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Association of Job Stressors With Panic Attack and Panic Disorder in a Working Population in Japan: A Cross-Sectional Study

Asai, Yumi MHSc; Imamura, Kotaro PhD; Kawakami, Norito MD, PhD

Journal of Occupational and Environmental Medicine: June 2017 - Volume 59 - Issue 6 - p 516–521
doi: 10.1097/JOM.0000000000001021

Objective: This study aimed to investigate associations of job stressors with panic attack (PA) and panic disorder (PD) among Japanese workers.

Methods: A cross-sectional online questionnaire survey was conducted of 2060 workers. Job strain, effort/reward imbalance, and workplace social support were measured by the job content questionnaire and effort/reward imbalance questionnaire. These variables were classified into tertiles. PA/PD were measured by self-report based on the mini international neuropsychiatric interview (MINI). Multiple logistic regression was conducted, adjusting for demographic, lifestyle, and health-related covariates.

Results: Data from 1965 participants were analyzed. Adjusted odds ratio (OR) of PA/PD was significantly greater for the group with high effort/reward imbalance compared with the group with low effort/reward imbalance (ORs, 2.64 and 2.94, respectively, both P < 0.05).

Conclusion: This study found effort/reward imbalance was associated with having PA/PD among Japanese workers.

Department of Mental Health (Ms Asai, Dr Imamura, Dr Kawakami), Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.

Address correspondence to: Norito Kawakami, MD, PhD, Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan (

Source of Funding: The Health and Labor Sciences Research Grant 2015 to 2017 (H27-Rodo-Ippan-004) from the Ministry of Health, Labour, and Welfare, Japan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Authors Kawakami, Asai, and Imamura have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Copyright © 2017 by the American College of Occupational and Environmental Medicine