title: Relationships of alcohol use, stress, avoidance coping, and other factors with mental health in a highly educated workforce.
abstract: OBJECTIVE
  The relationships of drinking, stress, life satisfaction, coping style, and antidepressant use to mental health were examined in a highly educated workforce.
  
  
  METHODS
  This study used a one-time mail-out, mail-back cross-sectional survey design to examine the relationships of mental health with three kinds of stress (life events, work stress, home stress); two kinds of life satisfaction (work and home); use of avoidance coping; and antidepressant use.
  
  
  METHODS
  This study was conducted at a large worksite in northern California in which the workforce was comprised of predominantly highly educated employees.
  
  
  METHODS
  Questionnaires were mailed to a random sample of 10% of 8567 employees, and 504 were completed and returned by participants (59%). Complete data were provided by 460 participants (53%).
  
  
  METHODS
  Respondents completed the Mental Health Index, the Alcohol Use Disorders Identification Test (AUDIT), and measures of coping style, work and home stress and satisfaction, stressful life events, and antidepressant use.
  
  
  RESULTS
  Mean Mental Health Index scores were at the 32nd percentile of the U.S. population-based norms, with low percentile values associated with worse mental health. Using multiple regression analysis, the factors examined in this study were significantly related to Mental Health Index scores as the dependent variable [F(16, 443) = 27.41, p < .001, adjusted overall R2 = .48]. Poor mental health scores were significantly related to the following: age (p < .05); screening positively for current harmful or hazardous drinking (p < .05); having high levels of stress at work (p < .05) or home (p < .01); experiencing dissatisfaction with work (p < .001) or home life (p = .01); engaging in avoidance coping (p < .001); and using antidepressants (p < .001). Employees currently using antidepressants had significantly more outpatient medical and mental health visits, indicating higher health costs. Furthermore, mental health status was also significantly related to the interactions between several pairs of these variables: education and gender, age and job stress, home satisfaction and work stress, home satisfaction and avoidance coping, and home satisfaction and use of antidepressants.
  
  
  CONCLUSIONS
  Mental health status was poorer on average in a highly educated workforce compared with general U.S. norms. Most of the factors that were found to be associated with poorer mental health were ones that are potentially modifiable, such as experiencing more stress and less satisfaction in work and home life and engaging in current hazardous or harmful drinking. The findings that mental health is worse among individual employees who exhibit combinations of these factors suggest that we need to better understand possible effects of these factors in the context of one another. As interpretation of these results may be limited by the single worksite that participated in this study, future research should re-examine these relationships in other worksites varying from this one in geography and demographic characteristics.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5718, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Koopman
authors.forename: Stanley F
authors.initials: SF
authors.lastname: Wanat
authors.forename: Shelly
authors.initials: S
authors.lastname: Whitsell
authors.forename: Darrah
authors.initials: D
authors.lastname: Westrup
authors.forename: Robert A
authors.initials: RA
authors.lastname: Matano
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology* / Q000517:prevention & control; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006240:Happiness; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010549:Personal Satisfaction; D011315:Preventive Medicine; D011594:Psychometrics; D012044:Regression Analysis; D012307:Risk Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires