ABSTRACT Objectives This cross‐sectional study examined the association between pregnancy hope and premenstrual dysphoric disorder (PMDD) outcomes among full‐time working women. Methods We analyzed an October 2023 survey of nulligravid women aged 20–44 years (N = 1947). PMDD diagnosis and symptom severity were assessed using a DSM‐IV‐based scale. Logistic and linear regression examined associations with pregnancy hope and tested interaction by marital status. Results PMDD prevalence was 5.4% with pregnancy hope and 4.8% without. Pregnancy hope was not associated with PMDD diagnosis (crude OR = 1.13, 95% CI: 0.71–1.80) and remained null after adjustment. Pregnancy hope was weakly associated with higher symptom scores (crude standardized β = 0.059, p = 0.009), persisting after adjustment. Interaction by marital status was not significant. Conclusion Among full‐time workers, pregnancy hope was unrelated to PMDD diagnosis but was weakly associated with subthreshold symptom severity. Longitudinal studies that comprehensively assess multidimensional pregnancy intention, perceptions of menstruation, and work‐related constraints are needed to clarify causal directionality and mechanisms.

Aim:This study examined the longitudinal associations between psychosocial factors in the workplace and the emergence of premenstrual dysphoric disorder (PMDD) symptoms among Japanese female workers, with a particular focus on psychological distress as a potential moderator. Methods:We conducted a 6-month follow-up of 2000 full-time Japanese female workers aged 20-39 without PMDD symptoms at baseline. PMDD symptoms were assessed at follow-up using a validated PMDD scale. Psychosocial factors in the workplace (job demands, job control, supervisor and coworker support, and workplace rewards) were measured at baseline using the New Brief Job Stress Questionnaire. Psychological distress was assessed using the Kessler 6 psychological distress scale (K6), and participants were stratified by K6 scores (K6 < 5 and K6 ≥ 5). Logistic regression analyses were performed. Results:Of the eligible participants, 1064 completed both surveys (response rate: 61.6%). In the adjusted models, high job control was associated with the emergence of PMDD symptoms among all participants (odds ratio [OR] = 1.26, p = 0.025) and those with high psychological distress (OR = 1.37, p = 0.011). Job stability was negatively associated with the emergence of PMDD symptoms among participants with high psychological distress (OR = 0.48, p = 0.010). No significant associations were found among those with low psychological distress. Conclusion:Job stability was a protective factor for the emergence of PMDD symptoms among female workers with high psychological distress, while job control may act as an enhancing factor in the overall sample and among those with high psychological distress. Ensuring job stability might be a measure to prevent PMDD symptoms, especially for female workers with high psychological distress.

Previous studies have reported associations between restless legs syndrome (RLS) and perinatal depressive symptoms. However, no study has used diagnostic instruments to examine changes in RLS status during pregnancy in relation to the incidence of perinatal depression. This study aimed to investigate whether time-varying RLS status is associated with an increased risk of incident perinatal depression. This prospective cohort study analyzed data from 2435 Japanese pregnant women in the control group of a randomized controlled trial on perinatal depression. Time-varying RLS status was assessed using data obtained in the second and third trimesters with the short form of the Cambridge–Hopkins diagnostic questionnaire. Incident major depressive episodes and depressive symptoms from the second trimester to 3 months postpartum were assessed using the self-administered World Health Organization Composite International Diagnostic Interview 3.0 and the Edinburgh Postnatal Depression Scale (EPDS), respectively. Associations were examined using Cox proportional hazards models with time-varying covariates. The prevalence of RLS was 40 (1.6

