The association of work stress with somatic symptoms in Chinese working women: a large cross-sectional survey

Document Type

Journal Article


Elsevier Inc.

Place of Publication

United States


School of Medical and Health Sciences




Originally published as: Li, J., Ding, H., Han, W., Jin, L., Kong, L., Mao, K., ... Angerer, P. (2016). The association of work stress with somatic symptoms in Chinese working women: a large cross-sectional survey. Journal of Psychosomatic Research, 89(1), 7-10. Available here


Objective It has been suggested that the relationship between work stress and somatic symptoms (e.g., cardiopulmonary, gastrointestinal complaints, general pain, and fatigue) is particularly pronounced in women. As evidence from China is sparse, we used a large sample of Chinese working women to test those potential associations. Methods Data were obtained from a cross-sectional study of 6826 working women in five urban areas in China who were free from major clinical disease. The sample was drawn from five occupations (physicians, nurses, school teachers, bank employees, and industrial workers). The Effort-Reward Imbalance Questionnaire and Patient Health Questionnaire-15 were used to measure work stress and somatic symptoms, respectively. Multivariate ordinal logistic regression was performed to analyze the associations. Results 52.6% participants reported high work stress in terms of concurrent high effort and low reward. The distribution of severity of somatic symptoms covered the full range from minimal (37.3%) and low (30.6%), to medium (19.7%) and high (12.4%). The adjusted odds ratio of somatic symptoms by high work stress was 2.45 (95% confidence interval = 2.24–2.68), and all single psychosocial work factors (effort, reward, and over-commitment) exerted substantial effects on somatic symptoms (odds ratios > 2.00). Conclusions Work stress is strongly associated with somatic symptoms in Chinese working women. Future longitudinal studies and intervention studies are needed to understand and improve women's psychosocial work environment and their psychosomatic health in China and elsewhere




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