Work and mental health

Impacts of sleep disturbance and work-related life stress on depression among Japanese and Chinese workers

The present study investigated how life stress and sleep disturbance impact depressive symptoms among Chinese (N = 185) and Japanese (N = 464) workers. Based on a hypothesis that sleep disturbance can cause depression, a statistical model is established, expecting that work-related life stress indirectly increases depressive symptoms by worsening sleep disturbance rather than initiating depression directly. The study also examined the buffering effects of social support on depression. The extent of depressive symptoms, sleep disturbance symptoms (insomnia, hypersomnia, and nightmare), work-related stressors, and available social support were measured. The result revealed that the extent of depression was equivalent for both groups, but the Chinese reported more stress, less social support, and more severe sleep disturbance symptoms than the Japanese. Despite those differences, the statistical model fitted both groups well, suggesting that addressing sleep disturbance at the earliest opportunity can effectively prevent depression onset for workers.

The working life expectancy of American adults experiencing depression

OBJECTIVES

To estimate the working life expectancies (WLE) of men and women with depression, examining depression by symptom trajectories from the late 20s to early 50s, and to estimate WLE by race/ethnicity and educational attainment.

METHODS

Data from 9206 participants collected from 1979 to 2018 in the US National Longitudinal Survey of Youth 1979 cohort were used. Depression was measured using the Center for Epidemiologic Studies Depression Scale Short Form at four time points (age 28-35, age 30-37, age 40, and age 50). Labor force status was measured monthly starting at age 30 until age 58-62. Depressive symptom trajectories were estimated using growth mixture modeling and multistate modeling estimated WLE from age 30-60 for each gender and depressive symptom trajectory.

RESULTS

Five latent symptom trajectories were established: a persistent low symptom trajectory (n = 6838), an episodic trajectory with high symptoms occurring before age 40 (n = 995), an episodic trajectory with high symptoms occurring around age 40 (n = 526), a trajectory with high symptoms occurring around age 50 (n = 570), and a persistent high symptom trajectory (n = 277). The WLE for men at age 30 was 30.3 years for the persistent low symptom trajectory, 22.8 years for the episodic before 40 trajectory, 19.6 years for the episodic around age 40 trajectory, 18.6 years for the episodic around age 50 trajectory, and 13.2 years for the persistent high symptom trajectory. Results were similar for women. WLE disparities between depression trajectories grew when stratified by race/ethnicity and education level.

CONCLUSIONS

Roughly a quarter of individuals experienced episodic depressive symptoms. However, despite periods of low depressive symptoms, individuals were expected to be employed ~5-17 years less at age 30 compared to those with low symptoms. Accessible employment and mental health disability support policies and programs across the working life course may be effective in maintaining work attachment and improving WLE among those who experience depression.

A scoping review to map the research on the mental health of students and graduates during their university-to-work transitions

OBJECTIVES

This scoping review maps the extant literature on students' and graduates' mental health experiences throughout their university-to-work transitions. The current review investigates the methodological features of the studies, the main findings, and the theories that the studies draw on to conceptualise mental health and transitions.

DESIGN

This project used a scoping review methodology created and developed by Peters and colleagues and the Joanna Briggs Institute. The review searched academic databases and screened existing studies that met predetermined inclusion criteria.

DATA SOURCES

Seven academic databases and Google Scholar were searched with sets of search terms.

ELIGIBILITY

The included studies examined participants who were final-year university students or those who had graduated from university within a 3-year period. Studies published in English since 2000 and from any country were included. The review included studies examining the negative dimensions of mental health. The review excluded studies focusing on medical students and graduates.

DATA EXTRACTION

Basic information about the studies and their findings on mental health and university-to-work transitions was retrieved. The findings are presented in tables and in a qualitative thematic summary.

RESULTS

The scoping review included 12 studies. Mental health was often not explicitly defined and it's theoretical foundations were not clearly articulated. The review identified factors, including a lack of social support and economic precarity, as sources of adverse mental health. Other protective factors in these studies-variables that guard against mental health problems-were identified, such as career preparedness and having a good job.

CONCLUSIONS

Despite the methodological focus on the negative aspects of mental health, people's mental health experiences during university-to-work transitions are not uniformly negative. Clear conceptualisations of mental health in future studies will aid in developing resources to improve well-being.

TRIAL REGISTRATION NUMBER

This scoping review adhered to a protocol previously published in this journal and that is registered on the Open Science Framework website (https://osf.io/gw86x).

Psychometric Properties of the Korean Version of Functioning Assessment Short Test in Bipolar Disorder

Objective

The Functioning Assessment Short Test (FAST) is a relatively specific test for bipolar disorders designed to assess the main functioning problems experienced by patients. This brief instrument includes 24 items assessing impairment or disability in 6 domains of functioning: autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time. It has already been translated into standardized versions in several languages. The aim of this study is to measure the validity and reliability of the Korean version of FAST (K-FAST).

Methods

A total of 209 bipolar disorder patients were recruited from 14 centers in Korea. K-FAST, Young Mania Rating Scale (YMRS), Bipolar Depression Rating Scale (BDRS), Global Assessment of Functioning (GAF) and the World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were administered, and psychometric analysis of the K-FAST was conducted.

Results

The internal consistency (Cronbach's alpha) of the K-FAST was 0.95. Test-retest reliability analysis showed a strong correlation between the two measures assessed at a 1-week interval (ICC = 0.97; p < 0.001). The K-FAST exhibited significant correlations with GAF (r = -0.771), WHOQOL-BREF (r = -0.326), YMRS (r = 0.509) and BDRS (r = 0.598). A strong negative correlation with GAF pointed to a reasonable degree of concurrent validity. Although the exploratory factor analysis showed four factors, the confirmatory factor analysis of questionnaires had a good fit for a six factors model (CFI = 0.925; TLI = 0.912; RMSEA = 0.078).

Conclusion

The K-FAST has good psychometric properties, good internal consistency, and can be applicable and acceptable to the Korean context.

Parallel latent trajectories of mental health and personal earnings among 16- to 20 year-old US labor force participants: a 20-year longitudinal study

PURPOSE

Determine the number of latent parallel trajectories of mental health and employment earnings over two decades among American youth entering the workforce and estimate the association between baseline sociodemographic and health factors on latent trajectory class membership.

