医务人员工作中社会心理因素与抑郁症状的关系

目的 探讨医务人员工作上的付出-获得不平衡与抑郁症状之间的关系.方法 付出-获得不平衡采用付出-获得不平衡（the Effort-Reward Imbalance,ERI）量表测量,抑郁情绪调查采用美国流调中心的抑郁自评（Center of Epidemiology Survey Depression,CES-D）量表测量医务人员的抑郁症状.研究对象来自在浙江大学6个附属医院工作的1 179名医务人员.调查表包括ERI量表、CES-D量表和一些基本特征.使用Spearman相关分析、Mann-Whitney检验、Pearson χ^2检验或似然比χ^2检验进行单因素分析;用多元Logistic回归方法分析医务人员中工作上的付出-获得不平衡与抑郁症状之间的关系.结果 医务人员抑郁症状的阳性率为48.12%（95% CI：45.08%～51.16%）,护士抑郁症状的阳性率为52.40%（95%CI：47.87%～56.93%）,较医生抑郁症状的阳性率[44.70%（95%CI：10.64%～48.77%）]高,差异有统计学意义（χ^2=6.077,P=0.014）.工作高付出-低获得和超负荷是医务人员抑郁症状发生的相关因素（OR=1.859,95%CI：1.337～2.585;OR=2.207,95%CI：1.656～2.942）.结论 医务人员抑郁症状的发生与工作高付出-低获得、超负荷有关.     

公务员工作压力与抑郁症状之间的关系

目的探讨公务员工作压力和抑郁症状之间的关系。方法工作压力采用中文版的付出一获得不平衡量表，抑郁评价采用中文版CES—D量表。采用问卷形式对474名浙江省公务员进行横断面调查，调查内容包括工作付出、获得、超负荷，抑郁症状和一般情况。采用方差分析、秩和检验或X^2检验进行单因素分析，采用logistic回归进行多因素分析。使用Epidata2003建立数据库。采用SPSS13．0进行统计分析。结果本次调查结果显示浙江省公务员抑郁症状阳性率为41．56％（95％CI：39．30％～43．82％）。采用多元logistic回归校正了其他因素后，工作中付出一获得不平衡的0R=1．772（95％CI：0．369～8．508）。公务员抑郁症状与超负荷（OR=3．468，95％CI=1．542～7．801）、单身（OR=2．661，95％CI=1．017～6．963）、社会支持（0R=2．088，95％CI：1．246～3．498）和亚健康状态（0R=2．475，95％CI：1．110～5．520）有关。结论公务员工作超负荷对其健康状况有负面影响。     

小学教师工作压力及其与抑郁症状的关系

[目的]探讨小学教师工作压力现状及其与抑郁症状的关系。[方法]工作压力采用中文版的付出-获得不平衡量表,抑郁评价采用中文版流行病学研究中心的抑郁量表（Center for Epidemiological Survey,Depression Scale,CES-D）。采用问卷形式对287名杭州市小学教师进行横断面调查,调查内容包括工作付出、获得、内在投入,抑郁症状和一些基本特征。采用方差分析、秩和检验或χ2检验进行单因素分析,采用Logistic回归进行多因素分析。[结果]小学教师中抑郁症状的阳性率为42.38%（95%CI：36.47%～48.29%）,与付出-获得不平衡有关（OR=5.901,95%CI：2.948～11.812）。[结论]小学教师工作付出-获得不平衡对其健康状况有负面影响。     

Association between job stress and depression among Japanese employees threatened by job loss in a comparison between two complementary job-stress models.

