Multifaceted ORganizational InterventiONs (M-ORION) project for prevention of depression and anxiety among workers: study protocol for a five-arm cluster randomized controlled trial.

BACKGROUND: Depression and anxiety are the most common mental health issues experienced by workers. Although organizational intervention has been extensively evaluated as a primary prevention of depression and anxiety, the corresponding scientific evidence remains limited because of the lack of cluster randomized controlled trials (cRCT) and failure to detect organizational-level effects. Therefore, the present study aims to assess the preventive effects of four types of interventions on depression and anxiety among workers in an open, five-arm, parallel-group cRCT. METHODS: Overall, 140 worksites and 18,200 nested employees will be recruited from September 2023. The eligible worksites will be randomly assigned to each of the five arms, and programs will be offered for 6-12 months. The five arms are 1) psychoeducation for workers, 2) psychoeducation for supervisors, 3) work environment improvement, 4) physical activity promotion, and 5) active control. The primary outcomes of interest are depression and anxiety. We will also assess psychosocial factors at work, work engagement, health-related quality of life, well-being, economic outcomes, physiological outcomes of health checkups, cortisol levels extracted from fingernails, and indices representing the process and implementation outcomes, including program completion rates. Follow-up surveys will be conducted at 6, 12, and 18 months from baseline, and the primary endpoint is set at the 6-month follow-up. Repeated-measures multi-level mixed modeling will be used to evaluate the effect of each intervention compared with the control. ETHICS AND DISSEMINATION: The study protocol was approved by the Research Ethics Committee of the Kitasato University Medical Ethics Organization (C22-082). The results and findings of this study will be published in a scientific journal and disseminated to companies that participate in the study. TRIAL REGISTRATION NUMBER: UMIN000050949.

The effects of pregnancy discrimination on postpartum depressive symptoms: a follow-up study.

BACKGROUND: Pregnancy discrimination in the workplace is prevalent worldwide. However, few studies have examined the effects of pregnancy discrimination on mothers' perinatal mental health. We aimed to investigate the association between pregnancy discrimination and postpartum depressive symptoms, and the mediation effects of prenatal depressive symptoms on this association. METHODS: Our sample consisted of 285 Japanese women employed during pregnancy who completed a baseline online survey in May 2020 and a follow-up mail survey two months postpartum. Pregnancy discrimination was defined as exposure to any of 16 forms of disadvantageous treatment or harassment related to pregnancy, prohibited by national guidelines. Prenatal (assessed at baseline) and postpartum (assessed at follow-up) depressive symptoms were measured using the Edinburgh Postnatal Depression Scale. Multiple linear regression and mediation analyses were performed overall and stratified by regular (permanent) and non-regular (precarious) employees. RESULTS: Overall, 23.9% of participants experienced pregnancy discrimination during pregnancy. After adjusting for potential confounders, pregnancy discrimination was significantly associated with postpartum depressive symptoms (coefficient 1.76, 95% confidence interval [CI] 0.65-2.88). When stratified by employment type, these effects were observable among non-regular employees (coefficient 2.51, 95% CI 0.45-4.57) but not regular employees. Mediation analysis showed that prenatal depressive symptoms mediated 57.1% (95% CI 20.1-94.1%) of the association between pregnancy discrimination and postpartum depressive symptoms among all participants, with a greater effect among non-regular employees (64.1% [95% CI 18.5-109.8%]). CONCLUSIONS: Pregnancy discrimination has adverse effects on postpartum depressive symptoms, partially through prenatal depressive symptoms, especially among non-regular employees. To prevent perinatal depression in female workers, employers should comply with legislation and take preventive measures against pregnancy discrimination, while considering vulnerable employees.

Mothers' nonstandard work schedules and adolescent obesity: a population-based cross-sectional study in the Tokyo metropolitan area.

