The associations between childhood trauma and work functioning in adult workers with and without depressive and anxiety disorders
The associations between childhood trauma and work functioning in adult workers with and without depressive and anxiety disorders
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DOI：
10.1192/j.eurpsy.2020.70
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发表时间：
2020-01-01
影响因子：
7.8
通讯作者：
Penninx, Brenda W. J. H.
中科院分区：
文献类型：
--
作者：
De Venter, Maud;Elzinga, Bernet M.;Penninx, Brenda W. J. H.
背景：研究童年创伤和工作功能之间的联系，并阐明这种联系在多大程度上可以用抑郁和/或焦虑来解释。方法：1649名工作参与者的数据来自荷兰抑郁与焦虑研究（NESDA, n = 2981）。儿童创伤（16岁前的情感忽视、心理、身体和性虐待）分别通过结构化访谈和旷工和出勤的工作功能进行评估，并使用健康和劳动问卷简表（SF-HLQ）和世界卫生组织残疾评估表II （WHODAS-II）。抑郁和/或焦虑障碍用综合访谈诊断工具（CIDI）进行评估。进行了中介分析。结果：在基线时，44.8%的人报告曾经历过童年创伤。儿童期创伤程度最高的工人旷工率和出勤率均显著增加（p < 0.001）。中介分析显示，当前抑郁障碍（p = 0.023, p < 0.001）和当前抑郁焦虑共病（p = 0.020, p < 0.001）显著介导了儿童创伤指数和两项工作指数之间的间接影响，其中后者的影响最大（p - m = 0.23, p - m = 0.29）。未发现当前焦虑障碍与已缓解的抑郁和/或焦虑障碍之间存在显著的中介作用。结论：童年创伤的人在旷工和出勤方面显著降低了工作功能。这似乎在很大程度上是由当前的抑郁症和当前的抑郁焦虑共病造成的。
Background: To examine the association between childhood trauma and work functioning, and to elucidate to what extent this association can be accounted for by depression and/or anxiety.Methods: Data of 1,649 working participants were derived from the Netherlands Study of Depression and Anxiety (NESDA, n = 2,981). Childhood trauma (emotional neglect, psychological, physical, and sexual abuse before age 16) was assessed with a structured interview and work functioning, in terms of absenteeism and presenteeism, with the Health and Labor Questionnaire Short Form (SF-HLQ) and the World Health Organization Disability Assessment Schedule II (WHODAS-II), respectively. Depressive and/or anxiety disorders were assessed with the Composite Interview Diagnostic Instrument (CIDI). Mediation analyses were conducted.Results: At baseline, 44.8% reported to have experienced childhood trauma. Workers with the highest childhood trauma level showed significantly (p < 0.001) more absenteeism as well as more presenteeism. Mediation analyses revealed that indirect effects between the childhood trauma index and both work indices were significantly mediated by current depressive disorder (p = 0.023 and p < 0.001, respectively) and current comorbid depression-anxiety (p = 0.020 and p < 0.001, respectively), with the latter accounting for the largest effects (P-M = 0.23 and P-M = 0.29, respectively). No significant mediating role in this relationship was found for current anxiety disorder and remitted depressive and/or anxiety disorder.Conclusions: Persons with childhood trauma have significantly reduced work functioning in terms of absenteeism and presenteeism. This seems to be largely accounted for by current depressive disorders and current comorbid depression-anxiety.