METHODS

This study used data of 8173 participants from the National Longitudinal Survey of Youth 1997 who were 13-17 years old in 1997. Surveys occurred annually until 2011 then biennially until 2017, when participants were 33-37 years old. The Mental Health Inventory-5 measured mental health at eight survey cycles between 2000 and 2017. Employment earnings were measured annually between 1998 and 2017. Latent parallel trajectories were estimated using latent growth modeling. Multinomial logistic regression explored the association between baseline factors and trajectory membership.

RESULTS

Four parallel latent classes were identified; all showed stable mental health and increasing earnings. Three percent of the sample showed a good mental health, steep increasing earnings trajectory (average 2017 earnings ~ $196,000); 23% followed a good mental health, medium increasing earnings trajectory (average 2017 earnings ~ $78,100); 50% followed a good mental health, low increasing earnings trajectory (average 2017 earnings ~ $39,500); and 24% followed a poor mental, lowest increasing earnings trajectory (average 2017 earnings ~ $32,000). Participants who were younger, women, Black or Hispanic, from lower socioeconomic households, and reported poorer health behaviors had higher odds of belonging to the poor mental health, low earnings class.

CONCLUSION

Findings highlight the parallel courses of mental health and labor market earnings, and the influence of gender, race/ethnicity, and adolescent circumstances on these processes.

Suicide rates by occupation in Korea, 1993-2017: the impacts of financial crisis and suicide policy

This study compared the suicide rates among different groups of occupations in Korea and their changes from 1993 through 2017. The suicide rate tended to be low in the high skill occupations except the manager group. The suicide rates showed increases around the financial crises of 1997 and 2008 in most occupations, and the sharpest increase was observed in the managers. The suicide rate in the manager group, which was the lowest among all occupation groups until the mid 2000s, showed the sharpest increase and became the highest since 2012 among all occupation groups. The sustained reduction in suicide rates among the skilled agricultural, forestry and fishery workers in Korea, following the implementation of paraquat control since 2005, shows that means restriction is an effective and essential way for reducing suicides. While more efforts should be put into means restriction, policy makers should focus on changing public perceptions of suicide in order that it would not be accepted as a possible solution for the difficulties in life.

Effects of Job Content and Physical Activity on Body Mass Index among Obese Managers of the Mexican Manufacturing Industry

Mental health disorders resulting from work stressors are increasing in the Mexican manufacturing industry and worldwide. Managerial positions in these contexts are highly stressful, and although physical activity may reduce the negative effects of work stress, the relationships between these two aspects regarding their effects on the body mass index (BMI) of obese managers are scarcely studied. This article aims to study such relationships by using the Job Content Questionnaire (JCQ) dimensions with the Baecke's physical activity questionnaire dimensions and analyzing their effects on the BMI. A sample of 255 managers from the Mexican industry, with a (BMI > 30) participated by answering the surveys and providing their weight, their height, and certain sociodemographic information. The research hypotheses were tested using WarpPLS^® 6.0 for structural equation modeling. The results for three models featuring acceptable reliability to estimate the direct, indirect, and total effects are presented. The first model showed a medium explanatory power, the variable of job decision-making authority having the greatest direct effect on BMI. The second model showed a medium explanatory power, and the variable of physical activity during leisure-time observed the unique direct effect on BMI. Finally, although the integrating model showed a small explanatory power, both work stress and the physical activity exerted observed direct effects on BMI reduction.

Alcohol consumption of UK members of parliament: cross-sectional survey

OBJECTIVES

This study examined the prevalence of risky drinking by members of parliament (MPs), as well as the relationship between risky drinking and age, years spent as an MP, working outside parliament, awareness of the Parliamentary Health and Wellbeing Service, and probable mental ill health.

DESIGN

A survey questionnaire assessed alcohol consumption using the Alcohol Use Disorders Identification Test (AUDIT). Risky drinking was identified by combining categories of increasing (hazardous), higher (harmful) and probable dependent drinking for those with a total score of 8 or more. Comparator groups from the 2014 Adult Psychiatric Morbidity Survey (APMS) were used as controls.

SETTING

UK House of Commons.

PARTICIPANTS

650 MPs.

RESULTS

Compared with all 650 MPs, participants (n=146) were more likely to be female (p<0.05) or have an educational qualification (p<0.05). Weighted proportions on AUDIT items were higher than the APMS comparator group for participants who had a drink four or more times a week, 10 or more drinks on a typical drinking day, six or more drinks in one occasion, or felt guilty because of drinking (p<0.01). Weighted percentages for risky drinking were higher in MPs compared with the whole English population (p<0.05), but similar when compared with socioeconomic comparator groups. The odds of risky drinking were 2.74 times greater for MPs who had an additional work role outside parliament compared with those who did not (95% CI 0.98 to 7.65) and 2.4 times greater for MPs with probable mental ill health compared with those with no evidence of probable mental ill health (95% CI 0.78 to 7.43).

CONCLUSIONS

A low level of awareness of the Parliamentary Health and Wellbeing Service has implications for improving the detection of risky drinking and improving access to this service by MPs. Possible increased likelihood of risky drinking in MPs who also had an additional work role outside Parliament and among those with probable mental ill health requires further exploration.

Mental health of UK Members of Parliament in the House of Commons: a cross-sectional survey

OBJECTIVES

The purpose of this study was to assess (1) the overall mental health of Members of Parliament (MPs) and (2) awareness among MPs of the mental health support services available to them in Parliament.

DESIGN

An anonymous self-completed online cross-sectional survey was conducted in December 2016.

SETTING

56th UK House of Commons.

PARTICIPANTS

All 650 members of the 56th UK House of Commons were invited to participate; 146 MPs (23%) completed the survey.

OUTCOMES

The General Health Questionnaire-12 was used to assess age- and sex-standardised prevalence of probable common mental disorders (CMD). Results were compared with a nationally representative survey, the Health Survey for England (HSE) 2014. Core demographic questions, MPs' awareness of available mental health services, their willingness to discuss mental health issues with party Whips and fellow MPs and the effects of employment outside Parliament were assessed.

RESULTS

Comparison of MP respondents with HSE comparator groups found that MPs have higher rates of mental health problems (age- and sex-standardised prevalence of probable CMD in 49 surveyed MPs 34% (95% CI 27% to 42%) versus 17% (95% CI 13% to 21%) in the high-income comparison group). Survey respondents were younger, more likely to be female and more educated compared with all MPs. 77% of MPs (n=112) did not know how to access in-house mental health support. 52% (n=76) would not discuss their mental health with party Whips or other MPs (48%; n=70).

