Christine Cohidon

Prevalence of common mental disorders and their work consequences in France, according to occupational category.

BACKGROUND The aims of the study are to estimate the prevalence of the common mental disorders according to occupational category and to describe the consequences of these disorders on their work, in the French population. METHODS It took place in France from 1999 to 2003. The sample consisted of about 36,000 people aged 18 years and older. Data were collected face-to-face using the Mini International Neuropsychiatric Interview (MINI). RESULTS Anxiety disorders were most common (17% in men and 26% in women), while prevalence estimates for mood disorders were 10% in men and 14% in women. Prevalence of troubles were consistently higher among those in the lowest occupational categories. Among those reporting mental disorders, about 50% said that their work was affected. The repercussions on job varied by occupational category and differently for men and women. CONCLUSION This study shows the social and occupational inequalities in the prevalence of mental disorders and their important work consequences in the French working population. Am. J. Ind. Med. 52:141-152, 2009. (c) 2008 Wiley-Liss, Inc.

Depressive symptoms and atypical jobs in France, from the 2003 Decennial health survey.

BACKGROUND The objective is to study the relations between depressive symptoms and atypical jobs in the working population in France and to determine if these associations might be linked with psychosocial and organizational constraints. METHODS The data come from the 2003 Decennial health survey and concern 11,895 workers. Depressive symptoms were measured by the CES-D scale. Atypical jobs were defined by employment status (fixed-term or temporary job contract, permanent job contract, self-employed) and by part-time work during working life (involuntary or chosen). Working conditions related to atypical hours and psychosocial factors were also studied. RESULTS For both sexes, involuntary part-time work was associated with a higher frequency of depressive symptoms, but part-time work by choice was not. Fixed-term contracts were associated with depressive symptoms only in women. All of these associations persisted after adjustment for psychosocial and organizational factors. CONCLUSION The associations between atypical jobs and depressive symptoms differ for job status according to sex and do not seem to be associated with the worst psychosocial working conditions. The interpretation of these results is nonetheless limited in part by the cross-sectional nature of the survey.

Psychosocial exposures at work and mental health: potential utility of a job-exposure matrix.

Objective: To examine the associations between psychosocial exposures at work and depressive symptoms by using two independent French national databases. Methods: A job-exposure matrix of psychosocial work exposures was constructed from data collected by the national medical monitoring of occupational risks survey in 2003. Depressive symptoms came from the 2002 to 2003 decennial health survey. Data were linked by age, occupational group, and economic activity. Results: The crude and adjusted results showed small but significant and systematic associations between job strain and depressive symptoms among men. These associations were much weaker for psychological demands and decision latitude. No statistical associations were observed among women. Conclusion: The results suggest that, among men, using independent data on exposure and health, there is a robust association between job strain and depressive symptoms. They contribute to the debate about the causal nature of associations between psychosocial exposures at work and mental health.

Psychotropic Drug Use in a Cohort of Workers 4 Years After an Industrial Disaster in France

Two years after the 2001 Toulouse industrial disaster, a longitudinal study was set up to evaluate the impact of the disaster. The current substudy examines the medium-term impact (5 years) the incident had on the mental health of 3,004 participants. As part of the monitoring, data relating to the psychotropic drug use of 2,494 participants were collected from administrative databases 4 years after the disaster. Use of psychotropics was higher among women for anxiolytics (10.4% for men and 15.0% for women), hypnotics (10.5% and 17.0%), and antidepressants (7.6% and 11.2%). Exposure to the disaster, especially proximity to the exposure, was significantly associated with the use of antidepressants in men, OR = 3.22, 95% CI[1.57, 6.61]. This was also the case for other exposure factors (saw dead or injury, injured, home damage, death or injury loved one, psychological disorders, exposure toxic fumes): range of OR 1.75 to 2.52 in men, 1.48 to 1.62 in women. In conclusion, this study highlights the medium-term psychological impact of an industrial disaster on psychotropic drug use and the potential for using medical records data as a means for tracking postdisaster mental health.

0145 Surveillance of mortality by suicide among French farmers

Objectives An excessive risk of suicide among agriculture workers has been observed in several studies in France and abroad. Accordingly, French Institute for Public Health Surveillance and Social Insurance in agriculture sector launched collaboration with aim at producing indicators of suicide mortality among agriculture workers population on a regular basis. Method The study population included all active farmers and their collaborating spouses. The study covered tree consecutive years: 2007 to 2009. Mortality data by cause from death registrations were used to calculate standardised mortality ratios (SMRs) for both men and women. Results The annual study population was around 500 000 subjects in average, including 68% of men. During the 3-year study period, 2769 men and 997 women were deceased. From these deaths, 417 deaths were due to suicide among men and 68 deaths among women. Suicides represented the third most important cause of death. The comparison of mortality among male study population with that of French national male population revealed a 28%-excess in mortality by suicide in 2008 and 22%-excess in 2009. This excess was particularly high among the 45–64 year age category and in cattle breeding-dairy and meat -sectors. These sectors presented the highest over mortality due to suicide in 2008 and 2009. Conclusions The first results of this study confirm the necessity to continue the surveillance in this population. Especially, further analysis could provide more information to document risk factors of this excess.

Suicide and occupation: first assessments from French available data

Objectives Suicide is a complex and multifactorial phenomenon. The number of work-related suicides is difficult to assess in France. There are nevertheless some data available to document this problem. The aim of this study is to describe suicide mortality and its temporal evolution in employees (men) according to economic sectors in France. Methods The description of suicide mortality comes from the Cosmop programme, conducted by the Department of Occupational Health/InVS. Individual administrative occupational data (DADS-Panel/Insee) have been linked to the medical causes of death from the French National Death Registry (CépiDc/Inserm). Suicide mortality (age-standardised) were calculated in men employees each year from 1976 to 2002 according to economic sector (agriculture sector excluded). Results Over the period from 1976 to 2002, the age-standardised mortality from suicide is estimated at 25.5/100 000. There is no significant temporal trend. However, the mortality differs according to economic sector. The human health and social activities present the highest mortality (34.3/100 000) followed by the public administration (29.8/100 000), the construction (27.3/100 000) and the real estate activities (26.7/100 000). Conclusions This study points out inequalities of mortality by suicide according to economic sectors. However, there is a relative stability over time in the working population between 1976 and 2002 which is overlapping the trend observed in the general population. Despite some limitations (in particular the absence of agricultural workers and a part of civil servants), these results provide a first assessment on suicide mortality according to economic sectors in France.