Job strain as a risk factor for clinical depression

Systematic review and meta-analysis with additional individual participant data

Datos Bibliográficos

ID23315500
AutoresI E H Madsen, S T Nyberg, L L Magnusson Hanson, J E Ferrie, K Ahola, L Alfredsson (0000-0003-1688-6697), G D Batty, J B Bjorner, M Borritz, H Burr, J-F Chastang, R DE GRAAF, N Dragano, M Hamer (0000-0003-1550-2030), M Jokela, A Knutsson, M Koskenvuo (0000-0002-3796-0991), A Koskinen, C Leineweber, I Niedhammer, M L Nielsen, M Nordin (0009-0000-0841-1267), T Oksanen, J H Pejtersen, J Pentti, I Plaisier, P Salo, A Singh-Manoux, S Suominen, M ten Have, T Theorell, S Toppinen-Tanner, J Vahtera, A Vaananen, P J M Westerholm, H Westerlund, E I Fransson, K Heikkilä, M Virtanen (0000-0001-8757-1671), R Rugulies, M Kivimäki
Año2017
Volumen47
Número8
Páginas1342-1356
Fecha de publicación2017-06-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaPsychological Medicine (JOURNAL)
Identificadores de la revistaISSN: 0033-2917 • E-ISSN: 1469-8978
EditorialCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s003329171600355x
IdiomaEN
Citas recibidas64
Referencias citadas54

Background Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression. Method We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol. Results We included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47–2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04–1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94–1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81–1.32). Conclusions Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.