Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, United States.
School of Nursing, University of California, Los Angeles, United States.
J Psychosom Res. 2021 Aug;147:110541. doi: 10.1016/j.jpsychores.2021.110541. Epub 2021 Jun 8.
Studies assessing sex differences in the associations of psychosocial strain with depression have shown mixed and inconsistent results. Our objective was to examine prospective associations of job strain and family strain with risk of major depressive episode (MDE) among United States workers, as well as assess potential effect modification by sex.
Using data from the nationally representative and population-based Mid-life in the United States (MIDUS) study with a prospective cohort design and a 9-year follow-up period, the effects of job strain and family strain at baseline on risk of MDE within the 12 months prior to the follow-up assessment were examined in 1581 workers (805 men, 776 women) who were free from MDE within the 12 months prior to the baseline survey, by multivariate Poisson regression analysis.
After adjustment for relevant covariates, there was evidence for effect modification by sex for the association between job strain and MDE but not for the association between family strain and MDE. Indeed, high job strain was prospectively associated with the risk of MDE (RR and 95% CI = 2.14 [1.14, 4.03]) in men but not in women. Moreover, high family strain was prospectively associated with a higher risk of MDE (RR and 95% CI = 1.57 [1.05, 2.37]) in the whole sample.
Family strain was associated with risk of MDE regardless of the sex of a person. In contrast, high job strain may involve an increased risk of developing MDE only in men but not in women.
评估心理社会压力与抑郁之间关联的性别差异的研究结果存在差异且不一致。我们的目的是在美国工人中检验工作压力和家庭压力与重度抑郁发作（MDE）风险的前瞻性关联，并评估性别可能产生的影响。
使用具有前瞻性队列设计和 9 年随访期的全国代表性和基于人群的美国中年（MIDUS）研究的数据，通过多变量泊松回归分析，在基线时无 MDE（在基线调查前 12 个月内）的 1581 名工人（805 名男性，776 名女性）中，考察基线时的工作压力和家庭压力对随访前 12 个月内 MDE 风险的影响。
在调整了相关协变量后，工作压力和 MDE 之间的关联存在性别效应修饰，但家庭压力和 MDE 之间的关联没有性别效应修饰。实际上，高工作压力与男性 MDE 的风险呈前瞻性相关（RR 和 95%CI=2.14[1.14,4.03]），但与女性无关。此外，高家庭压力与 MDE 的风险呈前瞻性相关（RR 和 95%CI=1.57[1.05,2.37]）。
家庭压力与 MDE 的风险有关，而与一个人的性别无关。相比之下，高工作压力可能仅与男性而非女性发生 MDE 的风险增加有关。