BACKGROUND: Many wage earners in developed countries have irregular shift patterns and work evenings, nights, and weekends. Some studies have demonstrated that the nonstandard work schedules of parents have adverse effects on their children's weight, specifically leading to or worsening obesity. However, no such study has been conducted in adolescents of high school age. This study examined the association between mothers' nonstandard work schedules and adolescent obesity. METHODS: A cross-sectional study of adolescents aged 16-17 years (n = 1743) used paired matches of self-administered questionnaires for adolescents and their mothers from Tokyo, Japan. Obesity was defined by International Obesity Task Force cut-offs. Nonstandard work schedules were defined as working early mornings, nights, overnights, or weekends. Chi-square tests were conducted to examine the association between the mothers' work schedules and their adolescent children's poor lifestyles, overall and stratified by income levels. Then, logistic regression analyses were conducted to examine the association between mothers' work schedules and obesity of their adolescent children, overall and stratified by income levels. RESULTS: Overall, 6.5% of adolescents had obesity. The prevalence of obesity was higher among adolescents from low-middle income groups (8.2%) than that among those from high-income groups (5.9%). No clear patterns were found between mothers' work schedules and adolescents' poor lifestyles when stratified by income levels. Mothers' nonstandard work schedules were significantly associated with adolescent obesity (odds ratio [OR]: 1.56, 95% confidence interval [CI]: 1.02-2.40). However, this association was not significant after adjustment for confounders. After stratification by income levels, mothers' nonstandard work schedules significantly associated with their children's obesity (OR: 2.93, 95% CI: 1.45-5.92) only in high-income groups. This association remained after adjustment of the adolescents' lifestyles and their mothers' working hours. CONCLUSIONS: Our results suggest that mothers' nonstandard work schedules have adverse effects on adolescent obesity only in high-income families. Low-middle income families experienced higher levels of adolescent obesity, regardless of the mothers' work schedules. Policy makers should consider mothers' work schedules as a factor in preventing adolescent obesity.

Factors Related to Oncologists' Use of the Disease Treatment and Employment Support Guidance Fee.

The purpose of this study is to examine the factors related to oncologists' use of the disease treatment and employment support guidance fee in Japan. A cross-sectional online survey was conducted in January 2021 among all the diplomates of the subspecialty board of medical oncology in the Japanese Society of Medical Oncology (n = 1,452), using the official mailing list. Logistic regression analysis was used to investigate the association between demographic and other factors and use of the disease treatment and employment support guidance fee. In total, 146 individuals participated in the study (response rate 10.0%). Experience of using the fee was associated with medical specialty and knowledge of the Guideline for Workplace Patient Coordination and Disease Treatment. It may be possible to increase the use of the disease treatment and employment support guidance fee among oncologists by raising awareness of the Guideline for Workplace Patient Coordination and Disease Treatment.

Spouse Factors Related to the Leave Period of Employees on Temporary Leave for Depression.

In depression, the health condition of family members (particularly spouses) may influence the reinstatement process of employees on temporary leave. The length of leave from work may reflect the quality of the process leading to the stage of reinstatement, and a short period to reinstatement may increase the possibility of a smooth reinstatement. In this study we investigated the relationship between spouse factors and length of leave period. The subjects were 63 permanent employees on temporary leave for depression and their spouses. We investigated demographic characteristics, spouse factors, individual factors, household factors, and workplace factors, and extracted the factors related to the length of leave period through hierarchical multiple regression analysis. Results revealed that the Frenchay Activities Index (FAI), a spouse factor, was consistently and significantly related to the length of leave (ß = -0.37, P < 0.01). The higher the spouse FAI, the shorter the leave period of employees on temporary leave. In particular, the spouses' leisure activities were related to the leave period, whereas the effects of housework and work were unclear. The results suggest that the assessment and intervention of the spouses' activities of daily living are important in reinstatement support.

Protocol for a Nationwide Internet-based Health Survey of Workers During the COVID-19 Pandemic in 2020.

The ever-changing social implications of the COVID-19 pandemic have resulted in an urgent need to understand the working environments and health status of workers. We conducted a nationwide Internet-based health survey of Japanese workers in December 2020, in the midst the country's "third wave" of COVID-19 infection. Of 33,087 surveys collected, 6,051 were determined to have invalid responses. The 27,036 surveys included in the study were balanced in terms of geographical area, sex of participants, and type of work, according to the sampling plan. Men were more likely than women to have telecommuted, while women were more likely to have resigned since April 2020. Forty percent and 9.1% of respondents had a K6 score of 5 or higher and 13 or higher, respectively, and they did not exhibit extremely poor health. The present study describes the protocol used to conduct an Internet-based health survey of workers and a summary of its results during a period when COVID-19 was spreading rapidly in Japan. In the future, we plan to use this survey to examine the impact of COVID-19 on workers' work styles and health.