CONCLUSIONS

MPs in the study sample had higher rates of mental health problems than rates seen in the whole English population or comparable occupational groups. Most surveyed MPs are unaware of mental health support services or how to access them. Our findings represent a relatively small sample of MPs. There is a need for MPs to have better awareness of, and access to, mental health support.

Comparing time off work after work-related mental health conditions across Australian workers' compensation systems: a retrospective cohort study

Workers' compensation claims (WCC) due to mental health conditions (MHC) are the most expensive due to often lengthy periods off work. This retrospective cohort study aims to determine the factors associated with work time loss in Australian workers with accepted WCCs for MHCs, and investigate whether jurisdiction in which a claim is made affects work time loss, using administrative claims data between January 2010 and June 2011. Cox regression analysis showed that worker age, industry, occupation and type of MHC were associated with work time loss. Workers with depressive disorders had longer time loss than those with stress-related conditions. Workers from South Australia, Comcare and Victoria had the longest durations of work time loss, while Australian Capital Territory and Tasmania had shorter durations. Future research should investigate policy variations that could explain the differences in time spent on compensation between jurisdictions.

The moderating effects of aging and cognitive abilities on the association between work stress and negative affect

OBJECTIVES

Given that the association between work stress and negative affect can exacerbate negative health and workplace outcomes, it is important to identify the protective and risk factors that moderate this association. Socioemotional aging and cognitive abilities might influence how people utilize emotion regulation skills and engage in practical problem solving to manage their work stress. The aim of this study is to examine whether age and cognitive abilities independently and interactively moderate the association between work-related stress and negative affect.

METHOD

A diverse working adult sample (N = 139, age 25-65, 69% of females) completed a cross-sectional survey that assessed chronic work stress, negative affect, and fluid and crystallized cognitive abilities.

RESULTS

Results from regression analyses suggested that both fluid and crystallized cognitive abilities, but not age, moderated the association between work stress and negative affect. Further, we found that crystallized cognition had a stronger attenuating effect on the work stress-negative affect association for older compared to younger workers. The moderating effect of fluid cognition was invariant across age.

CONCLUSION

Our findings demonstrate that cognitive abilities are an important personal resource that might protect individuals against the negative impacts of work stress and negative affect. Although the role that fluid cognition plays in work stress-negative affect association is comparably important for both younger and older workers, crystallized cognition might play a more valuable role for older than younger workers.

Extending knowledge of illegitimate tasks: Student satisfaction, anxiety, and emotional exhaustion

Illegitimate tasks represent assignments that individuals feels they "should not have to do" because they are not appropriate given their role. The primary aim of this study was to broaden existing knowledge on illegitimate tasks beyond workplace contexts by exploring whether this stressor was also negatively related to psychological well-being in higher education students. This study examined illegitimate tasks in relation to student satisfaction, anxiety, and emotional exhaustion in a college student setting through the demand-control-support framework. Reports from 473 college students indicated that illegitimate tasks may be important in student populations, as they were linked to student satisfaction and both psychological strain markers. In addition, perceptions of control over how to complete illegitimate tasks did not moderate relationships between illegitimate tasks and these outcomes, but perceptions of instructor support did. Specifically, instructor support buffered the negative effects of illegitimate tasks on anxiety and emotional exhaustion, such that the relationship between perceived task illegitimacy and both outcomes was less pronounced for students perceiving higher levels of support. However, an unexpected pattern emerged for the moderating effect of instructor support such that satisfaction deteriorated with high support, which underscores the need to further explore the function of social support in relation to illegitimate tasks.

Working conditions and mental health: Results from the CARESUN study

The authors conducted a work-related stress surveillance study in 2013 on 6,558 public-sector employees in Italy, examining how they perceived their jobs, via the Job Content Questionnaire, and their mental health status, via the General Health Questionnaire 12 (GHQ-12). Of the 2,094 employees completing the questionnaires, 60% were male, 52% had a medium-level education, and 76% had a medium-level job. Three hundred and eighty-five employees (18%) had a GHQ-12 score >3 and were classified as GHQ-12 cases: these were more often female (54%), medium-to-highly educated (54%), and had more often reported health problems over the previous year (51%). Thus, GHQ-12 cases represented a significant percentage of the examined population, indicating that work-related stress surveillance programs are needed for the planning of psychosocial interventions aimed at the reintegration of individuals with mental health problems.

Work Content and Serious Mental Illness among Middle-Aged Men: Results from a 6-Year Longitudinal Study in Japan

Objective

The present study aimed to determine prospective associations between work content after a working life of more than 20 years and serious mental illness among Japanese men aged 50 to 59 years, using a nationwide population-based survey.

Methods

Data were extracted from a national longitudinal survey of middle-aged and elderly persons previously conducted by the Ministry of Health, Labour and Welfare in Japan. We analyzed data across 10 work content categories for Japanese men who had been working in the same job type or industry for over 20 years. As part pf the survey, participants completed the Kessler (K)6 scale each year to determine their level of psychological distress (with scores ≥13 indicating serious mental illness). Cox discrete time proposal hazard regression analysis was used to examine potential associations between work content and serious mental illness from 2005 to 2010. Further adjustments were made for other sociodemographic characteristics and lifestyle factors.

Results

The current study involved a total of 11,942 participants with a mean (± standard deviation [SD]) of follow-up was 3.4 (± 2.0) years, during which time 892 participants (7.5%) had been classified as having a new-onset serious mental illness. Men who had worked in service jobs and in manufacturing jobs at baseline were more likely to develop serious mental illness than those in managerial jobs (hazard ratio 1.37, 1.30, 95% confidence intervals 1.04–1.80, 1.02–1.65) after adjustment for confounding variables.

Conclusion

These findings suggest that Japanese men aged 50 to 59 years who have worked in service and manufacturing jobs after a working life of over 20 years have an increased risk of serious mental illness during follow-up. Identifying the most at-risk work content category after a working life of over 20 years would be an essential part of providing more effective interventions for psychological distress among Japanese men in this age group.

Depression among physicians working in public healthcare in Belo Horizonte, Brazil

PURPOSE

Prevalence of depressive disorders has been reported among physicians in a number of different settings. The aim of the present study is to assess the prevalence of self-reported depression and its associated factors among physicians working in the public healthcare system of Belo Horizonte, Minas Gerais state, Brazil.

METHODS

A cross-sectional survey was carried out in 2009 to investigate individual and occupational dimensions of depressive disorders in a group of physicians working at several municipal healthcare units. The percentage of physicians that self-reported a confirmed diagnosis of depression by another physician was used as the prevalence proportion; the Poisson regression univariate and multivariate models were applied to study factors associated with depression.

