Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
BMC Public Health. 2024 Jun 1;24(1):1473. doi: 10.1186/s12889-024-19000-z.
The aim of this study was to investigate associations between exposure to work-related violence/threats and harassment, and future sickness absence (SA) due to common mental disorders (CMDs), taking familial factors (shared genetics and early-life environment) and neuroticism into account.
The study sample included 8795 twin individuals from the Swedish Twin Project of Disability Pension and Sickness Absence (STODS), including survey data from the Study of Twin Adults: Genes and Environment (STAGE). Self-reported work-related violence and/or threats as well as work-related harassment (including bullying) and national register data on SA due to CMDs were analyzed using standard logistic regression, and conditional logistic regression among complete twin pairs discordant on exposures. Individuals were followed for a maximum of 13 years. Interactions between neuroticism and exposures were assessed using both multiplicative and additive interaction analyses.
Exposure to work-related violence/threats was associated with higher odds of SA due to CMDs when adjusting for age, sex, marital status, children, education, type of living area, work characteristics, and symptoms of depression and burnout (OR 2.11, 95% CI 1.52-2.95). Higher odds of SA due to CMDs were also found for exposure to harassment (OR 1.52, 95% CI 1.10-2.11) and a combined indicator of exposure to violence/threats and/or harassment (OR 1.98, 95% CI 1.52-2.59), compared with the unexposed. Analyses of twins discordant on exposure, using the unexposed co-twin as reference, showed reduced ORs. These ORs were still elevated but no longer statistically significant, potentially due to a lack of statistical power. No multiplicative interaction was found between neuroticism and exposure to work-related violence/threats, or harassment. However, a statistically significant additive interaction was found between neuroticism and exposure to violence/threats, indicating higher odds of SA due to CMDs in the group scoring lower on neuroticism.
Exposure to work-related offensive behaviors was associated with SA due to CMDs. However, the results indicated that these associations may be partly confounded by familial factors. In addition, an interaction between exposure and neuroticism was suggested. Thus, when possible, future studies investigating associations and causality between offensive behaviors at work and mental health-related outcomes, should consider familial factors and neuroticism.
本研究旨在探讨工作场所暴力/威胁和骚扰暴露与常见精神障碍（CMD）未来旷工（SA）之间的关联，同时考虑到家族因素（共同遗传和早期环境）和神经质。
研究样本包括来自瑞典残疾抚恤金和病假双胞胎研究（STODS）的 8795 对双胞胎个体，包括来自成人双胞胎研究：基因与环境（STAGE）的调查数据。使用标准逻辑回归分析自我报告的与工作相关的暴力和/或威胁以及与工作相关的骚扰（包括欺凌）和因 CMD 导致的 SA 的国家登记数据，并在暴露情况不一致的完整双胞胎对中进行条件逻辑回归。对个体进行了最长 13 年的随访。使用乘法和加法交互分析评估神经质与暴露之间的相互作用。
在调整年龄、性别、婚姻状况、子女、教育、居住类型、工作特征以及抑郁和倦怠症状后，工作场所暴力/威胁暴露与因 CMD 导致的 SA 几率增加相关（OR 2.11，95%CI 1.52-2.95）。与未暴露者相比，暴露于骚扰（OR 1.52，95%CI 1.10-2.11）和暴力/威胁暴露与/或骚扰的综合指标（OR 1.98，95%CI 1.52-2.59）也与因 CMD 导致的 SA 几率增加相关。使用暴露情况不一致的双胞胎，以未暴露的同卵双胞胎为参照，分析显示 OR 降低。这些 OR 仍然升高，但不再具有统计学意义，这可能是由于缺乏统计能力。在神经质与工作场所暴力/威胁暴露之间未发现乘法交互作用，但在神经质与暴力/威胁暴露之间发现了统计学上显著的加法交互作用，表明神经质得分较低的人群因 CMD 导致 SA 的几率更高。
工作场所的攻击性行为与因 CMD 导致的 SA 有关。然而，结果表明，这些关联可能部分受到家族因素的混淆。此外，还提示了暴露与神经质之间存在交互作用。因此，在可能的情况下，未来研究在调查工作场所攻击性行为与心理健康相关结果之间的关联和因果关系时，应考虑家族因素和神经质。
