JMIR Publications

ABSTRACT

Background:

Depressive and anxiety symptoms are primary drivers of China's mental-health burden, while workplace psychological issues are growing increasingly pronounced. Yet, compelling evidence comparing mental-health patterns across distinct industries remains strikingly scarce. Understanding these sector-specific differences is critical for pinpointing high-risk occupations and designing effective, tailored intervention strategies.

Objective:

Our objective was to assess the prevalence, determinants, and industry-specific patterns of depressive, anxiety, and comorbid symptoms across multiple industries.

Methods:

We conducted a large cross-sectional survey among 10,112 workers from 11 industries in all districts or counties of Chongqing, China. Depressive and anxiety symptoms were measured using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scales, with comorbidity defined as meeting criteria for both. Weighted prevalence and 95% Confidence Cnterval (CI) were calculated using Tylor series linearization accounting for cluster effects. Mixed-effects logistic regression models were applied to examine associations between demographic, health, and occupational factors and depressive and anxiety symptoms, as well as to compare these outcomes across industries. Multinomial mixed-effects models were used to examine patterns of comorbidity by modeling the four-category outcome—no symptoms, depression only, anxiety only, and comorbid depression- anxiety symptoms.

Results:

Overall, 19.0% (95%CI 16.7%–21.3%) of workers reported depressive symptoms, 7.8% (95%CI 6.4%–9.1%) reported anxiety symptoms, and 13.1% (95%CI 11.7%–14.5%) experienced comorbidity. Younger age, being single, poor self-rated health, recent sick leave, low sleep quality, and occupational stress were strongly associated with all outcomes, with the largest effects observed for the comorbid symptoms. Significant disparities were observed across industries, dominated by education, healthcare, express delivery, and construction, while the lowest prevalence was found in traditional manufacturing and mining. These disparities persisted significantly after comprehensive adjustment for demographic, health-related, and occupational factors.

Conclusions:

Depressive, anxiety, and comorbid symptoms are prevalent among Chinese workers, exhibiting significant variation across industries and distinct links to modifiable occupational and health factors. Targeted, sector-specific interventions and integration of mental-health promotion into occupational health systems are vital to alleviate work-related psychological burdens and propel national mental-health initiatives. Clinical Trial: Not applicable