RESULTS

The response rate was 81.2 %, of which 12.0 % reported depression confirmed by another physician. Reports of RSI/WMSD (p < 0.001) and passive work (p < 0.05) were positively and independently associated with the outcome.

CONCLUSIONS

Our data bring valuable information that may help guide interventions and health-promoting activities for physicians by indicating concrete measures to change working conditions that affect mental health.

Short-term effects of the 2008 Great Recession on the health of the Italian population: an ecological study

PURPOSE

To report on the effects on health that the 2008 Great Recession is producing in Italy, by comparing the consistency of Italian data with general observations reported in the scientific literature, and by pointing out consequences on the rates of all-cause mortality, cardiovascular mortality, male suicidal behaviours, daytime alcohol drinking and traffic fatalities.

METHODS

This is an ecological study in which MEDLINE, PsycINFO and PubMed were searched for the literature with combinations of the following keywords: economic recession, financial crisis, unemployment, health, suicide and mental health. Data from two Italian government agencies (Italian Institute of Statistics, ISTAT, and Italian Agency of Drugs, AIFA) in the years from 2000 to 2010 were obtained and analysed, by producing models of multiple linear regressions.

RESULTS

After the recession onset, all-cause mortality remained stable, and was not associated with the economic fluctuations. Differently, cardiovascular mortality was associated with the rate of unemployment, and showed a significant increase in 2010. Alcohol consumption increased in 2009, the year with the worst real GDP decrease (-5.1 %). Though the total rate of suicide was not associated with the economic situation, male completed and attempted suicides due to financial crisis were significantly associated with the rate of unemployment and the real GDP. The increasing diffusion of antidepressants was not associated with a lowering of the rate of suicide.

CONCLUSIONS

The data on the Italian situation here discussed are sufficiently reliable to conclude that a link exists between the ongoing economic recession and health and mental health of Italians. Further research is needed to understand more in detail and with stronger reliability such link, to support primary and secondary preventive interventions and orient the development of effective sociopolitical interventions.

Psychosocial work factors, blood pressure and psychological strain in male bus operators

The research aim was to predict the bus operators' blood pressure (BP) and psychological strain using a combination of the Job-Demand Control (JDC) and Effort-Reward Imbalance (ERI) models. The study was conducted with a sample of 139 bus operators in the city of Bogotá (Colombia), who answered a questionnaire that included the Job Content Questionnaire (JCQ), the ERI Questionnaire, and the General Health Questionnaire (GHQ). Four consecutive BP readings taken in the workplace were averaged to calculate an estimation of the bus operators' BP. By conducting multiple linear regressions it was found that, taken together, JDC and ERI models explain 10% (F(11,139)=2,502; p=0.00) of systolic BP variance, and 34% (F(6,139)=8,638; p=0.00) of psychological strain variance. These results suggest that the JDC and ERI predictors provide complementary information which increases the probability of accurately model the bus operators' health.

Impact of social discrimination, job concerns, and social support on Filipino immigrant worker mental health and substance use

BACKGROUND

The personal and social impact of mental health problems and substance use on workforce participation is costly. Social determinants of health contribute significantly to health disparities beyond effects associated with work. Guided by a theory-driven model, we identified pathways by which social determinants shape immigrant worker health.

METHOD

Associations between known social determinants of mental health problems and substance use (social discrimination, job and employment concerns, and social support) were examined using structural equation modeling in a sample of 1,397 immigrants from the Filipino American Community Epidemiological Study.

RESULTS

Social discrimination and low social support were associated with mental health problems and substance use (P < 0.05). Job and employment concerns were associated with mental health problems, but not substance use.

CONCLUSIONS

The integration of social factors into occupational health research is needed, along with prevention efforts designed for foreign-born ethnic minority workers.

The importance of both workplace and private life factors in psychological distress: a large cross-sectional survey of French railway company employees

PURPOSE

The psychological well-being of employees is a priority in occupational health. This study aimed to estimate the prevalence of psychological distress among employees of a large French company, to calculate the associations between distress and stressors in the workplace and private life domains, and to explore confounding across stressor domains.

METHODS

8,058 employees of the French national railways company completed a nation-wide survey in 2006 (94.3 % participation). Psychological distress was measured by the 12-item General Health Questionnaire and 21 potential stressors and socio-demographic factors by a self-administered questionnaire. Stressors were summarized in scores for work pressure, workplace conflict, and personal life domains. Risk ratios (RRs) between psychological distress and stressors were calculated using robust-variance Poisson regression.

RESULTS

The prevalence of psychological distress was 32.8 % (95 % CI 31.8-33.9 %), higher among women (48.9 %, 95 % CI 46.5-51.7 %) than men (30.1 %, 95 % CI 29.0-31.2 %). Each stressor domain was associated with distress in the final model containing likely confounders and all three domains (RR highest vs. lowest level-work pressure: men 1.55, 95 % CI 1.42-1.70, women 1.42, 95 % CI 1.23-1.63; work conflict: men 2.63, 95 % CI 2.38-2.91, women 1.98, 95 % CI 1.70-2.30; life concerns: men 2.04, 95 % CI 1.86-2.23, women 1.53, 95 % CI 1.32-1.78). The mutually adjusted RRs for the stressor domains were smaller than the unadjusted RRs.

CONCLUSIONS

Almost one-third of all employees and one-half of female employees experienced psychological distress. All three stressor domains were associated with psychological distress and adjustment reduced the association size, suggesting possible over-estimation if one or more domains are omitted from the survey.

Job and life satisfaction of nonstandard workers in South Korea

Since the South Korean financial crisis of the late 1990s, the number of nonstandard workers in South Korea has increased rapidly. With such a drastic change, it has been difficult to establish national welfare systems (e.g., accident insurance or support for families with dependent children) for nonstandard workers and identify critical aspects of their health. To evaluate job and life satisfaction among nonstandard workers, this study used a representative sample of South Koreans. Using data from the 2008 Korean Labor and Income Panel Study, the sample size totaled 4,340 observations, of which 1,344 (31.0%) involved nonstandard workers. Significant differences in job and life satisfaction between nonstandard workers and standard workers were found. The results also indicate discrimination in the welfare and fringe benefit systems in South Korea. Occupational health nurses must address the physical and psychological health issues, personal problems, and everyday life concerns of nonstandard workers. Given that the employment status of nonstandard workers in companies is generally unstable, it is difficult for these workers to report poor working conditions to employers or other authorities. Accordingly, occupational health nurses should advocate for nonstandard workers by notifying employers of the many problems they face.