OBJECTIVES:Participatory organizational interventions (POIs) may improve workers' mental health and work performance, but evidence from systematic reviews and meta-analyses of cluster-randomized controlled trials (cRCTs) remains limited. The meta-analysis has not been updated since it was published in 2015; a previous study focused on health care workers; and potential outcomes have not been adequately examined. This systematic review and meta-analysis aimed to investigate the effects of POIs on mental health and work performance among workers. METHODS:The current study searched PubMed, EMBASE, PsycINFO, PsycARTICLES, and Japan Medical Abstracts Society for papers published up until November 11, 2022. Eligible studies were cRCTs assessing the effects of POIs on mental health or work performance. The risks of bias were evaluated by using the Cochrane risk-of-bias tool for cRCTs and meta-analysis was performed using a random effects model. RESULTS:Fourteen cRCTs were included in the systematic review, and 8 cRCTs in the meta-analysis. The meta-analysis showed a nonsignificant beneficial effect on mental health conditions [standardized mean difference (SMD) = -0.04; 95% CI, -0.10 to 0.03], positive mental health (SMD = -0.004, 95% CI, -0.077 to 0.068), and work performance (SMD = 0.01; 95% CI, -0.10 to 0.13). CONCLUSIONS:This study did not confirm that POIs had a statistically significant effect on mental health or work performance. However, several studies that reported favorable results tended to emphasize active and structured participation, alignment with workers' needs, and attention to organizational context. Further research is needed to identify the conditions under which the interventions are effective.

Abstract Aim This randomized controlled trial aims to examine the effects of an internet‐delivered compassion‐focused therapy program on depressive symptoms in women with recurrent pregnancy loss. Methods The target population will be non‐pregnant women aged 18–50 years with at least two pregnancy losses who visit the recurrent pregnancy loss outpatient clinics. Participants who fulfill the eligibility criteria will be randomly assigned to either a 5‐week intervention group (n = 55) or a waitlist control group (n = 55). Participants in the intervention group will be asked to complete four weekly video modules (20–25 min each), including psychoeducation, experiential exercises, and homework assignments based on compassion‐focused therapy principles. The intervention incorporates psychiatrist‐guided support through weekly messages encouraging participants to share insights and questions about the program. The primary outcome is depression severity measured by the Patient Health Questionnaire‐9. Secondary outcomes are psychological distress, perinatal grief, self‐compassion, rumination, and worry about future pregnancies. Assessments will be conducted at baseline, 5‐week follow‐up (post‐intervention), and 13‐week follow‐up. Mixed model analyses will be conducted to test the effectiveness of the intervention. Results As this is a study protocol, results are not yet available. Conclusion If the intervention program demonstrates significant benefits, it could be offered to all women with recurrent pregnancy loss in Japan.

Background:Mindfulness interventions are considered an effective strategy for preventing mental health problems among health care workers (HCWs). While prior reviews have often included facilitator-guided or multicomponent interventions, it is unclear whether self-guided digital mindfulness interventions can also be effective without professional or in-person support. Objective:This systematic review aimed to investigate the effects of self-guided digital mindfulness interventions on the mental health and well-being of HCWs. Methods:This work was conducted as part of the DeLiGHT project. We searched electronic databases, including PubMed (MEDLINE), Embase, Cochrane CENTRAL, PsycINFO, PsycARTICLES, and the Japan Medical Abstract Society database, from inception in 2010 to July 25, 2023. To ensure timeliness, we performed an updated search on December 27, 2025. Database searching yielded 37,851 abstracts and 145 studies that examined the effectiveness of digital health interventions for workers in the initial 2023 screen. In the present study, we limited the included studies to those that met the following criteria: randomized controlled trials (RCTs) using self-guided digital mindfulness interventions (eg, smartphone apps or web-based programs) delivered without face-to-face or professional support compared to waiting list controls or usual care among HCWs. The updated search in 2025 yielded 6328 additional records, of which 11 studies were examined. Study quality was assessed using the Cochrane Risk of Bias tool, with meta-analyses conducted using a random-effects model. Results:A total of 9 RCTs with 3088 participants were included in the final analysis. The study populations were diverse, covering North America, Europe, Oceania, and Asia. Interventions were delivered via various digital platforms, including commercial mindfulness apps (n=3), social networking service tools (n=3), and web-based programs (n=3), with an average duration of 6.17 weeks (range: 1.5-18 wk). Five studies assessed outcomes only postintervention, and 4 included short-term follow-up (4-12 wk); no long-term effects were evaluated. The meta-analysis showed a significant beneficial effect on depression (standardized mean difference [SMD]=-0.44, 95% CI -0.88 to -0.00; P=.049), anxiety (SMD=-0.29, 95% CI -0.51 to -0.06; P=.011), perceived stress (SMD=-0.42, 95% CI -0.77 to -0.06; P=.02), and well-being (SMD=0.20, 95% CI 0.09 to 0.30; P<.001) immediately postintervention. The adherence rates reported across studies were highly variable, ranging from 19% to 56%. According to the Cochrane Risk of Bias tool, most studies were rated as having some concerns or a high risk of bias. The certainty of evidence included in the analysis ranged from "Low" to "Very Low." Conclusions:Overall, low to very low certainty evidence suggests that self-guided digital mindfulness interventions may have short-term beneficial effects on depression, anxiety, perceived stress, and well-being among HCWs. Future high-quality studies are needed to examine the long-term effects and cross-cultural generalizability of these interventions.