Work-Family Spillover, Job Demand, Job Control, and Workplace Social Support Affect the Mental Health of Home-Visit Nursing Staff.

The primary purpose of this study was to clarify the path by which high job demands on home-visit nursing staff affect their mental health through work-family negative spillover (WFNS, FWNS). The secondary purpose was to clarify the path by which high job control and high social support in the workplace positively affect the mental health of nursing home-visit staff through work-family positive spillover (WFPS, FWPS). A cross-sectional survey using a self-administered questionnaire was conducted on 1,022 visiting nursing staff working at 108 visiting nursing stations in Fukuoka Prefecture in February, 2019. The measurement tools comprised sociodemographic factors, the Japanese version of the Survey Work-Home Interaction - NijmeGen (SWING-J), Job Content Questionnaire (JCQ-22), the Work-Family Culture Scale, and the K6 scale. Six models were determined in an analysis of the model: (1) working time load → WFNS → FWNS → psychological distress, (2) job demands → WFNS → FWNS → psychological distress, (3) job demands → psychological distress, (4) workplace support → job control → WFPS → psychological distress, (5) workplace support → WFPS → psychological distress, and (6) workplace support → psychological distress. This study clarified that job demands and working time load may adversely affect the mental health of home-visit nursing staff through the mediation of WFNS. It was also clarified that high job control and workplace support may have a positive effect on mental health through the mediation of WFPS.

Psychosocial Work Environment Explains the Association of Job Dissatisfaction With Long-term Sickness Absence: A One-Year Prospect Study of Japanese Employees.

BACKGROUND: Using a 1-year prospective design, we examined the association of job dissatisfaction with long-term sickness absence lasting 1 month or more, before and after adjusting for psychosocial work environment (ie, quantitative job overload, job control, and workplace social support) in Japanese employees. METHODS: We surveyed 14,687 employees (7,343 men and 7,344 women) aged 20-66 years, who had not taken long-term sickness absence in the past 3 years, from a financial service company in Japan. The Brief Job Stress Questionnaire, including scales on job satisfaction and psychosocial work environment, was administered, and information on demographic and occupational characteristics (ie, age, gender, length of service, job type, and employment position) was obtained from the personnel records of the surveyed company at baseline (July-August 2015). Subsequently, information on the start dates of long-term sickness absences was obtained during the follow-up period (until July 2016) from the personnel records. Cox's proportional hazard regression analysis was conducted. RESULTS: After adjusting for demographic and occupational characteristics, those who perceived job dissatisfaction had a significantly higher hazard ratio of long-term sickness absence than those who perceived job satisfaction (hazard ratio 2.91; 95% confidence interval, 1.74-4.87). After additionally adjusting for psychosocial work environment, this association was weakened and no longer significant (hazard ratio 1.55; 95% confidence interval, 0.86-2.80). CONCLUSIONS: Our findings suggest that the association of job dissatisfaction with long-term sickness absence is spurious and explained mainly via psychosocial work environment.

Occupational stress and the risk of turnover: a large prospective cohort study of employees in Japan.

BACKGROUND: Although several studies have examined the association between occupational stress and turnover, these studies relied on cross-sectional designs, subjects' self-report, healthcare workforce, or small sample sizes. This study aimed to confirm whether occupational stress increases the risk of turnover in a large-scale prospective cohort study using actual turnover data from company records. METHODS: The participants were 3892 male and 5765 female employees aged 20-49 years in a financial service company. We followed them from October 2012 until April 1, 2016 and used company records to identify employees who resigned. We identified employees with high and low stress using the Brief Job Stress Questionnaire. Hazard ratios for turnover in high-stress employees were estimated using Cox proportional hazards models, and population attributable risks were calculated separately for men and women. RESULTS: During 11,475,862 person-days, 122 men and 760 women resigned. After adjustment for age, length of service, job type, and position, the hazard ratios (95% confidence intervals) for turnover in high-stress employees were 2.86 (1.74-4.68) for men and 1.52 (1.29-1.78) for women. The corresponding population attributable risks for high stress were 8.2% for men and 8.3% for women. The component scores, i.e., job stressors, psychological/physical stress response, workplace social support, and job strain (the combination of high job demands and low job control) were also significantly associated with turnover (p < 0.05). CONCLUSIONS: Occupational stress increases the risk of actual turnover. Measures to prevent occupational stress may be useful to prevent employee turnover.