Occupations, work characteristics and common mental disorder

BACKGROUND

The present study aimed to assess the prevalence of common mental disorders (CMDs) by occupation in a representative sample of the English adult population. Another aim was to examine whether the increased risk of CMD in some occupations could be explained by adverse work characteristics. Method We derived a sample of 3425 working-age respondents from the Adult Psychiatric Morbidity Survey 2007. Occupations were classified by Standard Occupational Classification group, and CMD measured by the Revised Clinical Interview Schedule. Job characteristics were measured by questionnaire, and tested as explanatory factors in associations of occupation and CMD.

RESULTS

After adjusting for age, gender, housing tenure and marital status, caring personal service occupations had the greatest risk of CMD compared with all occupations (odds ratio 1.73, 95% confidence interval 1.16-2.58). The prevalence of adverse psychosocial work characteristics did not follow the pattern of CMD by occupation. Work characteristics did not explain the increased risk of CMDs associated with working in personal service occupations. Contrary to our hypotheses, adding work characteristics individually to the association of occupation and CMD tended to increase rather than decrease the odds for CMD.

CONCLUSIONS

As has been found by others, psychosocial work characteristics were associated with CMD. However, we found that in our English national dataset they could not explain the high rates of CMD in particular occupations. We suggest that selection into occupations may partly explain high CMD rates in certain occupations. Also, we did not measure emotional demands, and these may be important mediators of the relationship between occupation type and CMDs.

Psychosocial work factors, major depressive and generalised anxiety disorders: results from the French national SIP study

BACKGROUND

Anxiety and depression are prevalent mental disorders in working populations. The risk factors of these disorders are not completely well known. Developing knowledge on occupational risk factors for mental disorders appears crucial. This study investigates the association between various classical and emergent psychosocial work factors and major depressive and generalised anxiety disorders in the French working population.

METHODS

The study was based on a national random sample of 3765 men and 3944 women of the French working population (SIP 2006 survey). Major Depressive Disorder (MDD) and Generalised Anxiety Disorder (GAD) were measured using a standardised diagnostic interview (MINI). Occupational factors included psychosocial work factors as well as biomechanical, physical, and chemical exposures. Adjustment variables included age, occupation, marital status, social support, and life events. Multivariate analysis was performed using logistic regression analysis.

RESULTS

Low decision latitude, overcommitment, and emotional demands were found to be risk factors for both MDD-GAD among both genders. Other risk factors were observed: high psychological demands, low reward, ethical conflict, and job insecurity, but differences were found according to gender and outcome. Significant interaction terms were observed suggesting that low decision latitude, high psychological demands, and job insecurity had stronger effects on mental disorders for men than for women.

LIMITATIONS

Given the cross-sectional study design, no causal conclusion could be drawn.

CONCLUSIONS

This study showed significant associations between classical and emergent psychosocial work factors and MDD-GAD. Preventive actions targeting various psychosocial work factors, including emergent factors, may help to reduce mental disorders at the workplace.

Personality Development at Work: Workplace Conditions, Personality Changes, and the Corresponsive Principle

Investigations concerning adult personality development have increasingly focused on factors that are associated with apparent personality trait changes. The current study contributes to this literature by replicating and extending previous research concerning personality trait development in young adulthood and perceptions of workplace conditions. Analyses were based on up to 442 individuals who participated in the ongoing Family Transitions Project (e.g., Conger & Conger, 2002). The current analyses included personality trait data from 1994 and 2003, high school grades and socioeconomic status indicators from 1994, and reports about work conditions in 2001, 2003, and 2005. Personality attributes were prospectively associated with work conditions and income. Findings also support the corresponsive principle of personality development (e.g., Roberts, Caspi, & Moffitt, 2003): Traits that were prospectively associated with particular workplace conditions often seemed to be accentuated by those conditions. Personality traits are prospectively associated with perceptions of the workplace. Workplace conditions are also associated with trait development.

Psychological distress in Canada: the role of employment and reasons of non-employment

BACKGROUND

This study investigated variations in psychological distress in a large sample of the Canadian population according to employment status, occupation, work organization conditions, reasons for non-employment, stress and support outside the work environment, family situation and individual characteristics.

METHODS

Data came from cycle 4 (2000-1) of the Canadian National Population Health Survey conducted by Statistics Canada. Multiple regression analyses, adjusted for the family situation, the level of support from the social network and the individual characteristics, were carried out on a sample of 7258 individuals aged from 18 to 65 years.

RESULTS

Occupation, social support at work, age, self-esteem, presence of children aged five and under and social support outside of the workplace were associated with lower levels of psychological distress, while permanent and temporary disability, psychological demands in the workplace, job insecurity, female gender, and stressful financial, marital and parental situations were related to higher levels of psychological distress.

CONCLUSIONS

Findings from this study suggest that, in terms of psychological distress, having a job is not always better than non-employment, and that specific non-employment situations associate differently with psychological distress.

Predictors for suicidal ideation after occupational injury

Risk of suicide has been associated with trauma and negative life events in several studies. Our aim was to investigate the prevalence and risk factors of suicidal ideation, and the population attributable risk among workers after occupational injuries. We investigated workers who had been hospitalized for ≧3 days after occupational injuries between February 1 and August 31, 2009. A self-reported questionnaire including demographic data, injury condition, and the question of suicidal ideation was sent to 4498 workers at 3 months after their occupational injury. A total of 2001 workers (45.5%) completed the questionnaires and were included in final analysis. The prevalence of reporting suicidal ideation was 8.3%. After mutual adjustment, significant risk factors for suicidal ideation higher than "serious" in a self-rated severity scale (adjusted odds ratio, aOR=2.31; adjusted population attributable risk, aPAR=34.7%), total hospital stay for 8 days or longer (OR=1.98; aPAR=20.5%), intracranial injury (OR=2.30; aPAR=10.2%), and marriage status of being divorced/separated/widowed (OR=2.70; aPAR=10.0%). Three months after occupational injury, a significant proportion of workers suffered from suicidal ideation. Significant predictors of suicidal ideation after occupational injury included broken marriage, intracranial injury, injury severity, and total hospital stay. Identification of high risk subjects for early intervention is warranted.