Background:While scolding is an often problematic form of workplace communication in Japan, little research exists regarding its impact on employees' mental health. Objectives:This study investigated the associations between being scolded at work and psychological distress. Methods:Data from the Employee Cohort Study during the COVID-19 pandemic in Japan (E-COCO-J) surveys obtained in September 2023 (14th wave) were used. Psychological distress was measured using the Kessler Psychological Distress Scale (K6), with a cutoff of 13 points. Multivariable logistic regression was conducted by adjusting demographic factors, psychiatric treatment history, and workplace factors. Results:A total of 758 participants were included in the analysis. Among the participants, 159 individuals (21%) reported having been scolded at least one time in the past month, and 116 individuals (15.3%) had a K6 score of 13 or higher. Compared to those who were not scolded, being scolded less than 1 day a week (adjusted odds ratio [AOR] 1.83; 95% confidence interval [CI], 1.07-3.11) and about more than 1 day a week (AOR 2.42; 95% CI, 1.23-4.76) showed significant associations with high psychological distress. Conclusion:This study suggested that being scolded has a negative impact on employees' mental health. Further study is needed to investigate effective methods of delivering constructive negative feedback rather than resorting to scolding.

Enhancing the well-being of mentally healthy workers (i.e., those with lower psychological distress) is important to prevent mental health conditions, aligning with the trend of occupational positive psychology. No intervention study has investigated the effect of digital health intervention on well-being among workers with low levels of psychological distress in micro- and small-sized enterprises (MSEs). This secondary analysis examined the effectiveness of a fully automated text-based stress management program, "WellBe-LINE," using the LINE app to improve the well-being of employees with low levels of psychological distress in MSEs. It used data from a previous randomized controlled trial (RCT) study. The previous RCT recruited adult Japanese full-time employees at an enterprise with fewer than 50 employees from registered members of a web survey company. From the RCT, only participants with low psychological distress (Kessler 6 score under 4) were employed for the present analyses. Participants in an intervention group received text messages once per week for 8 weeks. Well-being was assessed by the Mental Health Continuum-Short Form (MHC-SF) at baseline, post (2-month), and follow-up (6-month) surveys. A mixed model for repeated measures conditional growth model analysis was conducted using a group*time interaction as an intervention effect. 638 (62.5%) participants with low psychological distress were included in this secondary analysis from the 1,021 total participants. The intervention group showed a significant intervention effect post survey on improving well-being (Cohen's d = 0.19 [95%CI 0.03-0.35], p = 0.016) and social well-being at both the post and follow-up survey with a small effect size (Cohen's d = 0.26 [95%CI: 0.10-0.42], d = 0.17 [0.002-0.34]; respectively). No effect was observed on emotional and psychological well-being. This study suggested that fully automated universal mental health interventions with low intensity may benefit the healthy population. Further research is needed, focusing on the development and evaluation of programs aimed at promoting well-being and positive mental health among mentally healthy workers as part of primary mental health prevention.Trial registration: The study protocol was registered in the UMIN clinical trial registration before starting recruitments: UMIN000050624 (registration date: March 18, 2023) https://center6.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000057552 .

