴露因素及症状量表。
本研究基于一个具有全国代表性的样本，包含25977名员工，其中男性14682名，女性11295名。使用PHQ-9工具及算法测量抑郁症。职业暴露包括与心理社会和物理工作环境相关的因素。分别对男性和女性进行加权逻辑回归分析，以研究暴露因素与结果之间的关联，并对协变量进行调整。
女性抑郁症患病率高于男性（5.70%对3.78%）。最终模型显示，低决策自由度、低回报、欺凌、工作-家庭及道德冲突对男女皆是抑郁症的风险因素，而高心理需求、低社会支持及女性长时间工作也是抑郁症的风险因素。物理、生物力学、化学和生物性质的职业暴露与抑郁症均无关联。敏感性分析证实了结果的稳健性。
心理社会工作暴露与抑郁症之间存在显著关联，且这些关联在性别上存在一些差异。本研究是首批全面概述职业暴露与抑郁症关联的研究之一。需要更多针对心理社会工作环境的预防措施来改善劳动人口的心理健康。