[Consumption of alcohol and other drugs by the active population in Spain]

OBJECTIVE

To describe consumption patterns of alcohol and other drugs in the active population in Spain by gender.

METHODS

Based on 15,082 active persons selected from the Domiciliary Survey of Alcohol and Drugs (Encuesta Domiciliaria de Alcohol y Drogas [EDADES]) 2007, we estimated prevalences for high-risk alcohol consumption (>50 g/day in males, >30 g/day in females), daily intake of tranquilizers, cannabis consumption in the last 30 days, and consumption of any other illegal drug in the last 12 months, by employment status, economic sector and occupational categories. Odds ratios (OR) and their confidence intervals (95% CI) were estimated by logistic regression models.

RESULTS

The following prevalences were found: high-risk alcohol consumption, 3.4%; daily use of tranquilizers, 2.3%; cannabis consumption in the last 30 days, 7.9%; and consumption of any illegal drug in the last 12 months, 11.9%. Except for tranquilizer use, prevalences were higher in men than in women. Consumption of tranquilizers (OR = 1.68; 95%CI: 1.04-2.73), cannabis and other illegal drugs were all higher in unemployed men than in employed men, while only tranquilizer consumption was higher in unemployed women (OR = 1.70; 95% CI: 1.23-2.34). High-risk alcohol consumption was greater among men engaged in the catering, primary production and construction sectors in comparison to manufacturing industries: OR = 1.63 (95% CI: 1.11-2.38), OR = 1.52 (95% CI: 1.04-2.20), and OR = 1.50 (95% CI: 1.10-2.04), respectively. For women, those in catering showed higher consumptions of cannabis (OR = 2.34; 95% CI: 1.28-4.27) and of other illegal drugs (OR = 2.85; 95% CI: 1.71-4.76); the latter were also higher in commerce, transport and administration sectors than in manufacturing industries.

CONCLUSIONS

These findings could serve as a useful reference for companies wanting to carry out preventive programs, and also for future studies assessing the impact of preventive measures.

Alcohol dependence, consumption of alcoholic energy drinks and associated work characteristics in the Taiwan working population

AIMS

To examine the association between work characteristics and the risk of alcohol dependence across different employment types and occupations, including the pattern of alcohol consumption in the form of energy drinks and its association with alcohol dependence.

METHODS

A total of 13,501 men and 8584 women participated in a national survey in Taiwan. Alcohol dependence was defined as ≥2 points in the CAGE questionnaire. A self-administered questionnaire recorded drinking behaviors, consumption of alcoholic energy drinks, employment type, occupation and a number of psychosocial work stressors, namely job demands, job control, employment security and workplace justice.

RESULTS

Of the total, 9.4% of men and 0.8% of women were CAGE-positive, and 6.0% of men and 0.7% of women regularly consumed alcoholic energy drinks. In male and female regular consumers of alcoholic energy drinks, 38.7 and 23.3%, respectively, were alcohol-dependent. Multivariate regression analyses showed that male employees in manual skilled occupations, with lower workplace justice, having weekly working hours <40 h and on piece-rated or time-based pay systems were at higher risks of alcohol dependence.

CONCLUSION

Certain occupational groups and workers with adverse psychosocial work characteristics should be targets for prevention of alcohol dependence. Alcoholic energy drink consumption should be taken into consideration while studying alcohol dependence in the work population in Taiwan.

Working conditions and psychotropic medication: a prospective cohort study

PURPOSE

To examine whether work arrangements, physical working conditions and psychosocial working conditions are associated with subsequent mental health problems, measured by prescribed psychotropic drugs.

METHODS

Data on working conditions collected among 40-60-year-old employees of the City of Helsinki, Finland (N = 6,498) were linked with the register of prescribed medication. Purchases of antidepressants (ATC class N06A), sleeping pills and sedatives (N05B and N05C), and any psychotropic drugs during a 5-year follow-up were examined. Current users and those with regular use of psychotropic drugs during the past 3 years were excluded, leaving 5,786 respondents for analysis.

RESULTS

Working overtime was associated with purchases of sleeping pills among men but otherwise the associations between work arrangements and psychotropic medication were negligible. Desktop work was associated with purchases of sleeping pills among women. Among psychosocial working conditions, high self-assessed mental strenuousness and job dissatisfaction were consistently associated with purchases of antidepressants, sleeping pills and any psychotropic drugs. The strongest association was found for job dissatisfaction, which increased the risk of antidepressant purchases by 24% per one standard deviation increase in job dissatisfaction. The results for men were largely similar, with high mental strenuousness and job dissatisfaction, and poor workplace climate showing the strongest associations, particularly with antidepressant purchases.

CONCLUSIONS

Adjustment of work environments by reducing mental strenuousness and improving job satisfaction might help in prevention of mental health problems that account for a major part of the disease burden among employees.

Considerações sobre trabalho e suicídio: um estudo de caso

As empresas vêm presenciando o suicídio de seus empregados, atribuído, de acordo com Dejours e Bègue (2010), às consequências negativas das novas organizações do trabalho. Com base no estudo de óbito de trabalhador bancário, o foco deste artigo é avaliar se o trabalho poderia ser um dos fatores relacionado à decisão de cometer-se o suicídio. Avaliou-se o significado qualitativo da morte sob o ponto de vista do irmão do suicida (ambos colegas de trabalho durante mais de 20 anos), entrevistado em 2009. Visto que esse tipo de análise produz volume significativo de dados sobre o fenômeno pesquisado, estes foram processados e analisados por meio de análise categorial. O bancário trabalhava na empresa havia três décadas e morreu em meados de 2000, faltando um ano para aposentadoria, após a esposa requerer o divórcio. O trabalho foi o contexto para compreender o processo que o conduziu à ruína familiar, à exasperação psíquica e, por fim, à morte. O caso não envolveu assédio moral, já que se tratava de empregado muito bem conceituado, mas de patologia associada à servidão voluntária, patologia essa cada vez mais estimulada como símbolo de sucesso. No ambiente de trabalho, problemas conjugais foram os fatores atribuídos como causa maior do suicídio, mais conveniente como forma de eximir responsabilidades perante o infortúnio, transferindo somente ao sujeito a culpa por conflitos pessoais ou desordens psíquicas.

Occupation and mental health in a national UK survey

OBJECTIVES

To measure the prevalence of common mental disorder (CMD) by occupation in a representative sample of Great Britain and to identify occupations with increased and decreased risk of CMD.