Organizational Justice and Refraining from Seeking Medical Care Among Japanese Employees: A 1-Year Prospective Cohort Study.

BACKGROUND: Using a 1-year prospective design, we examined the association of organizational justice (i.e., procedural justice and interactional justice) with refraining from seeking medical care (RSMC) among Japanese employees. METHODS: We surveyed 2695 employees (1994 men and 701 women) from two factories of a manufacturing company in Japan. A self-administered questionnaire comprising scales for measuring organizational justice (Organizational Justice Questionnaire) and potential confounders (i.e., demographic and socioeconomic characteristics as well as health-related behaviors) was administered at baseline (from April to June 2011). At 1-year follow-up (from April to June 2012), a single-item question was used to measure RSMC during the follow-up period. Multiple logistic regression analysis was conducted by gender. RESULTS: After adjusting for potential confounders, low procedural justice and low interactional justice at baseline were found to be significantly associated with higher odds of RSMC during the 1-year follow-up for male employees (odds ratio = 1.33 [95% confidence interval = 1.16-1.52], p < 0.001 and 1.15 [95% confidence interval = 1.02-1.29], p = 0.019, respectively). Similar patterns were observed for female employees (odds ratio = 1.37 [95% confidence interval = 1.08-1.74], p = 0.009 and 1.23 [95% confidence interval = 1.02-1.50], p = 0.035 for low procedural justice and low interactional justice, respectively). CONCLUSIONS: The present study provided evidence that the lack of organizational justice is positively associated with RSMC among Japanese employees, independently of demographic and socioeconomic characteristics as well as of health-related behaviors.

[A Field Survey of Working Conditions of Parents with Children Requiring Medical Care].

The number of children in Japan with disabilities who require medical care is increasing and is estimated to have reached about 17,000 in 2015. Their home care is a great burden on mothers, therefore it is presumed to be hard for the mothers to find outside employment. The aims of this survey are to clarify the working conditions of mothers of children with disabilities that require medical care, and to investigate effective social support for improving their working and economic status. We carried out an original questionnaire survey on parents of children with disabilities who were visiting the University Hospital of Occupational and Environmental Health, Japan or daycare facilities in Kitakyushu City. Seventy-five parents, including 73 mothers, responded. The median age of the enrolled children with disabilities was 9 years old. Thirty-two of the mothers who responded (42.7%, median age 40) were employed, but two-thirds of them were non-regular employees. Twenty-two of the mothers had experienced a loss of work because of their children's disabilities. There were no significant relationships among the working conditions, children's age, size of family and household income. Almost 89% of the mothers desired to get employment for their sense of worth and economic status, but almost 11% did not. This survey clarified that the employment rate of mothers of disabled children with special care needs was low, and that most of those who were employed had non-regular employment. It is important to support the mothers in finding employment for their mental and economic status, and special attention must be paid to the diversity of their needs.

Gender differences in the effects of job insecurity on psychological distress in Japanese workers: a population-based panel study.

PURPOSE: This study aimed to examine effects of persistence or change in job insecurity on psychological distress (PD) among Japanese community dwellers. METHODS: The sample comprised 889 men and 762 women aged 25-50 years who were employed and completed both wave 1 (2010) and wave 2 (2012) surveys of the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE). Job insecurity, a perception of threat of job loss, was self-reported in both waves to define persistence and change of the status. Logistic regression analysis was performed to compare PD (K6 score ≥ 5) at wave 2 for employees whose job security changed or who remained insecure with that of those who remained secure. RESULTS: Persistent job insecurity was associated with PD (for men, OR 1.64, 95% CI 1.03-2.63; for women OR 1.65, 95% CI 1.02-2.65), after adjustment for confounders. Additionally, change from secure to insecure perception was also associated with PD in men, while change from insecure to secure was associated with PD in women. Regardless of gender, these effects were observable among workers with children but not among those without children. CONCLUSIONS: Persistent job insecurity and change in job insecurity has adverse effects on PD, especially for workers with children. Gender differences in the effects of change in job security on PD might be explained by the social norms of gender roles and labor market gender segregation. Policy makers should consider dependent family and gender inequalities when developing policies to reduce job insecurity and its negative health effects.

