职业应激与抑郁症状关系的性别差异

Gender difference of relationship between occupational stress and depressive symptoms

目的探讨职业应激与抑郁症状关系的性别差异。方法采用横断面研究设计和问卷调查方法对13家企业5338名工人进行调查，采用抑郁自评问卷调查抑郁症状，采用工作内容问卷和付出-回报失衡模式问卷调查职业应激。结果调查对象抑郁症状检出率为31．8％，其中男性抑郁症状检出率为33．8％，女性抑郁症状检出率为27．7％，差异有统计学意义（x：=19．62，P〈0．01）。男性工作心理需求、躯体需求、工作控制、付出、内在投入、负性情感评分高于女性，社会支持、回报、工作满意感评分低于女性，差异均有统计学意义（P〈0．01，P〈O．05）。有抑郁症状者的工作心理需求、躯体需求、付出、内在投入、负性情感评分均高于无抑郁症状者，工作控制、社会支持、回报、工作满意感、正性情感评分低于无抑郁症状者，差异均有统计学意义（P〈0．01）。男性抑郁症状者的工作心理需求、躯体需求、工作控制、内在投入、负性情感评分高于女性抑郁症状者，社会支持、回报、工作满意感评分低于女性抑郁症状者，差异均有统计学意义（P〈0．01）。男性以及男性抑郁症状者的工作紧张和付出一回报失衡指数〉1者、高需求低控制和高付出低回报者的比例大于女性以及女性抑郁症状者。在心理需求和躯体需求方面，女性高需求低控制者发生抑郁症状的风险是低需求高控制者的2倍，略高于男性（OR值分别为2．04和2．17）。男女高付出低回报者发生抑郁症状的风险是低付出高回报者的2．70倍。性别与工作紧张以及付出一回报失衡与抑郁症状无交互作用。结论男女抑郁症状检出率以及与职业应激关系的差异可能是因为男女经历的工作中社会心理因素的差异造成的，工作中社会心理因素与性别对抑郁症状可能无交互作用。

Objective To explore gender difference of relationship between occupational stress and depressive symptoms. Methods The cross-sectional study was used to investigate 5338 workers in 13 factories and companies, the depressive symptoms were assessed with Epidemiologic Studies Depression Scale （CES-D） and the perceived occupational stress was evaluated by the Chinese version of the Job Content Questionnaire （JCQ） and Effort-Reward Imbalance （ERI） Model Questionnaire. Logistic regression analyses were conducted to estimate the associations between occupational stress and prevalence of depressive symptoms. Results Preva- lence of depressive symptoms was 31.8% for all subjects, 33.8% for males and 27.7% for females, gender differ- ence of prevalence was significant （P〈0.01 ）. Psychological demands, physical demands, job control, effort, overc- ommitment and negative affectivity scores for males were significantly higher than those for females （P〈0.01 or 0.05 ）, social support, reward and job satisfaction scores for males were significantly lower than those for females （P〈 0.01）. Psychological demands, physical demands, job control, effort, overcommitment and nagetive affectivity scores for workers with depressive symptoms were significantly higher than those for workers without depressive symptoms （P〈0.01） but job control, social support, reward, job satisfaction and positive affectivity scores for workers with depressive symptoms were significantly lower than those for without depressive symptoms （P〈0.01）. Psychological demands, physical demands, job control, effort, overcommitment and nagetive affectivity scores for male workers with depressive symptoms were significantly higher than those for female counterparts （P〈0.01 ）, but social support, reward, job satisfaction scores for male workers with depressive symptoms were significantly lower than hose for female workers with depressive symptoms （P〈0.01）. Ratio of male workers and male workers with depressive symptoms with job strain and ERI 〉1, high demands and low control, and high effort and low reward were higher than female counterparts （P〈0.01）. The risk of depressive symptoms for female with high demands and low control was about two times as high as that for female workers with low demands and high control for psycholog!eal demands and physical demands （OR=2.0）, risk for females was slightly higher than that for males （OR=2.04 and 2.17, respectively）. The risk of depressive symptoms for workers with high efforts and low rewards was about two times as high as that for workers with low efforts and high rewards （0R=1.70）. No interactive effect between gender and job strain and ERI on depressive symptoms were found. Conclusion The gender difference of relationship between depressive symptom prevalence and job strain may due to the difference of psychosocial factors between females and males. There may be no interactive effect between psychosocial factors and gender on depressive symptoms.