Zusammenfassung
In dieser Studie wurde geprüft, ob in einer Gruppe Erwerbstätiger mittleren Alters
ein Zusammenhang zwischen dem Ausmaß erfahrener psychosozialer Arbeitsbelastungen
und depressiven Symptomen besteht. Psychosoziale Arbeitsbelastungen wurden anhand
des Modells beruflicher Gratifikationskrisen erfasst, das mittels einer psychometrischen
Skala gemessen wurde. Depressive Symptome wurden mithilfe der Allgemeinen Depressionsskala
(ADS) erhoben. Die Untersuchungsgruppe bestand aus 316 männlichen und weiblichen Beschäftigten
eines großstädtischen Verkehrsbetriebs (44,6 ± 7,5 Jahre). Anhand logistischer Regressionsanalysen
wurde ermittelt, dass nach statistischer Kontrolle konfundierender Variablen Beschäftigte,
welche durch ein Ungleichgewicht von Verausgabung und Belohnung bei der Arbeit belastet
waren, ein 5,9fach erhöhtes Risiko (95 %-Konfidenzintervall 2,4 - 14,3) gegenüber
beruflich nicht Belasteten aufwiesen, von depressiven Symptomen betroffen zu sein.
Ähnlich hoch war das Risiko bei Personen, welche eine übersteigerte berufliche Verausgabungsneigung
aufwiesen.
Abstract
This study explored associations of psychosocial stress at work with depressive symptoms
in a group of middle-aged employees. Psychosocial stress at work was conceptualized
in terms of the model of effort-reward imbalance. This model is measured by a psychometric
scale containing 23 Likert-scaled items. Depressive symptoms were assessed by the
German version of the CES-D scale. The sample consisted of 316 (44.6 ± 7.5 years)
men and women employed in an urban transport enterprise. Multivariate logistic regression
analysis adjusting for relevant confounders indicated an odds ratio of 5.9 (95 % CI
2.4 - 14.3) for depressive symptoms among employees defined by imbalance of high effort
and low reward at work. An association of similar strength was found among employees
characterized by a high level of work-related overcommitment. Findings reported for
the first time in Germany are in line with two international investigations.
Key words
Depressive symptoms - psychosocial work stress - effort-reward imbalance - overcommitment
Literatur
1
Tylee A, Gastpar M, Lepine J P, Mendlewicz J.
DEPRESS II (Depression Research in European Society II): a patient survey of the symptoms,
disability and current management of depression in the community. DEPRES Steering
Committee.
Int Clin Psychopharmacol.
1999;
14
139-151
2
Weissman M M, Olfson M.
Depression in women: implications for health care research.
Science.
1995;
269
799-801
3
Wittchen H-U, Hofler M, Meister W.
Prevalence and recognition of depressive syndromes in German primary care settings:
poorly recognized and treated?.
Int Clin Psychopharmacol.
2001;
16
121-135
4 Murray C JL, Lopez A D. The global burden of disease: a comprehensive assessment
of mortality and disability from disease, injuries, and risk factors in 1990 and projected
to 2020. Cambridge; Harvard University Press 1996
5
Ferketich A K, Schwartzbaum J A, Frid D J, Moeschberger M L.
Depression as an antecedent to heart disease among women and men in NHANES I study.
National Health and Nutrition Examination Survey.
Arch Intern Med.
2000;
160
1261-1268
6
Horsten M, Mittleman M A, Wamala S P, Schenck-Gustafsson K, Orth-Gomer K.
Depressive symptoms and lack of social integration in relation to prognosis of CHD
in middle-aged women. The Stockholm Female Coronary Risk Study.
Eur Heart J.
2000;
21
1072-1080
7
Sesso H D, Kawachi I, Fokonas P S, Sparrow D.
Depression and the risk of coronary heart disease in the Normative Ageing Study.
Am J Cardiol.
1998;
82
851-856
8
Björntorp P.
Heart and soul: stress and the metabolic syndrome.
Scand Cardiovascular J.
2001;
35
172-177
9
Dinan T G.
Glucocorticoids and the genesis of depressive illness. A psychology model.
Br J Psychiatry.
1994;
164
365-371
10
McEwen B S.
Protective and damaging aspects of stress mediators.
N Engl J Med.