Interaction effect of job insecurity and role ambiguity on psychological distress in Japanese employees: a cross-sectional study.

PURPOSE: We examined the interaction effect of job insecurity (JI) and role ambiguity (RA) on psychological distress in Japanese employees. METHODS: Overall, 2184 male and 805 female employees from two factories of a manufacturing company in Japan completed a self-administered questionnaire comprising the scales measuring JI (Job Content Questionnaire), RA (National Institute for Occupational Safety and Health Generic Job Stress Questionnaire), psychological distress (K6 scale), and potential confounders (i.e., age, education, family size, occupational class, and work shift). Taking psychological distress as a dependent variable, hierarchical multiple regression analyses were conducted by gender and employment status (i.e., permanent and non-permanent employees). An interaction term of JI × RA was included in the model. RESULTS: After adjusting for potential confounders, the main effects of JI and RA on psychological distress were significant regardless of gender or employment status. Furthermore, the significant interaction effect of JI × RA on psychological distress was observed among permanent male employees (ß = 0.053, p = 0.010). Post hoc simple slope analyses showed that the simple slope of JI was greater at higher levels of RA (i.e., one standard deviation [SD] above the mean) (ß = 0.300, p < 0.001) compared to lower levels of RA (i.e., one SD below the mean) (ß = 0.212, p < 0.001). On the other hand, the interaction effect of JI × RA was not significant among permanent or non-permanent female employees. CONCLUSIONS: The present study suggests that higher levels of RA strengthen the association of JI with psychological distress, at least among Japanese permanent male employees.

Co-worker perceptions of return-to-work opportunities for Japanese cancer survivors.

PURPOSE: This study examined workplace factors and perceptions of Return-to-Work (RTW) opportunities for colleagues with cancer-related symptoms and/or treatment side effects in Japan. METHODS: We conducted an online, cross-sectional survey of 3710 employed Japanese individuals of working age. Colleagues' perceptions of RTW opportunities for cancer survivors were examined (using a Japanese questionnaire), along with workplace factors such as job demand, job control and workplace social support (using the Brief Job Stress Questionnaire). Associations between workplace factors and RTW opportunities were evaluated using multiple logistic regression analysis, with participants stratified in tertiles (low, middle and high) according to their levels of workplace social support and job control. RESULTS: Colleagues' perceptions of inadequate RTW opportunities were associated with low workplace social support (middle tertile: Odds Ratio [OR] 1.22, 95% Confidence Interval [CI]: 1.08-1.36; low tertile: OR 1.43, 95%CI: 1.30-1.57; p for trend <0.01); low levels of job control (middle tertile: OR 1.27, 95%CI: 1.06-1.50; low tertile: OR 1.91, 95%CI: 1.64-2.21; p for trend <0.01); and no prior experience working with a cancer survivor (OR 2.08, 95%CI: 1.83-2.31). CONCLUSIONS: This study suggests that workplace factors and prior experience of working with a cancer survivor may affect a colleagues' perception of RTW opportunities in Japanese workplaces. Consideration of workplace social factors (workplace support and job control), as well as increased openness and awareness of the particular needs of cancer survivors, is therefore essential to facilitate successful RTW in Japan, as elsewhere.Copyright © 2016 John Wiley & Sons, Ltd.

Psychosocial factors and colleagues' perceptions of return-to-work opportunities for workers with a psychiatric disorder: a Japanese population-based study.