OBJECTIVES: This study compared the separate effects produced by two complementary stress models--the job demand-control model and the effort-reward imbalance model--on depression among employees threatened by job loss. METHODS: A cross-sectional analysis was conducted to examine these associations among 190 male and female employees who responded to a self-administered questionnaire in a small Japanese plant with economic hardship. The employees were engaged in 2 job types--direct assembly line and indirect supportive tasks--and the latter was threatened by job loss because of downsizing. Independent variables were measured by the Japanese versions of Karasek's demand-control questionnaire and Siegrist's effort-reward imbalance questionnaire. Depression was assessed by the Center for Epidemiologic Studies Depression Scale. RESULTS: The employees with indirect supportive tasks (target for downsizing) were more likely to have depressive symptoms than direct assembly-line workers. Job strain, a combination of high demand and low control at work, was more frequent among the latter, while the combination of high effort and low reward was more frequent among the former. After adjustment for work environment factors, low control [odds ratio (OR) 4.7], effort reward imbalance (OR 4.1), and overcommitment (the person characteristic included in the effort-reward imbalance model) (OR 2.6) were independently related to depression. There is some indication that these effects were particularly strong in the subgroup suffering from potential job loss. CONCLUSIONS: This study confirms that the 2 job stress models identify different aspects of stressful job conditions. Moreover, effort-reward imbalance and low control at work are both associated with symptoms of depression.     

职业紧张对不同职业人群抑郁症状的影响

[目的]探讨职业紧张对不同职业人群抑郁症状的影响。[方法]采用横断面研究方法,调查上海市某区职业人群2458名,年龄为20～63岁。工作紧张评估采用中文工作内容问卷（C-JCQ）-9中文工作付出一回报（C．ERI）问卷,同时调查社会人7／特征与个体生活行为因素,抑郁症状使用流行病学研究抑郁量表（CES．D）。采用多因素非条件logistic回归分析社会人口特征与职业紧张因素对抑郁症状的影响。[结果]抑郁评估均分为（16．1±7．2）分,抑郁症状阳性率为44．0％。社会人口与行为特征因素中,职务、受教育程度、工作时间、吸烟与抑郁症状有统计学关联。职业紧张评估变量中,高工作紧张、低工作控制、低社会支持、高工作付出一回报不平衡、高内在驱动是抑郁症状的危险因素。[结论]社会人口特征与职业紧张因素均可能增加职业人群抑郁症状的风险。     

Psychosocial work environment and mental health: Job-strain and effort-reward imbalance models in a context of major organizational changes

This study explored the association between the two job-stress models, job-strain and effort-reward imbalance, and mental health outcomes in a working population exposed to major organizational changes. The cross-sectional study was based on 680 subjects, 504 men and 176 women. Psychosocial factors at work included: psychological demands, decision latitude, social support, effort, reward, and overcommitment. Mental health outcomes were depressive symptoms (CES-D) and psychiatric disorders (GHQ-12). Job strain, low decision latitude, effort-reward imbalance, and low reward (especially job instability) were found to be associated with depressive symptoms and/or psychiatric disorders among men. Overcommitment at work was a risk factor for both men and women. Social support at work played a role to reduce depressive symptoms for women. These findings emphasize the deleterious effects of psychosocial work environment on mental health during major organizational changes.     

中国老年居民抑郁症状现状及其影响因素分析

目的 了解我国老年居民抑郁症状的流行现状及其影响因素。方法 采用中国家庭追踪调查（CFPS）2018年最新调查数据,共纳入60岁及以上老年居民7 138人,对不同特征的老年居民抑郁症状进行单因素分析,拟合两水平logistic回归模型探讨影响因素。结果 中国老年居民抑郁症状检出率为30.7%。多水平模型拟合结果表明数据在高水平单位存在聚集性,其层次结构不能忽略。农村户口（OR=1.32,95%CI:1.02~1.70）、女性（OR=1.48,95%CI:1.29~1.69）、未婚（OR=2.69,95%CI:1.44~5.04）、离婚及丧偶（OR=1.99,95%CI:1.70~2.33）、文化程度越低、人均年收入越低的老年居民发生抑郁症状的风险更高（P<0.05）;自评健康状况良好的老年居民发生抑郁症状的风险更低（OR=0.25,95%CI:0.22~0.29）;幸福感得分越高的老年居民发生抑郁症状的风险较低（OR=0.76,95%CI=0.74~0.78）。结论 中国老年居民抑郁情况目前仍十分严峻,抑郁的疾病负担在不断增加,应该采取强有力的干预措施,改善抑郁症状在老年居民中的流行和预防抑郁症的发生。     

