Background

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.

Methods

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.

Results

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.

Conclusion

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.

中文翻译：

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工作压力和家庭压力与重度抑郁发作风险的关联：一项针对美国职业男性和女性的前瞻性队列研究

 背景

评估社会心理压力与抑郁症之间的性别差异的研究显示出好坏参半且不一致的结果。我们的目标是研究美国工人中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，并评估性别带来的潜在影响。

 方法

使用具有全国代表性和以人群为基础的美国中年 (MIDUS) 研究的数据，采用前瞻性队列设计和 9 年随访期，研究基线工作压力和家庭压力对 MDE 风险的影响通过多元泊松回归分析，对基线调查前 12 个月内未患 MDE 的 1581 名工人（805 名男性，776 名女性）进行了跟踪评估前 12 个月内的检查。

 结果

调整相关协变量后，有证据表明性别对工作压力和 MDE 之间的关联有影响，但对家庭压力和 MDE 之间的关联没有影响。事实上，高工作压力与男性 MDE 风险存在前瞻性相关（RR 和 95% CI = 2.14 [1.14, 4.03]），但与女性无关。此外，在整个样本中，高家庭压力与较高的 MDE 风险前瞻性相关（RR 和 95% CI = 1.57 [1.05, 2.37]）。

 结论

无论性别如何，家庭压力都与 MDE 风险相关。相比之下，高工作压力可能只会增加男性罹患 MDE 的风险，而女性则不会。