Objective:This study aimed to develop a Japanese version and a shortened version of the Online Social Support Scale and test their reliability and validity. Method:A 40-item scale was developed with the permission of the original developer to measure online and other social support, depressive symptoms, and self-esteem. Study participants were recruited online using snowball sampling. Internal and test-retest reliability were tested; confirmatory factor analysis was used to test for structural validity, and correlation analysis was used to test for convergent validity. A follow-up survey was conducted 2 weeks later to examine the test-retest reliability of the scale. A shortened 12-item version was also developed and tested. Result:A total of 288 people participated in the survey, of whom 254 (88.2%) responded to the follow-up survey. The Cronbach's α coefficient was 0.98 for the overall scale and ranged from 0.94-0.96 for the subscales. The intraclass correlation coefficient was 0.90 for the scale as a whole and ranged from 0.85-0.88 for the subscales. Confirmatory factor analysis confirmed a four-factor structure with an acceptable model fit. The scale showed a significant positive correlation with social support and a significant negative correlation with depressive symptoms but no significant correlation with self-esteem. The shortened version demonstrated similar reliability and validity. Conclusion:The Japanese version of the Online Social Support Scale showed adequate reliability and some validity, and the short version showed adequate reliability and validity, making them useful tools for measuring online social support in various contexts, such as peer support groups or remote work environments.

OBJECTIVES:This systematic review aimed to assess the association between psychosocial factors in the workplace and menstrual abnormalities or fertility, focusing on literature implementing a prospective cohort design. METHODS:We searched MEDLINE, EMBASE, PsycINFO, PsycARTICLES, and Japan Medical Abstracts Society electronic databases for studies published from inception to February 26, 2020, and updated the search in PubMed on May 29, 2024. Inclusion criteria were (P) adult female workers (over 18 years old), (E) presence of adverse psychosocial factors at work, (C) absence of adverse psychosocial factors at work, and (O) any menstrual cycle disorders, menstrual-related symptoms, or fertility issues. Prospective cohort studies were included. The included studies were summarized descriptively. RESULTS:Database searching yielded 14,238 abstracts, with nine studies meeting the inclusion criteria. Outcomes included fertility (n = 5), irregular menstrual cycle (n = 1), early menopause (n = 1), endometriosis (n = 1), and serum hormones (n = 1). Study findings included that women with high job demands and low job control were less likely to conceive, and working over 40 h per week and frequent heavy lifting, and rotating night shift work increased the risk of earlier menopause. Studies on night shift/rotating work and fertility outcomes showed no significant differences. CONCLUSION:This review underscores the insufficient high-level evidence regarding the association of psychosocial factors at work with fertility and menstrual disorders, emphasizing the necessity for future well-designed studies.

School refusal is rising globally and has reached an all-time high in Japan. It imposes critical work-family conflict on employed parents, with preliminary surveys linking it to job loss, depression, and anxiety. Despite its public health importance, work-family conflict due to school refusal has scarcely been studied in occupational health. This Opinion reviews existing research on parents of school-refusing children, discusses how occupational health professionals can support this underserved population, and outlines priorities for future research to mitigate the impacts on working-age parents' health and employment.