中国女同性恋人群抑郁现状及影响因素

  目的  了解中国女同性恋(女同)人群抑郁状况,探讨影响女同人群抑郁症状发生的因素,为更好地进行女同人群的健康教育和后续心理干预提供建议和参考。  方法  2018年7月1日―2018年12月30日,通过问卷星对女同人群进行网络问卷调查。描述其抑郁状况分布,并用χ2检验、独立样本t检验进行单因素分析,用Logistic回归分析模型分析女同人群抑郁症状的影响因素。  结果  56.1%的女同存在抑郁症状。研究结果显示,和与家人同住相比,与女性朋友同住(OR=0.399, 95% CI: 0.182~0.872, P=0.021)、社会支持(OR=0.953, 95% CI: 0.926~0.980, P=0.001)和心理韧性(OR=0.934, 95% CI: 0.895~0.975, P=0.002)水平高的女同更不容易抑郁;少数民族(OR=5.849, 95% CI: 1.474~23.206, P=0.012)、童年期不良经历(OR=1.317, 95% CI: 1.065~1.628, P=0.011)是抑郁症状发生的危险因素。  结论  中国女同人群抑郁症状发生率较高,应关注性少数群体的心理状况,重视社会支持的积极作用,提供更多精神卫生资源,促进其心理健康。     

农转非居民社会资本对抑郁症状的影响研究

目的 了解社会资本对农转非居民抑郁症状的影响,探讨促进其心理健康的预防措施。方法 采用多阶段分层整群抽样的方法,抽取成都和昆明的农转非居民3223人,采用流调中心抑郁水平评定量表(CES-D)以及自编社会资本量表进行问卷调查。结果 本次研究对象的抑郁症状发生率为14.5%。女性、高龄、患有慢性病、文化程度低、非在婚、未与配偶住在一起、无业和失业的农转非居民抑郁症状的发生率较高(P<0.05);高“社会信任与安全感”的居民发生抑郁症状的风险较低(OR=0.321,P<0.05)、高“社区归属感”得分的居民产生抑郁症状的风险较低(OR=0.816,P<0.05),“社会支持”得分较高的居民发生抑郁症状的风险较低(OR=0.269,P<0.05)。结论 应采取有针对性的手段对影响农转非居民心理健康的社会资本因素进行干预,以改善其抑郁状况。     

The association of needlestick injury with depressive symptoms among first-year medical residents in Japan

Depressive symptoms among medical residents are common. The objective of this study was to determine the association of depressive symptoms with needlestick injury among first-year medical residents (so-called "intern"). We conducted a prospective cohort study among 107 medical residents in 14 training hospitals. The baseline survey was conducted in August 2005 and the follow-up survey was conducted in March 2006. Depressive symptoms were based on the Center for Epidemiological Study of Depression. Factors associated with depressive symptoms were examined using logistic regression analysis. For medical residents without depressive symptoms at the baseline survey, needlestick injury events were associated with depressive symptoms at the follow-up survey (corrected odds ratio [cOR]=2.98; 95% confidence interval [CI], 1.16-3.70). Because it was not possible to determine when the medical residents developed depressive symptoms, it is not possible to definitely determine causality between needlestick injury and depressive symptoms, although these findings are suggestive. Therefore, it would seem prudent to suggest the provision of mental health services to medical residents sustaining a needlestick injury since this may be helpful in identifying and treating depression.     