METHODS

A cross-sectional interview-based survey was carried out including 5,497 working male and female respondents, 16-64 years from a stratified random survey of private households in Britain. Occupations were classified by the Standard Occupational Classification (SOC) into four groups: major, sub-major, minor and constituent unit groups. Common Mental Disorder was measured by the Revised Clinical Interview Schedule.

RESULTS

Major SOC groups with higher prevalence of common mental disorder included clerical and secretarial, sales, and personal and protective services whereas craft and related, 'other' professional occupations and plant and machine operatives had lower prevalence compared to 13% overall prevalence in all adults. In sub-major SOC groups managers and administrators, teaching professionals, clerical and secretarial, 'other' sales and personal service occupations had higher prevalence whereas many professional and skilled occupations had lower prevalence. Specific SOC unit groups with higher prevalence included primary and secondary teachers, welfare community, youth workers, security staff, waiters, bar staff, nurse auxiliaries and care assistants. General managers in government and large organizations (OR=2.79, 95% CI 1.41-5.54), managers in transport and storing (OR=2.44, 95% CI 1.18-5.03), buyers and mobile sales persons (OR=2.48, 95% CI 1.09-5.60), sales occupations (NES) (OR=2.78, 95% CI 1.25-6.19) and clerks (NES) (OR=2.71, 95% CI 1.59-4.61) had increased risk of common mental disorder relative to specialist managers adjusting for social and financial factors and physical ill-health.

CONCLUSIONS

Occupations with higher risk of common mental disorder may be typified by high levels of job demands, especially emotional demands and lack of job security. The reasons why occupations have low rates of common mental disorder are varied and may include high levels of job discretion, good job training and clearly defined job tasks.

Association between bullying at work and mental disorders: gender differences in the Italian people

BACKGROUND

In the last few years the international literature has shown an increasing attention for the work as life-event stressor, for its organizational characteristics as well as for job insecurity and interpersonal conflicts.

METHODS

We have studied 707 subjects who approached the Work Psychopathology Medical Centre of Naples to evaluate the DSM IV diagnoses and the degree of bullying at the workplace according to Leymann's definition. Two groups, with high and with low severity of bullying, were compared, mainly in relation to gender differences.

RESULTS

The more frequent diagnoses were anxiety disorders (8.7% of the total), mood disorders (31.5%) and adjustment disorders (58.3%). The patients with higher degree of bullying were 55.7% among the subjects with anxiety disorders, 51.4% among the patients with adjustment disorders and 81.25% in the group with mood disorders. The odds of patients with severe bullying was 1.602 times higher for males than for females. Independently by the gender, the odds of patients being in the group with severe bullying were more than three times higher for subjects with mood disorders than for patients suffering from anxiety and adjustment disorders.

DISCUSSION

In the male gender, the psychiatric disturbances are more correlated to bullying at the workplace and this datum is especially linked to the gender differences found in the relationship between severity of bullying and adjustment disorders. Among female employees the psychopathological dimensions could be linked with a more multifactorial genesis in relation to their psychosocial role in the cultural context we examined (Southern Italy).

Changing job-related burnout after intervention--a quasi-experimental study in six human service organizations

OBJECTIVE

In a longitudinal study design to analyze the development of burnout at worksites and to study the effect of interventions intended to reduce the level of burnout at individual level.

METHODS

At baseline the study, sample consisted of 1024 individuals divided at six organizations and 18 worksites in the human service sector. Four different types of interventions were identified: external and internal reorganizations, educational days, and consultancy. Burnout defined as work related, client related, and personal burnout was measured by means of the Copenhagen Burnout Inventory at baseline and at first and second follow-up during the years 1999 to 2005.

RESULTS

We found a weak but statistically significant negative effect of reorganizations after adjusting for potential confounders and mediators defined as changes in the psychosocial working conditions.

CONCLUSION

The four types of interventions did not reduce the level of burnout in our study.

Veterinary surgeons and suicide: a structured review of possible influences on increased risk

Veterinary surgeons are known to be at a higher risk of suicide compared with the general population. There has been much speculation regarding possible mechanisms underlying the increased suicide risk in the profession, but little empirical research. A computerised search of published literature on the suicide risk and influences on suicide among veterinarians, with comparison to the risk and influences in other occupational groups and in the general population, was used to develop a structured review. Veterinary surgeons have a proportional mortality ratio (PMR) for suicide approximately four times that of the general population and around twice that of other healthcare professions. A complex interaction of possible mechanisms may occur across the course of a veterinary career to increase the risk of suicide. Possible factors include the characteristics of individuals entering the profession, negative effects during undergraduate training, work-related stressors, ready access to and knowledge of means, stigma associated with mental illness, professional and social isolation, and alcohol or drug misuse (mainly prescription drugs to which the profession has ready access). Contextual effects such as attitudes to death and euthanasia, formed through the profession's routine involvement with euthanasia of companion animals and slaughter of farm animals, and suicide 'contagion' due to direct or indirect exposure to suicide of peers within this small profession are other possible influences.

Psychosocial work environment and depressive symptoms among US workers: comparing working poor and working non-poor

BACKGROUND

The psychosocial work environment has been associated with mental health outcomes; however, little research has examined this relationship for low-wage workers. The purpose of this study was to investigate the relationship between psychosocial job characteristics and depressive symptoms for US workers using an expanded model of job quality.

METHODS

Data were from the 2002 National Study of the Changing Workforce, a nationally representative study of wage and salaried workers in the US. Working poor was defined as households earning <250% of the federal poverty threshold.

RESULTS

Multivariate logistic regression models show for working poor employees, job insecurity was the single significant correlate of depressive symptoms after controlling for other demographic and work environment variables. For working non-poor employees, high psychological demands and low supervisor and coworker support were associated with depressive symptoms.

CONCLUSIONS

Findings suggest all jobs do not equally affect employees' depressive symptoms. Implications for research that may improve the mental health of the working poor in the US are presented.

Gender specificity in the prediction of clinically diagnosed depression. Results of a large cohort of Belgian workers

BACKGROUND

The recent increase in the incidence of clinical depression represents a major public health and socio-economical burden. Depression has its roots in both professional and private domains but few epidemiological studies have looked at predictors of long term clinical depression as defined by a sick-leave of 28 days or more and a diagnosis by a general practitioner in both genders.

OBJECTIVES

To study baseline predictors of long term spells of clinical depression within the framework of a large prospective study, the Belstress Study, in 6,659 men and 2,737 women aged 35-59 years at baseline survey.

