目的:这项研究的目的是调查暴露于与工作有关的暴力/威胁和骚扰之间的关联。以及由于常见精神障碍(CMD)而导致的未来疾病缺席(SA),考虑家族因素(共有遗传和早期生活环境)和神经质。
方法:研究样本包括来自瑞典残疾养老金和疾病缺席(STODS)双胞胎项目的8795名双胞胎个体,包括来自双胞胎成人研究的调查数据:基因和环境(阶段)。使用标准逻辑回归分析了由于CMD而导致的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)和国家注册数据。和暴露不一致的完整双胞胎对之间的条件逻辑回归。对个人进行了最长13年的随访。使用乘法和加性相互作用分析评估了神经质与暴露之间的相互作用。
结果:在调整年龄时,由于CMD,暴露于与工作相关的暴力/威胁与更高的SA几率相关,性别,婚姻状况,孩子们,教育,生活区的类型,工作特点,抑郁和倦怠症状(OR2.11,95%CI1.52-2.95)。还发现,由于CMD而导致的SA暴露于骚扰(OR1.52,95%CI1.10-2.11)以及暴露于暴力/威胁和/或骚扰的综合指标(OR1.98,95%CI1.52-2.59),与未暴露的相比。双胞胎暴露不一致的分析,使用未暴露的共同双胞胎作为参考,显示OR降低。这些OR仍然升高,但不再具有统计学意义,可能是由于缺乏统计能力。在神经质和接触与工作相关的暴力/威胁之间没有发现乘法相互作用,或骚扰。然而,在神经质和暴露于暴力/威胁之间发现了统计学上显著的累加相互作用,表明在神经质得分较低的组中,由于CMD导致的SA几率较高。
结论:由于CMD,暴露于与工作相关的攻击性行为与SA相关。然而,结果表明,这些关联可能部分被家族因素所混淆.此外,提出了暴露和神经质之间的相互作用。因此,如果可能,未来研究调查工作中的攻击性行为与心理健康相关结果之间的关联和因果关系,应该考虑家族因素和神经质。
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.