心理社会职业暴露与精神疾病。
Psychosocial Occupational Exposures and Mental Illness.
机构信息
Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine, TU Dresden,Dresden, Germany; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine,Leipzig University, Leipzig, Germany.
出版信息
Dtsch Arztebl Int. 2022 Oct 21;119(42):709-715. doi: 10.3238/arztebl.m2022.0295.
BACKGROUND
The purpose of this study is to investigate the exposure-risk relationship between psychosocial occupational stress and mental illness.
METHODS
We conducted a systematic review with meta-analyses as an update of a systematic review published in 2014. The study protocol was registered in PROSPERO (CRD42020170032). Literature searches were carried out in the MEDLINE, PsycINFO, and Embase databases. All procedural steps were performed independently by two reviewers; discordances were solved by consensus. All of the included full texts were subject to a methodological appraisal. Certainty of evidence was determined with the GRADE procedure.
RESULTS
The pooled risk of depression was found to be approximately doubled in workers exposed to high job strain, which is defined as high work demands combined with low job control (effect estimate [EE] = 1.99, 95% CI [1.68; 2.35], heterogeneity [I2] = 24.7%, n = 8). In particular, high work demands are associated with incident depression (ES = 13.8 [1.19; 1.61], I2 = 69.0%, n = 9) and with incident anxiety disorder (ES = 1.79 [1.44; 2.23], I2 = 48.1%, n = 5). There were only a small number of methodologically adequate studies available on burnout, somatoform disorders, suicidal ideation, and suicide. Thus, no pooled risk estimates were calculated, although some individual studies showed a considerably increased risk.
CONCLUSION
Psychosocial occupational stress is clearly associated with depression and anxiety disorders.
背景
本研究旨在探讨心理社会职业压力与精神疾病之间的暴露风险关系。
方法
我们进行了一项系统综述和荟萃分析，作为 2014 年发表的系统综述的更新。研究方案在 PROSPERO（CRD42020170032）中注册。文献检索在 MEDLINE、PsycINFO 和 Embase 数据库中进行。所有程序步骤均由两名评审员独立进行；分歧通过协商解决。所有纳入的全文均进行了方法学评估。证据确定性采用 GRADE 程序确定。
结果
发现暴露于高工作压力（定义为高工作需求与低工作控制相结合）的工人患抑郁症的风险约增加一倍（合并效应估计值 [EE] = 1.99，95%置信区间 [1.68；2.35]，异质性 [I2] = 24.7%，n = 8）。特别是，高工作需求与抑郁发作（ES = 13.8 [1.19；1.61]，I2 = 69.0%，n = 9）和焦虑障碍发作（ES = 1.79 [1.44；2.23]，I2 = 48.1%，n = 5）相关。仅有少数关于倦怠、躯体形式障碍、自杀意念和自杀的方法学上足够的研究。因此，尽管一些个别研究显示风险明显增加，但未计算合并风险估计值。
结论
心理社会职业压力与抑郁和焦虑障碍明显相关。
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