OBJECTIVE:This study examined the relative contributions of mediation and interaction by psychological distress to the association between job stressors and menstruation-related symptoms. DESIGN:A cross-sectional study. SETTING:Online survey in August 2023. POPULATION:Japanese full-time female employees aged 20-44 not taking contraceptives. METHODS:Four-way decomposition analysis was used to estimate the relative contributions of psychological distress (mediation and interaction) to the potential pathways from job stressors and menstruation-related symptoms. MAIN OUTCOME MEASURES:The Menstrual Distress Questionnaire assessed menstruation-related symptoms before and during menstruation. RESULTS:Of 1818 participants, 995 (54.7%) demonstrated severe menstruation-related symptoms. Multivariable logistic regression showed that high job demands (OR = 1.50, 95% CI: 1.27-1.84) and low coworker support (OR = 1.57, 95% CI: 1.22-2.02) were associated with menstruation-related symptoms whereas job control and supervisor support were not. Relative excess risks due to interaction with psychological distress indicated were positive and large in coworker support (RERI = 1.04, 95% CI: -0.34-2.41). In the four-way decomposition analysis, the pure indirect effect (48.4%) and controlled direct effect (37.8%) accounted for a large part in job demands. In contrast, the proportion attributable interaction (44.1%) dominated the total effect and controlled direct effect (15.6%) accounted for fewer effects in coworker support. CONCLUSIONS:Psychological distress appeared to be an important determinant of menstruation-related symptoms in relation to job stressors. This study suggested that reducing job demands and improving coworker support accompanied with mental health care can mitigate the adverse effect of job stressors on menstruation-related symptoms.

OBJECTIVES:The purpose of this secondary analysis of data from a previous randomized controlled trial (RCT) was to investigate whether an internet-based cognitive behavioral therapy (iCBT) stress management program improved work performance, sick leave, and intention to leave among nurses in Vietnam and Thailand during the COVID-19 pandemic. METHODS:Full-time nurses were recruited from hospitals in Vietnam and Thailand. A 2-arm, parallel-group, RCT was conducted. The intervention groups were provided a 7-week self-guided iCBT program. As secondary outcomes, work performance (on-the-job performance and quality of nursing care), sick leave days, and intention to leave the profession and the organization were assessed at baseline and 3-month and 6-month follow-ups in each group. RESULTS:A total of 1203 participants were randomly allocated to the intervention and the control group. The program significantly improved on-the-job performance at 3-month follow-up (P = .0499), although the effect was nonsignificant at 6-month follow-up; Cohen's d was 0.16 and 0.04, respectively. The program also significantly reduced sick leave at 6-month follow-up (coefficient = -0.21; 95% CI, -0.36 to -0.07; prevalence ratio 0.81), although the effect at 3 months was nonsignificant. However, the effects of the intervention on the quality of nursing care and the intention to leave the profession or the organization were not significant. CONCLUSIONS:A smartphone-based iCBT stress management program improved on-the-job performance at 3-month follow-up and decreased sick leave days at 6-month follow-up among hospital nurses in Vietnam and Thailand during the COVID-19 pandemic.

BackgroundApproximately 1 out of 5 pregnant women develops depression. Internet-based cognitive behavioral therapy (iCBT) is an effective way to treat not only depression but also mild depressive symptoms or subthreshold depression. While numerous iCBT programs have been developed and tested through randomized controlled trials for various mental health conditions and specific populations, research on their effectiveness and application in the real world remains limited. ObjectiveThis study aimed to examine the effectiveness of a previously developed iCBT program implemented in an existing app for improving depressive symptoms among pregnant women in a real-world setting. MethodsThe previously developed iCBT program for preventing perinatal depression was already implemented in an existing app called Luna Luna Baby by MTI Ltd. The app aims to provide information to pregnant women about pregnancy and babies, and potential users can download it from the Japanese version of the Apple App Store or Google Play Store without any fee. The program does not require any additional fees. The log data stored on the app identified iCBT program users and nonusers, allowing us to conduct this retrospective cohort study. Data from September 2022 to September 2024 were extracted from the app after anonymous processing. The primary outcome was the score on the self-reported Edinburgh Postnatal Depression Scale (EPDS), which participants answer by themselves on the app. The exposure group was defined as completers of all 6 modules of the iCBT program. The nonexposure group was defined as users who did not use any module of the program and matched the baseline characteristics of the exposure group. The change in EPDS score before and after using the program was compared using effect sizes, and repeated 2-way ANOVA was conducted to test the difference between the exposure and nonexposure groups. ResultsData from 119 women who completed the iCBT program and 448 pair-matched controls were selected. The average EPDS scores at baseline were 7.24 (SD 5.30) in the exposure group and 7.25 (SD 5.18) in the nonexposure group. After using the iCBT program, the group mean EPDS scores changed by −0.69 (SD 4.92) and +0.99 (SD 5.56) over time in the exposure and nonexposure groups, respectively (Cohen d=0.31, 95% CI 0.11-0.51). The repeated 2-way ANOVA showed statistical significance in the interaction terms between the groups and the measurement time points (P=.04). ConclusionsThe previously developed iCBT program showed a significant effect with a modest effect size on decreasing depressive symptoms among pregnant women in a real-world setting. Future research should attempt to minimize dropouts and increase participation in the program.

