Diferenças geracionais e transtornos mentais comuns em participantes do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil).

Abstract

Aiming to collaborate with the field of workers' health in public services of federal institutions, this thesis proposes to present discussions regarding the occurrence of common mental disorders related to occupational stressors. This research is part of the Longitudinal Study of Adult Health (ELSA-Brazil). This is a cross-sectional study, including 15,105 participants interviewed at baseline, aged between 35 and 74 years. Sociodemographic characteristics, health behaviors, medication use, and work domains were considered in the analyses. Common mental disorders (CMD) were measured by the Clinical Interview Schedule (CIS-R) and occupational stressors by the Swedish scale of the Demand-ControlSocial Support Questionnaire (DCSQ). As a result of the thesis, three articles were written: (1) Birth generation, gender, and common mental disorders in public servants participating in ELSA-Brazil; (2) Occupational stress and common mental disorders: generational and gender differences in the ELSA-Brazil cohort; (3) Generational and gender differences in the severity of common mental disorders in the ELSA-Brazil cohort: the influence of occupational stress. In Article 01, the prevalence of CMDs was estimated and described according to race/skin color, education, marital status, alcohol consumption, smoking, use of antidepressants and benzodiazepines. Date of birth characterized the generation of birth. More than 60% of the cohort belongs to the Baby Boomer generation.The prevalence of CMD was 26.7% (women = 33.8% and men = 18.4%). The highest prevalence occurred among Generation X participants (30.4%). CMD were more prevalent among women compared to men in all generations. In Article 02, 12,015 active participants were eligible, excluding retired workers. Among active study participants, 26.8% had CMD. However, the prevalence among women reached 35.9% compared to 19.3% of men (PR = 1.86; 95% CI [1.75-1.98]). Analyzing the association between occupational stressors and CMDs after adjusting the model, the positive and statistically significant association between occupational stress and CMDs was maintained only among women from the Baby Boomer Generation who had active work (PR=1.32; 95%CI [1.13-1.54]) and high-demand/exhausting work (PR=1.41; 95%CI [1.14-1.73]) and among women from Generation X who had active work (PR=1.39; 95%CI [1.09-1.78]).In Article 03, the extent to which occupational stress modified the severity of CMDs according to gender and birth generation among active participants was assessed. Women presented 2.4 times more severe CMDs and 1.5 times more mild to moderate CMDs than men. The presence of interaction between education, occupational stress and severity of CMDs was observed in women from the Baby Boomer Generation. Women with a high school diploma submitted to active work (combined by high demands and high control) when compared to low-demand/exhaustion work (low demand and high control) have 53% more occurrence of mild to moderate CMDs (PR=1.53; 95% CI [1.09-2.15]) and 42% more severe CMDs. Based on these findings, we hope to contribute knowledge to public health, from the perspective of birth generations and gender, suggesting new studies to evaluate the role of public policies in the prevention of common mental disorders. It is important to highlight that new research based on generational cohorts is beneficial in order to analyze the impact of these work demands and domestic tasks on the illness of these workers, seeking alternatives to reduce the current demands at universities, in addition to promoting improvements to minimize gender inequalities.