BACKGROUND: This study examined associations between psychosocial factors and the perception that adequate employment opportunities might not be provided for people with limited work capacity due to psychiatric disorders. METHODS: We conducted an online, cross-sectional survey of 3,710 employed individuals aged 20 to 69 years in Japan. Our survey included the Brief Job Stress Questionnaire and investigated participants' perception of opportunities in their workplace for individuals with a psychiatric disorder returning to work (colleagues' negative perception) and psychosocial factors (job demand, job control, and workplace social support). Multiple logistic regression analysis was used to evaluate potential associations between psychosocial factors and colleagues' negative perception. RESULTS: Colleagues' negative perception was associated with low workplace social support (middle tertile: Odds Ratio [OR]: 1.26, 95% Confidence Interval [CI]: 1.12-1.40; low tertile: OR 1.45, 95% CI: 1.32-1.58; p for trend <0.01); low levels of job control (middle tertile: OR 1.22, 95% CI: 1.06-1.38; low tertile: OR 1.64, 95% CI: 1.46-1.81; p for trend <0.01); and no previous experience working with a person with a psychiatric disorder (OR 1.74, 95% CI: 1.60-1.88). CONCLUSIONS: Psychosocial factors may affect colleagues' perceptions of individuals with a psychiatric disorder returning to work in Japan. Greater consideration of psychosocial factors in the workplace may be necessary to facilitate people with a psychiatric disorder successfully returning to work in Japan, as elsewhere.

Modifying effect of cigarette smoking on the association of organizational justice with serious psychological distress in Japanese employees: a cross-sectional study.

PURPOSE: We examined the modifying effect of cigarette smoking (i.e., smokers vs. non-smokers) on the association of organizational justice (i.e., procedural justice and interactional justice) with serious psychological distress (SPD) in Japanese employees. METHODS: Overall, 2838 participants from two factories of a manufacturing company in Japan completed a self-administered questionnaire comprising the scales on organizational justice (Organizational Justice Questionnaire), smoking status, psychological distress (K6 scale), demographic and occupational characteristics (i.e., gender, age, education, family size, history of depression, chronic physical conditions, occupation, and work form), and other health-related behaviors (i.e., drinking habit and physical activity). Multiple logistic regression analyses were conducted. In a series of analyses, interaction term of procedural justice or interactional justice with smoking status was included in the model. RESULTS: After adjusting for demographic and occupational characteristics as well as other health-related behaviors, low procedural justice and low interactional justice were significantly associated with SPD (defined as K6 ≥ 13). Furthermore, marginally significant interaction effect of procedural justice with smoking status was observed. Specifically, the association of low procedural justice with SPD was greater among smokers [prevalence odds ratio 7.13 (95 % confidence interval 3.25-15.7) for low vs. high procedural justice subgroup] than among non-smokers [prevalence odds ratio 2.34 (95 % confidence interval 1.52-3.60) for low vs. high procedural justice subgroup]. On the other hand, interaction effect of interactional justice with smoking status was not significant. CONCLUSIONS: Cigarette smoking seems to have a harmful effect on the association of the lack of procedural justice with SPD in Japanese employees.

Source-specific workplace social support and high-sensitivity C-reactive protein levels among Japanese workers: A 1-year prospective cohort study.

BACKGROUND: This study investigated the prospective association between source-specific workplace social support and high-sensitivity C-reactive protein (hs-CRP) levels in workers in Japan. METHODS: We conducted a 1-year prospective cohort study with 1,487 men and 533 women aged 18-65 years. Participants worked at two manufacturing worksites in Japan and were free of major illness. We used multivariable linear regression analyses to evaluate the prospective association between supervisor and coworker support at baseline, and hs-CRP levels at follow-up. We conducted the analyses separately for men and women. RESULTS: For women, high supervisor support at baseline was significantly associated with lower hs-CRP levels at follow-up (ß = -0.109, P < 0.01), whereas coworker support at baseline was not significantly associated with hs-CRP levels at follow-up. Associations between supervisor and coworker support and hs-CRP levels were not significant for men. CONCLUSIONS: Supervisor support may have beneficial effects on inflammatory markers in working women. Am. J. Ind. Med. 59:676-684, 2016. © 2016 Wiley Periodicals, Inc.

An international comparison of occupational health guidelines for the management of mental disorders and stress-related psychological symptoms.