Demenz, Depressionen und Aktivit?ten des t?glichen Lebens als Risikofaktoren von Stürzen bei Betagten

OBJECTIVES: Falls among elderly are a well-recognised public health problem. The purpose of the present study was to explore the relation between dementia, number of depressive symptoms, activities of daily living, setting, and risk of falling. METHODS: Data for the analysis came from a cross-sectional study about dementia, depression, and disabilities, carried out 1995/96 in Zurich and Geneva. The random sample stratified, by age and gender consisted of 921 subjects aged 65 and more. The interview was conducted by means of the Canberra interview for the Elderly, extended by short questionnaire. The subject was classified as a faller if the subject and/or the informant had reported a fall within the last 12 months prior to the interview. Logistic-regression analysis was used to determine the independent impact of dementia, depressive symptoms, and ADL-score on risk of falling. RESULTS: The stepwise logistic regression analysis has revealed a statistically significant association between dementia (OR 2.14, 95% CI 1.15-3.96), two resp. three depressive symptoms (OR 1.64, 95% CI 1.04-2.60) as well as four or more depressive symptoms (OR 2.64, 95% CI 1.39-5.02) and the risk of falling. There was no statistically significant relationship between studied risk factors and the risk of being one-time faller. However, we found a strong positive association between dementia (OR 3.92, 95% CI 1.75-8.79), four or more depressive symptoms (OR 3.90, 95% CI 1.55-9.83) and the risk of being recurrent faller. Moreover, residents of nursing homes (OR 8.50, 95% CI 2.18-33.22) and elderly aged 85 or more (OR 2.29, 95% CI 1.08-4.87) were under statistically significant higher risk of sustaining recurrent falls. CONCLUSIONS: The results of the present study confirm that dementia and depression substantially increase the risk of falling.     

Depressive symptoms in users and non-users of depot medroxyprogesterone acetate

To evaluate the possible effects of depot medroxyprogesterone acetate (DMPA) injectable contraception on depressive symptoms, we conducted a population-based prospective study with women aged 18–39 years old enrolled at a health maintenance organization. At baseline, 183 women used DMPA and 274 were non-users. Data on depressive symptoms and on factors potentially related to DMPA use and depression were collected by questionnaire at 6-month intervals for up to 3 years. In multivariate longitudinal analysis, we found an increased likelihood of reporting depressive symptoms among continuous DMPA users (OR = 1.44; 95% CI = 1.00–2.07) and discontinuers (OR = 1.60; 95% CI = 1.03–2.48) when compared to non-users. Women who discontinued DMPA use had elevated depressive symptoms prior to discontinuation (OR = 2.30; 95% CI = 1.42–3.70) and immediately following discontinuation (OR = 2.46; 95% CI = 1.46–4.14), and depressive symptoms subsided at subsequent visits relative to non-users. Our prospective analyses found an association between DMPA use and depressive symptoms but further research is needed to determine whether the relationship is causal.     

Quality of work, well-being, and intended early retirement of older employees: baseline results from the SHARE Study

BACKGROUND: Given the challenge of a high proportion of older employees who retire early from work we analyse associations of indicators of a poor psychosocial quality of work with intended premature departure from work in a large sample of older male and female employees in 10 European countries. METHODS: Baseline data from the 'Survey of Health, Ageing and Retirement in Europe' (SHARE) were obtained from 3523 men and 3318 women in 10 European countries. Data on intended early retirement, four measures of well-being (self-rated health, depressive symptoms, general symptom load, and quality of life), and quality of work (effort-reward imbalance; low control at work) were obtained from structured interviews and questionnaires. Country-specific and total samples are analysed, using logistic regression analysis. RESULTS: Poor quality of work is significantly associated with intended early retirement. After adjustment for well-being odds ratios (OR) of effort-reward imbalance [OR 1.72 (1.43-2.08)] and low control at work [OR 1.51 (1.27-1.80)] on intended early retirement are observed. Poor quality of work and reduced well-being are independently associated with the intention to retire from work. CONCLUSION: The consistent association of a poor psychosocial quality of work with intended early retirement among older employees across all European countries under study calls for improved investments into better quality of work, in particular increased control and an appropriate balance between efforts spent and rewards received at work.     