OBJECTIVE:Participatory workplace environmental improvement programs have proven to be effective in addressing mental health issues in the workplace. However, their implementation remains challenging. This study aimed to identify the facilitators and barriers faced by part-time occupational health physicians in proposing and implementing such programs and to develop effective implementation strategies. METHODS:A web-based questionnaire survey was conducted among part-time occupational health physicians between September and October 2023. This survey examined their experiences in proposing workplace environment improvements, their knowledge of participatory workplace environmental improvement programs, and their experience in proposing and introducing such programs. It also assessed the facilitators and barriers to the introduction and implementation of such programs. Respondents who had proposed such a program to their client companies were asked to connect the research team with the individual responsible for workplace environmental improvement at those companies. After obtaining consent, we interviewed these individuals in November and December 2023 to explore the facilitators and barriers to introducing participatory workplace environmental improvement programs. The questionnaire and interview data were analyzed using the occupational health version of the Consolidated Framework for Implementation Research (CFIR), and implementation strategies were developed with reference to expert recommendations for implementing change (ERIC). RESULT:We received 57 responses overall. Of the 49 respondents who were familiar with participatory workplace environmental improvement programs, 33 (67.8%) had proposed them. Of those with the proposed experience, 11 (33.3%) reported successful implementation. Interviews were conducted with representatives from two workplaces that implemented the program after receiving a proposal from their occupational health physicians and one that had yet to implement it. The analysis identified "Relative Advantage, Tension for Change," and "Implementation Climate" as high-priority facilitators and barriers during the Pre-Proposal Internal Setting phase. During the proposal, additional factors such as "trialability," "formally appointed internal implementation leaders," "self-efficacy," and "relative priority" were extracted. Based on the ERIC framework, "Create a Learning Collaborative," "Make Training Dynamic," "Shadow Other Experts," and "Identify and Prepare Champions" were selected as feasible implementation strategies. CONCLUSION:This study identified facilitators and barriers to introducing participatory workplace environmental improvement programs. Findings suggest that part-time occupational health physicians should provide educational materials and opportunities to build confidence among internal implementation leaders in client companies. Further research should incorporate more on-site practitioner feedback to refine implementation strategies and evaluate their effectiveness.

BACKGROUNDS:Menstruation-related symptoms are a common and serious health problem even without a specific diagnosis such as premenstrual dysphoric mood disorder (PMDD) or dysmenorrhea. Various adverse childhood experiences (ACEs) might be associated with menstruation-related symptoms, not only traditional traumatic events such as abuse, but also expanded ACEs such as childhood poverty, school bullying, or natural disasters. OBJECTIVE:This study examined the association between expanded ACEs (ACEs for Japanese) and menstruation-related symptoms among Japanese working women. METHODS:Data came from an online survey conducted in October 2023 that included women aged 20-44 working full-time, who have never been pregnant and are not currently using contraception. Menstruation-related symptoms severity was evaluated using the Menstrual Distress Questionnaire (MDQ) and the Premenstrual Dysphoric Disorder (PMDD) scale. The MDQ score of the premenstrual and menstrual phases were classified into four categories as menstrual symptoms severity of each phase. Logistic regression assessed the association between ACEs and each outcome, adjusting for covariates. RESULTS:The analysis included 2000 women. Premenstrual and menstrual symptoms severity increased with two or more ACEs. In the fully adjusted model, women with four or more ACEs significantly showed severe premenstrual symptoms (adjusted odds ratio [aOR] = 2.81, 95%CI:2.12-3.72), and severe menstrual symptoms (aOR = 3.03, 95%CI: 2.29-4.02). Four or more ACEs were associated with PMDD (aOR = 5.61, 95%CI: 2.65-11.89). Childhood poverty and school bullying were also associated with menstruation-related symptoms severity, and natural disasters with PMDD. CONCLUSIONS:Expanded ACEs were associated with menstruation-related symptoms. The results suggested the importance of trauma-informed care in gynecology, obstetrics, and occupational health practice.

