Abstract
The manual for the Japanese Stress Check Program recommends the use of the Brief Job Stress
Questionnaire (BJSQ) from among the program's instruments and proposes criteria for defining high−stress employees.
We conducted an online survey to administer the BJSQ with a psychological distress scale (K6) to randomly selected
employees (n=1,650) to examine the screening performance of the BJSQ. Our findings indicated that less than half of theidentified high−stress employees warrant consideration for secondary screening for psychological distress as defined by a K6 score ≥13. The positive likelihood ratio was estimated as 6. We then sought to estimate the risk of stress−associated long−term sickness absence as defined in the program manual. We followed 7356 male and 7362 female employees of a financial service company who completed the BJSQ for 1 year and identified employees with sickness absence of 1 month or longer. After adjustment for confounders, hazard ratios for incident−related sickness absence in high−stress employees
were 6.6 for men and 2.8 for women. The corresponding population−attributable risks for high stress were 24% and 21%, respectively. The estimated prevalence of severe mental disorder at the workplace is low, and the effectiveness of secondary prevention is limited. The BJSQ criteria should be considered as an indicator mainly for primary prevention.
