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Aim This study aimed to investigate the association between occupational participation and depressive symptoms among middle-aged adults in Hokkaido, Japan. Methods Community-dwelling adults aged 40–64 years were recruited using snowball sampling, and 165 participants who returned the questionnaires and met the selection criteria were included in the analysis. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Occupational participation, including three domains (leisure, productivity, and self-care) and three aspects (occupational control, occupational balance, and satisfaction of performance), was assessed using Self-completed Occupational Performance Index (SOPI) questionnaire. Results Multivariate-adjusted regression analysis revealed that depressive symptoms were associated with lower occupational participation in the productivity domain (β = −0.34, p < .001), whereas analysis of each aspect of the SOPI showed a significant association of depressive symptoms with lower occupational control in productivity domain (β = −0.33, p < .001), occupational balance in productivity domain (β = −0.25, p < .001), and satisfaction with performance in leisure domain (β = −0.16, p = .045) and productivity domain (β = −0.35, p < .001). Conclusion Depressive symptoms was significantly associated with low occupational participation in productivity domain in middle-aged adults. In the domains of leisure and self-care, significant associations were found only between depression symptoms and satisfaction of performance. Occupational therapy interventions for middle-aged adults targeting the maintenance and improvement of participation in productive activities may help preventing depressive symptoms.
Yokoyama et al. (Fri,) studied this question.