BACKGROUND: We compared available guidelines on the management of mental disorders and stress-related psychological symptoms in an occupational healthcare setting and determined their development and reporting quality. METHODS: To identify eligible guidelines, we systematically searched National Guideline Clearinghouse, Guidelines International Network Library and PubMed. Members of the International Commission on Occupational Health (ICOH), were also consulted. Guidelines recommendations were compared and reporting quality was assessed using the AGREE II instrument. RESULTS: Of 2126 titles retrieved, 14 guidelines were included: 1 Japanese, 2 Finnish, 2 Korean, 2 British and 7 Dutch. Four guidelines were of high-reporting quality. Best described was the Scope and Purpose, and the poorest described were competing interests (Editorial independence) and barriers and facilitators for implementation (Applicability). Key recommendations were often difficult to identify. Most guidelines recommend employing an inventory of symptoms, diagnostic classification, performance problems and workplace factors. All guidelines recommend specific return-to-work interventions, and most agreed on psychological treatment and communication between involved stakeholders. DISCUSSION: Practice guidelines to address work disability due to mental disorders and stress-related symptoms are available in various countries around the world, however, these guidelines are difficult to find. To promote sharing, national guidelines should be accessible via established international databases. The quality of the guideline's developmental process varied considerably. To increase quality and applicability, guideline developers should adopt a common structure for the development and reporting of their guidelines, for example Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. Owing to differences in social systems, developers can learn from each other through reviews of this kind.

Work engagement and high-sensitivity C-reactive protein levels among Japanese workers: a 1-year prospective cohort study.

PURPOSE: Evidence on the association between psychological well-being and high-sensitivity C-reactive protein (hs-CRP) levels is limited. We carried out a prospective study to investigate the association between work engagement and hs-CRP levels in a group of Japanese workers. METHODS: Our cohort included 1,857 men and 657 women aged 65 and under, and free from major illness, working at two manufacturing worksites in Japan. Baseline examinations were conducted from April to June 2011 to determine the demographic and lifestyle characteristics and levels of work engagement. Blood samples were obtained from participants at baseline and after 1 year. Participants were classified into tertiles of low, moderate, and high work engagement at baseline. Hs-CRP levels were split into low (≤3.0 mg/L) and high (>3.0 mg/L). We used multiple logistic regression analyses to evaluate the association between work engagement at baseline and hs-CRP levels at follow-up, adjusting for hs-CRP at baseline and potential confounding factors. RESULTS: Participants reporting moderate and high levels of work engagement at baseline had significantly lower odds ratios (ORs) of having high hs-CRP levels at follow-up than those with low levels of work engagement at baseline [OR of moderate level 0.44, 95% confidence interval (CI) 0.24-0.81; OR of high level 0.57, 95% CI 0.33-0.99; p for trend <0.05]. CONCLUSION: Findings suggest that work engagement has beneficial effects on workers' cardiovascular health.

Associations between psychological distress and the most concerning present personal problems among working-age men in Japan.

BACKGROUND: Personal problems are known to influence mental health among workers. The current study investigated the most concerning present personal problems which have the greatest impact on psychological distress among working-age Japanese men, rather than issues relating to work tasks or duties. METHODS: We obtained data from the 2010 Comprehensive Survey of Living Conditions conducted by the Ministry of Health, Labour and Welfare. The original survey interviewed 289,363 households in 5,150 randomly selected municipalities of Japan, from which 228,664 households agreed to participate. We analyzed the data pertaining to men who were 20 to 59 years of age and the head of a family. The questionnaire included occupation, employment status, the most concerning present personal problems, and a measure of psychological distress (the Kessler 6 scale). Multiple logistic regression analysis was conducted to delineate the association between present personal problems and psychological distress. RESULTS: A total of 76,950 males were included in the analysis, 27.7% of whom reported some type of psychological distress. Statistical analysis revealed that psychological distress was associated with bullying and harassment (Odds Ratio (OR): 2.05, 95% Confidence Interval (95% CI): 1.50-2.56), divorce (OR: 1.90, 95% CI: 1.53-2.26), concerns about one's purpose in life (OR: 1.73, 95% CI: 1.59-1.88), personal relationships with family members (OR: 1.49, 95% CI: 1.37-1.60), personal relationships with others (OR: 1.38, 95% CI: 1.29-1.48), own diseases (OR: 1.24, 95% CI: 1.15-1.33), and financial difficulties (OR: 1.16, 95% CI: 1.12-1.20); when compared with problems related to work tasks or duties. CONCLUSIONS: Several personal factors appear to have a greater impact on the mental health of Japanese men of working age, when compared to the influence of work tasks or duties. Asking workers directly about the problems that most concern them in life might help better identify those in need psychological support. Multidisciplinary interventions to address their life concerns will likely be necessary for solving these problems and reducing psychological distress.