Demographic features.

Background
Almost 10% of the population develop depression or anxiety disorder during their lifetime. Considering that people who are exposed to high stress are more likely to develop mental disorders, it is important to detect and remove mental stress before depression or anxiety disorder develops. We aimed to develop an objective screening test that quantifies mental stress in workers so that they can recognize and remove it before the disorder develops.
Methods
We obtained urine specimens from 100 healthy volunteers (49 men and 51 women; age = 48.2 ± 10.8 years) after they received medical checks and answered the Brief Job Stress Questionnaire (BJSQ). Participants were divided into high- and low- stress groups according to their total BJSQ scores. We further analyzed six urinary neurotransmitters (dopamine, serotonin, 5-hydoroxyindoleacetic acid, gamma-aminobutyric acid, homovanillic acid, and vanillylmandelic acid) using liquid chromatography-mass spectrometry to compare their levels between the two groups.
Results
We obtained the concentrations of the six analytes from 100 examinees and revealed that the levels of urinary dopamine (p = 0.0042) and homovanillic acid (p = 0.020) were significantly lower in the high-stress group than those in the low-stress group. No biases were observed between the two groups in 36 laboratory items. The stress index generated from the six neurotransmitter concentrations recognized high-stress group significantly. Moreover, we discovered that the level of each urinary neurotransmitter changed depending on various stress factors, such as dissatisfaction, physical fatigue, stomach and intestine problems, poor appetite, poor working environments, sleep disturbance, isolation, worry, or insecurity.
Conclusion
We revealed that urinary neurotransmitters could be a promising indicator to determine underlying mental stress. This study provides clues for scientists to develop a screening test not only for workers but also for patients with depression.