1998;
338
171-179
11 Berkman L, Kawachi I. Social Epidemiology. Oxford; Oxford University Press 2000
12 Karasek R, Theorell T. Healthy Work: Stress, Productivity and the Reconstruction
of Working Life. New York; Basic Books Inc 1990
13
Siegrist J.
Adverse health effects of high effort - low reward conditions at work.
J Occup Health Psychol.
1996;
1
27-43
14
Siegrist J.
Reciprocity in basic social exchange and health: Can we reconcile person-based with
population-based psychosomatic research?.
J Psychsom Res.
1998;
45
99-105
15 Marmot M G, Siegrist J, Theorell T, Feeney A.
Health and the psychosocial environment at work. In: Marmot M, Wilkinson R (eds) Social Determinants of Health. Oxford; Oxford University
Press 1999: 105-131
16
Niedhammer I, Goldberg M, Leclerc A, Bugel I, David S.
Psychosocial factors at work and subsequent depressive symptoms in the GAZEL cohort.
Scand J Work Environ Health.
1998;
24
197-205
17
Mausner-Dorsch H, Eaton W.
Psychosocial work environment and depression: Epidemiologic assessment of the demand-control
model.
Am J Public Health.
2000;
90
1765-1770
18
Stansfeld S A, Fuhrer R, Shipley M J, Marmot M G.
Work characteristics predict psychiatric disorder: prospective results from the Whitehall
II Study.
Occup Environ Med.
1999;
56
302-307
19
Tsutsumi A, Kayaba K, Theorell T, Siegrist J.
Association between job stress and depression among Japanese employees threatened
by job loss in a comparison between two complementary job-stress models.
Scand J Work Environ Health.
2001;
27
146-153
20
Aust B, Peter R, Siegrist J.
Stress management in bus drivers: A pilot study based on the model of effort-reward-imbalance.
Int J Stress Management.
1997;
4
297-305
21
Peter R, Geissler H, Siegrist J.
Association of effort-reward imbalance at work and reported symptoms in different
groups of male and female public transport workers.
Stress Med.
1998;
14
175-182
22 Larisch M. Über den Zusammenhang zwischen Arbeitsbelastungen und depressiven Störungen. Düsseldorf;
Magisterarbeit im Zusatzstudiengang Public Health der Heinrich Heine-Universität 2001
23
Radloff L S.
The CES-D Scale: A self-report depression scale for research in the general population.
Appl Psychological Measurement.
1977;
1
385-401
24 Hautzinger M, Bailer M. Allgemeine Depressionsskala, Manual. Göttingen; Beltz Test
1993
25 Siegrist J, Starke D, v d Knesebeck O, Joksimovic L, Dragano N, Larisch M. Soziale
Reziprozität und Gesundheit - eine exploratorische Studie zu beruflichen und außerberuflichen
Gratifikationskrisen. Düsseldorf; Unveröffentlichter Forschungsbericht. Inst für Med
Soziologie der Universität 2002
26
Niedhammer I, Siegrist J, Landre M F, Goldberg M, Leclerc A.
Étude des qualités psychométriques de la version francaise du modèle du Déséquilibre
Efforts/Récompenses.
Rev Epidemiol Sante Publique.
2000;
48
419-437
27 Adam C. Depressive Störungen im Alter. Weinheim; Juventa 1998
28
Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B.
The job content questionnaire (JCQ): an instrument for internationally comparative
assessments of psychosocial job characteristics.
J Occup Health Psychol.
1998;
3
322-355
29
Efron B.
The efficiency of logistic regression compared to normal discriminant analysis.
J Am Statistic Assoc.
1975;
70
892-898
30 Siegrist J, Broer M, Junge A. Profil der Lebensqualität chronisch Kranker, Manual. Göttingen;
Beltz Test 1996
31
Joksimovic L, Starke D, von dem Knesebeck O, Siegrist J.
Perceived work stress, overcommitment and self reported muskulosceletal pain: a cross-sectional
investigation.
Int J Behav Med.
2002;
9
122-138
32 Siegrist J. Soziale Krisen und Gesundheit. Göttingen; Hogrefe 1996
Univ.-Prof. Dr. Johannes Siegrist
Heinrich-Heine-Universität Düsseldorf · Institut für Medizinische Soziologie
Postfach 101007
40001 Düsseldorf