Psychosocial factors at work and depression in three countries of Central and Eastern Europe

Psychosocial factors at work have been found to predict a range of health outcomes but their effect on mental health outcomes has not been extensively studied. This paper explores the relationship between psychosocial factors at work and depression in three countries of Central and Eastern Europe. The data come from a cross-sectional study of working men (n = 645) and women (n = 523) aged 45-64 years, randomly selected from population registers in Novosibirsk (Russia), Krakow (Poland) and Karvina-Havirov (Czech Republic). The questionnaire included questions on the effort and reward at work, job control, the full CES-D scale of depression, and a range of other characteristics. Linear regression was used to estimate the association between depression score and work characteristics: the logarithm of the effort-reward ratio, and continuous job control score. The means of the depression score were 10.5 for men and 14.2 for women. After controlling for age, sex and country, effort-reward ratio (logarithmically transformed) was strongly related to depression score; a 1 SD increase in the log transformed effort-reward ratio was associated with an increase in the depression of 2.0 points (95% CI 1.5; 2.4), and further adjustment did not materially change the effect. Job control was inversely associated with depression score in Poland and the Czech Republic (not in Russia) but the association was largely eliminated by controlling for socioeconomic characteristics. This study suggests that the effort-reward imbalance at work is related to prevalence of depression in these central and eastern European populations.     

劳动密集型企业女工职业紧张与职业倦怠、抑郁症状关系研究

目的探讨劳动密集型企业女工职业紧张、职业倦怠和抑郁症状的关系。方法采用整群随机抽样方法,选取广东省佛山市5家劳动密集型企业的665名女工作为研究对象,应用工作付出-回报失衡紧张量表、职业倦怠通用量表、患者健康问卷对其职业紧张、职业倦怠和抑郁症状水平进行调查。结果女工付出-回报失衡(ERI)指数中位数(M)为0.80,ERI模式高职业紧张检出率为28.6%;职业倦怠、抑郁症状得分M分别为35.0和8.0分,职业倦怠感检出率为7.4%,抑郁症状检出率为32.8%。偏相关分析显示,女工职业倦怠得分与职业紧张的付出、内在投入维度以及抑郁症状得分均呈正相关(P0.05),与职业紧张的回报维度得分呈负相关(P0.01)。职业紧张和职业倦怠对抑郁症状变化解释量分别为7.4%和7.7%。结论劳动密集型企业女工职业倦怠在职业紧张和抑郁症状之间具有某些中介作用,降低其职业紧张与职业倦怠水平有助于缓解抑郁症状。     

Associations of depressive symptoms with regular leisure activity and family social support among Japanese workers

This study was performed to determine the associations of depressive symptoms with regular leisure activity and family social support among Japanese workers. The study participants consisted of 1,605 men and 348 women. Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression scale. Multiple logistic regression analysis was used to adjust for potentially associated variables. Depressive symptoms were associated with lack of regular leisure activity for men [odds ratio (OR) = 2.05, 95% confidence interval (CI) = 1.55-2.71] and for women (OR = 2.53, 95% CI = 1.30-4.95). Depressive symptoms were also associated with lack of family social support for men (OR = 1.87, 95% CI = 1.43-2.43). Although a cross-sectional study does not determine which factors are determinants or consequences, these findings suggest regular leisure activity for men and women and family social support for men are independently associated with depressive symptoms.     

