Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, and the Institute for Work and Health, Toronto, Canada.
Department of Psychiatry, University of Toronto, and Women's College Hospital and Research Institute, Toronto, Canada.
Health Rep. 2020 Dec 16;31(12):12-23. doi: 10.25318/82-003-x202001200002-eng.
Understanding the prevalence of major depressive episodes (MDEs) and anxiety disorders at the population level among different labour force segments is critical to assessing and planning equitable mental health policies for Canadians adults. This study quantified prevalence trends of annually reported MDEs, anxiety disorders, and comorbid MDEs and anxiety disorders among working-age Canadians by labour force status, between 2000 and 2016.
This study used multiple cycles of the Canadian Community Health Survey. MDE prevalence was assessed using variants of the Composite International Diagnostic Interview and the Patient Health Questionnaire-9. Anxiety disorder prevalence captured the presence of an anxiety disorder diagnosed by a healthcare professional. Prevalence estimates were calculated in each survey cycle for three labour force groups: employed, unemployed and not participating in the labour force. A meta-analytic framework stratified by labour force status estimated prevalence trends.
Between 2000 and 2016, MDE prevalence remained statistically stable over time at 5.4% (95% confidence interval [CI]: 4.7% to 6.0%), 11.7% (95% CI: 10.4% to 13.0%) and 9.8% (95% CI: 8.5% to 11.2%) among participants who were employed, unemployed, and not participating in the labour force, respectively. Anxiety prevalence ranged from 4.6% to 10.8%, and increased over time (employed: β=0.26%/year, 95% CI: 0.08% to 0.45%; unemployed: β=0.34%/year, 95% CI: -0.10% to 0.78%; not participating in the labour force: β=0.55%/year, 95% CI: 0.15% to 0.95%). Stable comorbid MDE and anxiety prevalence ranged from 1.2% to 4.1% between 2003 and 2016.
Trends suggest that MDE prevalence has remained stable among all labour force groups since 2000, while anxiety disorder prevalence has modestly increased since 2003. Disorder prevalence increased as labour force attachment decreased across all outcomes studied.
了解不同劳动力群体中人口水平上的重度抑郁发作（MDE）和焦虑障碍的患病率对于评估和规划加拿大成年人公平的心理健康政策至关重要。本研究通过劳动力状况量化了 2000 年至 2016 年期间加拿大工作年龄人群中每年报告的 MDE、焦虑障碍以及 MDE 和焦虑障碍共病的患病率趋势。
本研究使用了加拿大社区健康调查的多个周期。使用复合国际诊断访谈和患者健康问卷-9 的变体评估 MDE 的患病率。焦虑障碍的患病率捕捉了由医疗保健专业人员诊断的焦虑障碍的存在。在每个调查周期中，为三个劳动力群体计算了患病率估计值：就业、失业和未参与劳动力。劳动力状况分层的荟萃分析框架估计了患病率趋势。
2000 年至 2016 年间，MDE 的患病率在就业、失业和未参与劳动力的参与者中分别保持稳定，分别为 5.4%（95%置信区间[CI]：4.7%至 6.0%）、11.7%（95% CI：10.4%至 13.0%）和 9.8%（95% CI：8.5%至 11.2%）。焦虑症的患病率范围为 4.6%至 10.8%，并随时间增加（就业：β=0.26%/年，95% CI：0.08%至 0.45%；失业：β=0.34%/年，95% CI：-0.10%至 0.78%；未参与劳动力：β=0.55%/年，95% CI：0.15%至 0.95%）。2003 年至 2016 年期间，稳定的 MDE 和焦虑共病患病率范围为 1.2%至 4.1%。
趋势表明，自 2000 年以来，MDE 的患病率在所有劳动力群体中保持稳定，而焦虑症的患病率自 2003 年以来略有增加。所有研究结果显示，随着劳动力参与度的降低，疾病的患病率增加。