Although the relationship between previous pregnancy loss and perinatal depression has been explored, most previous research has been cross-sectional and has not utilized diagnostic evaluation techniques. This study longitudinally examined the relationship using the self-administered web-based World Health Organization Composite International Diagnostic Interview 3.0. This study used data from a control group of pregnant women in a randomized controlled trial conducted between November 2019 and March 2020. An accelerated failure time model with Weibull distribution was conducted to evaluate the impact of previous pregnancy loss by number (never, once, and two or more times) on the onset of perinatal depression from 18 ± 2 weeks (baseline) to 3 months postpartum. The final analysis included 2,347 participants. The risk of developing perinatal depression was significantly higher for those with two or more previous pregnancy losses compared to those with no previous pregnancy loss (adjusted models: time ratio 0.17, 95

OBJECTIVES:This longitudinal study examined the associations of workplace loneliness with job turnover at 6-month follow-up among Japanese full-time employees. METHODS:This study employed a 6-month prospective design as part of the Employee Cohort Study in Japan. Data from wave 15 (February 2024; baseline, T1) and wave 16 (August 2024; follow-up, T2) were used. Only participants who were employed at baseline and completed the follow-up survey were included in the analysis. Workplace loneliness at T1 was measured using 3 scales: the Loneliness at Work Scale (LAWS), a single-item workplace loneliness scale, and a 3-item scale developed by modifying the short UCLA (University College, Los Angeles) Loneliness Scale for workplace loneliness. Job turnover at T2 was defined based on responses indicating either leaving a job or moving to a different company within the preceding 6 months. Multivariable logistic regression analysis assessed the association between workplace loneliness and job turnover, adjusting for sociodemographic variables. RESULTS:In total, 706 employees who were employed at baseline were included in the analysis. Observed turnover at follow-up was n = 47 (6.7%). Participants who experienced turnover had significantly higher baseline scores for LAWS and the 3-item scale (P = .044 and P = .012, respectively). In the multivariable logistic regression, all 3 workplace loneliness scales demonstrated similar and significant associations with turnover at follow-up. CONCLUSIONS:Workplace loneliness leads to job turnover. Further research is needed to address the generalization and explore mechanisms of the present findings.

This study investigated trends in psychological distress and mental health service use in Japan before and after the COVID-19 pandemic using nationally representative data from the Comprehensive Survey of Living Conditions (2013-2022). Psychological distress was assessed using the Japanese version of the Kessler 6 Scale, with scores of 5-12 indicating moderate distress and scores of ≥13 indicating high distress. Mental health service use was defined as regular visits to hospitals or clinics for depression or other psychological disorders. Analysis of data from 1,765,102 participants revealed that while the prevalence of moderate distress decreased from 24.9 % in 2019 to 21.8 % in 2022, the prevalence of high distress increased from 4.7 % to 5.0 % over the same period. Notably, increases in high distress were most prominent among aged 35-49 population. Cross-sectionally, women aged 26-34 showed highest prevalence of high distress (7.6 %). Additionally, mental health service use rose markedly, especially among young adults with high distress, with women consistently reporting higher distress and service utilization than men. These findings suggest a polarization in psychological distress in Japan, with a decline in moderate symptoms concurrent with a rise in severe distress, highlighting emerging gaps in mental health care. The results underscore the need for targeted interventions and the expansion of accessible, diverse mental health services to address unmet needs, particularly among vulnerable subgroups including young women and middle-aged population.