Occupational stress and depression in Korean employees

PURPOSE: The purpose of this study is to analyze what aspects of occupational stress predict depression among Korean workers, and determine which components of occupational stress or job characteristics is more strongly associated with depression. METHODS: In this cross-sectional study, a total of 8,522 workers (21-65 years of age) from a nationwide sample were recruited. A self-administered questionnaire was used to assess socio-demographics, job characteristics, depressive symptoms measured by the Center for Epidemiologic Studies Depression Scale, and occupational stress assessed by the Korean occupational stress scale (KOSS). RESULTS: Multivariate analyses show that inadequate social support (OR = 1.58, 95% CI = 1.52, 1.66) and discomfort in occupational climate (OR = 1.25, 95% CI = 1.18, 1.32) were more important risk factors for depression than organizational injustice, job demand and job control. Compared to the 'business activities' industries, 'recreational, cultural and sporting activities' (OR = 3.45, 95% CI = 1.80, 6.58), 'hotel and restaurants' (OR = 3.34, 95% CI = 1.92, 5.80), 'real estate and renting and leasing' (OR = 2.24, 95% CI = 1.13, 4.44), 'wholesale and retail' (OR = 1.85, 95% CI = 1.28, 2.67), 'transportation' (OR = 1.85, 95% CI = 1.11, 3.07), and 'financial institute and insurance' (OR = 1.60, 95% CI = 1.04, 2.48) industries had significantly greater risk of depression after controlling for gender, age, marital status, duration of employment and all subscale of KOSS. CONCLUSION: The finding that inadequate social support and discomfort in occupational climate is a better predictor of depressive symptoms than organizational injustice in Korea, indicates that the newly developed KOSS has cultural relevance for assessing occupational stress in Korea. Future studies need to understand factors such as "emotional labor" within certain industries where increased risk for depression is observed.     

付出-获得不平衡量表中文版的信度和效度

目的 评价付出-获得不平衡（ERI）量表中文版的信度和效度.方法 采用中文版ERI量表对4782名不同职业人群进行工作压力的横断面调查,量表包括付出、获得和超负荷三部分23个条目.运用可靠性分析来评价ERI量表的信度,运用因子分析方法来评价ERI量表的结构效度.结果 研究中获取的调查数据支持付出-获得不平衡模式的理论假设;中文版ERI量表中付出和获得子量表的信度和效度均较高,但是超负荷子量表的信度和效度均不高.结论 ERI量表中付出、获得子量表可以直接应用于中国人群的调查,但是超负荷子量表中条目不能直接用于中国人群的调查.     

Depressive Symptoms and Mortality in Older Mexican Americans

PURPOSE: We examined the prevalence of comorbid depressive symptomatology and leading chronic medical conditions, and their influence on death rates in older Mexican Americans.METHODS: Data from the Hispanic Established Population for the Epidemiologic Study of the Elderly (EPESE) were used. Differences in death rates across sociodemographics, self-ratings of health, and health conditions were examined with analysis of variance statistics. Logistic regression models were used to examine main effects and interaction effects of each medical condition separately and in conjunction with depressive symptomatology.RESULTS: Bivariate analyses indicated that death rates were substantially higher when a high level of depressive symptoms was comorbid with diabetes (OR = 3.84, 95% CI = 2.55–5.78), cardiovascular disease (OR = 4.04, 95% CI = 2.36–6.91), hypertension (OR = 2.27, 95% CI = 1.57–3.27), stroke (OR = 3.00, 95% CI = 1.44–6.15), and cancer (OR = 4.46, 95% CI = 2.48–8.01). Multivariate analyses indicated a synergistic effect for comorbid diabetes and depressive symptoms such that the odds of having died among diabetics with high levels of depressive symptoms (OR = 4.03, 95% CI = 2.67–6.11) were three times that of diabetics without high levels of depressive symptoms (OR = 1.36, 95% CI = 0.89–2.06).CONCLUSIONS: High levels of depressive symptoms concomitant with major chronic medical conditions elevate the risk for death among older Mexican Americans. Given the fact that depression is often unrecognized and undertreated in the elderly, awareness of the potential for loss of life as well as the potential for treatment may help to improve this situation not only for older Mexican Americans, but for older adults in general.