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      Relationships between Depression and Stress Factors in Housework and Paid Work among Japanese Women

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          Abstract

          Objective/Background

          The prevalence of depression in women is two times as much as that in men. However, the rehabilitation programme for return to work for patients with depression in Japan mainly focuses on male individuals. Japanese working women usually have the central role in housework in addition to paid work. Therefore, we hypothesized that Japanese working women with depression need a support programme for housework as well as paid work. The purpose of this study was to investigate the stress factors relevant to the existence of depression, in both paid work and housework, among working women.

          Methods

          This study recruited 35 women with depression and 35 women without depression. We carried out a cross-sectional investigation with two questionnaires having the same structure: The National Institute for Occupational Safety and Health (NIOSH) Generic Job Stress Questionnaire (for paid work) and the NIOSH Generic Housekeeping Labor Stress Questionnaire (for housework). We extracted the stress factors contributing to the existence of depression using logistic regression.

          Results

          Three stress factors were found–-two in housework, and one in paid work. In housework, variance in workload and underutilization of abilities were associated with the presence of depression. In paid work, interpersonal conflict was an associated factor.

          Conclusion

          Rehabilitation programmes involving variance in workload and under self-evaluation in housework, and interpersonal conflict in paid work must be adequately addressed to support working women with depression.

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          Most cited references13

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          Gender, household labor, and psychological distress: the impact of the amount and division of housework.

          Using a national longitudinal survey of a representative sample of 1,256 adults, I assess the impact of the amount of household labor performed and its division within the household on men's and women's depression levels, adjusting for prior mental health status. I test two alternative explanations of the contributions of household labor and the division of household labor to gender differences in depression: differential exposure and differential vulnerability. The results indicate that men's lower contributions to household labor explain part of the gender difference in depression. Inequity in the division of household labor has a greater impact on distress than does the amount of household labor. Employment status moderates the effect of the division of labor on depression. Among those who describe themselves as keeping house, depression was lowest for those who performed 79.8 percent of housework. In contrast, for those employed full-time the minimum level of depression occurs at 45.8 percent of the household labor. Men report performing 42.3 percent of the housework in their homes compared to 68.1 percent reported by women. Thus, on average women are performing household labor beyond the point of maximum psychological benefit, whereas men are not. Social support mediates the effects of the division of household labor. The only gender difference in effects occurred among those who are married, for whom social support was associated with lower levels of depression for women than men.
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            Disability in major depression related to self-rated and objectively-measured cognitive deficits: a preliminary study

            Background Although major depression (MD) is associated with high levels of disability, the relationships between cognitive dysfunction and self-rated disability are poorly understood. This study examined the relationships between self-rated disability in persons with MD and both self-rated and objectively-measured cognitive functioning. Methods Twenty-one persons with MD and 21 control participants underwent neuropsychological assessment and z-scores representing deviations from control performance were calculated and averaged across the domains of psychomotor speed, initial learning, memory retention and executive function. Self-ratings of cognitive deficits (SRCDs) were reported on a 6-point scale for overall rating of cognitive change, speed of thinking, concentration, and short-term memory. Disability scores for self-rated physical, mental-health and functional (ie. days out of role) disability were computed from the Brief-Disability Questionnaire and the SF-12 'mental component' subscale. Results Persons with MD had a mean age of 53.9 years (SD = 11.0, 76% female) and had moderate to high depression severity (mean HDRS 21.7, sd = 4.4). As expected, depression severity was a strong predictor of physical (r = 0.7, p < 0.01), mental-health (r = 0.7, p < 0.01) and functional (r = 0.8, p < 0.001) disability on the Brief Disability Questionnaire. Additionally, for physical disability, both overall SRCDs and objectively-measured psychomotor speed continued to be independent significant predictors after controlling for depression severity, uniquely accounting for 13% and 16% of variance respectively. For functional disability scores, objectively-measured memory impairment and overall SRCDs were no longer significant predictors after controlling for depression severity. Conclusion While depression severity is associated with disability, the contributions of both self-rated and objectively-measured cognitive deficits are substantial and contribute uniquely and differentially to various forms of disability. Efforts directed at reducing cognitive deficits in depression may have the potential to reduce disability.
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              The mental health effects of multiple work and family demands. A prospective study of psychiatric sickness absence in the French GAZEL study.

              Individuals who experience work stress or heavy family demands are at elevated risk of poor mental health. Yet, the cumulative effects of multiple work and family demands are not well known, particularly in men. We studied the association between multiple work and family demands and sickness absence due to non-psychotic psychiatric disorders in a longitudinal study conducted among members of the French GAZEL cohort study (8,869 men, 2,671 women) over a period of 9 years (1995-2003). Work stress and family demands were measured by questionnaire. Medically certified psychiatric sickness absence data were obtained directly from the employer. Rate ratios (RRs) of sickness absence were calculated using Poisson regression models, adjusting for age, marital status, social support, stressful life events, alcohol consumption, body mass and depressive symptoms at baseline. Participants simultaneously exposed to high levels of work and family demands (> or =2 work stress factors and > or =4 dependents) had significantly higher rates of sickness absence due to non-psychotic psychiatric disorders than participants with lower levels of demands (compared to participants exposed to 0-1 work stress factors and with 1-3 dependents, age-adjusted rate ratios were 2.37 (95% CI 1.02-5.52) in men and 6.36 (95% CI 3.38-11.94) in women. After adjusting for baseline socio-demographic, behavioral and health characteristics, these RRs were respectively reduced to 1.82 (95% CI 0.86-3.87) in men, 5.04 (95% CI 2.84-8.90) in women. The effect of multiple work and family demands was strongest for sickness absence due to depression: age-adjusted RRs among participants with the highest level of work and family demands were 4.70 (1.96-11.24) in men, 8.57 (4.26-17.22) in women; fully adjusted RRs: 3.55 (95% CI 1.62-7.77) in men, 6.58 (95%CI 3.46-12.50) in women. Men and women simultaneously exposed to high levels of work stress and family demands are at high risk of experiencing mental health problems, particularly depression.
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                Author and article information

                Journal
                Hong Kong J Occup Ther
                Hong Kong J Occup Ther
                HJO
                sphjo
                Hong Kong journal of Occupational Therapy : HKJOT
                SAGE Publications (Sage UK: London, England )
                1569-1861
                1876-4398
                10 June 2016
                June 2016
                : 27
                : 1
                : 35-41
                Affiliations
                [a ] Department of Physical and Occupational Therapy, Graduate School of Medicine, Nagoya University, Nagoya, Japan
                [b ] Department of Human Informatics, Aichi Shukutoku University, Nagakute, Japan
                [c ] Department of Health and Medical Sciences, Aichi Shukutoku University, Nagakute, Japan
                Author notes
                [*] [* ]Graduate School of Medicine, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya 461-8673, Japan. E-mail address: hoshino@ 123456met.nagoya-u.ac.jp
                Conflicts of interest: All contributing authors declare that they have no conflicts of interest.
                Article
                10.1016_j.hkjot.2016.03.001
                10.1016/j.hkjot.2016.03.001
                6091998
                30186059
                231bdeff-70de-4dfb-89fd-05d74a772a66
                © 2016 Hong Kong Occupational Therapy Association. Published by Elsevier (Singapore) Pte Ltd.

                This is an open access article under the CC BY-NC-ND license ( http://www.creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 11 November 2015
                : 14 March 2016
                : 8 March 2016
                Categories
                Original Article

                depression,housework,national institute for occupational safety and health,stress factors,women

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