METHODS

Kaplan-Meyer survival curves and Cox regression models were used in order to relate long term clinical depression defined by a sick-leave of 28 days or more to baseline socio-demographic and work and non-work variables.

RESULTS AND CONCLUSIONS

Density incidence of long term clinical depression is 0.5 years and 1.1/1,000 persons/months for men and women respectively. In univariate analyses specific gender predictors were observed as for men predictors besides level of education, were work related: high job-strain OR 1.67 (CI 95% 1.03; 2.71) and work dissatisfaction OR 1.78 (CI 95% 1.09; 2.91) whereas for women baseline predictors are related to private life dissatisfaction OR 1.84 (CI 95% 1.16; 2.91) and to a lesser degree low social support from co-workers OR 1.50 (CI 95% 0.93; 2.40). In both genders baseline severe depression symptoms defined by a CES-D score of percentile 90 or above is a predictor of long term sick-leave for clinical depression. In multivariate analyses, in a model without baseline CES-D high job-strain and job dissatisfaction remain independent predictors for incident clinical depression in men whereas only private life dissatisfaction remains a significant predictor in women. When added to the model CES-D is the most powerful predictor of clinical depression in both genders. Together with level of education, work dissatisfaction remains borderline significant in men whereas private life dissatisfaction remains an independent predictor for clinical depression in women. In men baseline symptoms of depression alleviate the impact of high job-strain on incident clinical depression whereas in women, private life dissatisfaction remains an independent predictor of clinical depression.

Psychosocial factors at work and perceived health among agricultural meat industry workers in France

OBJECTIVE

The objective of this study was to describe the perceived health status of the meat industry employees--i.e., working in the slaughtering, cutting, and boning of large animals and poultry--and its relation to their organisational and psychosocial constraints at work.

METHODS

This postal survey included all 3,000 employees of the meat industry (beef, pork and poultry) in four districts in Brittany, France, whose companies were affiliated with the agricultural branch of the national health insurance fund. The questionnaire asked for social and demographic data and information describing their job and the organisation of their work. The psychosocial factors at work were described according to Karasek's questionnaire (demand, latitude and social support at work). Perceived health was measured with the Nottingham Health Profile perceived health indicator.

RESULTS

This study shows the high prevalence of poor health reported by the workers in this industry. This poor perceived health was worse in women and increased regularly with age. Among the psychosocial factors studied, high quantitative and qualitative demand at work, inadequate resources for good work and to a lesser extent, inadequate prospects for promotion appear especially associated with poor perceived health. Other factors often associated with poor perceived health included young age at the first job and work hours that disrupt sleep rhythms (especially for women).

CONCLUSION

Our results show that this population of workers is especially vulnerable from the point of view of perceived physical and psychological health and is exposed to strong physical, organisational and psychosocial constraints at work. They also demonstrate that poor perceived health is associated with some psychosocial (such as high psychological demand and insufficient resources) and organisational factors at work. These results, in conjunction with those from other disciplines involved in studying this industry, may help the companies to develop preventive activities.

Prevalence of common mental disorders and their work consequences in France, according to occupational category

BACKGROUND

The aims of the study are to estimate the prevalence of the common mental disorders according to occupational category and to describe the consequences of these disorders on their work, in the French population.

METHODS

It took place in France from 1999 to 2003. The sample consisted of about 36,000 people aged 18 years and older. Data were collected face-to-face using the Mini International Neuropsychiatric Interview (MINI).

RESULTS

Anxiety disorders were most common (17% in men and 26% in women), while prevalence estimates for mood disorders were 10% in men and 14% in women. Prevalence of troubles were consistently higher among those in the lowest occupational categories. Among those reporting mental disorders, about 50% said that their work was affected. The repercussions on job varied by occupational category and differently for men and women.

CONCLUSION

This study shows the social and occupational inequalities in the prevalence of mental disorders and their important work consequences in the French working population. Am. J. Ind. Med. 52:141-152, 2009. (c) 2008 Wiley-Liss, Inc.

Risk factors for depression in truck drivers

OBJECTIVE

Depression is a major public health problem. Work stress is associated with depression and workers whose jobs impose high levels of psychological demands, such as truck drivers, may be at increased risk. The aim of this study was to investigate the prevalence and correlates of depression in truck drivers.

METHOD

This was a cross-sectional study of 300 male truck drivers. Presence and severity of depression were assessed by the Mini International Neuropsychiatric Interview followed by the Beck Depression Inventory Short Form. Relevant demographic, clinical and occupational data were collected using a purpose-built questionnaire.

RESULTS

The prevalence of depression among truck drivers was 13.6%. Multivariate analysis showed that being 45 years or older had a protective effect (OR=0.19; P=0.02), whereas low educational level (OR=3.03; P=0.01), use of stimulants (OR=5.03; P<0.01) and wage-earning (OR=2.84; P=0.01), as opposed to self-employment, increased the risk for depression.

CONCLUSIONS

Truck drivers are at increased risk for depression when compared to the general population. Efforts to increase awareness of this problem and to limit the use of stimulants, as well as measures to improve job satisfaction, particularly among the wage-earning drivers, may have a positive impact on mental health in these workers.

A proposed approach to suicide prevention in Japan: the use of self-perceived symptoms as indicators of depression and suicidal ideation

The incidence of suicide in Japan has increased markedly in recent years, making suicide a major social problem. Between 1997 and 2006, the annual number of suicides increased from 24,000 to 32,000; the most dramatic increase occurred in middle-aged men, the group showing the greatest increase in depression. Recent studies have shown that prevention campaigns are effective in reducing the total number of suicides in various areas of Japan, such as Akita Prefecture. Such interventions have been targeted at relatively urban populations, and national data from public health and clinical studies are still needed. The Japanese government has established the goal of reducing the annual number of suicides to 22,000 by 2010; toward this end, several programs have been proposed, including the Mental Barrier-Free Declaration, and the Guidelines for the Management of Depression by Health Care Professionals and Public Servants. However, the number of suicides has not declined over the past 10 years. Achieving the national goal during the remaining years will require extensive and consistent campaigns dealing with the issues and problems underlying suicide, as well as simple screening methods for detecting depression. These campaigns must reach those individuals whose high-risk status goes unrecognized. In this review paper, we propose a strategy for the early detection of suicide risk by screening for depression according to self-perceived symptoms. This approach was based on the symposium Approach to the Prevention of Suicide in Clinical and Occupational Medicine held at the 78th Conference of the Japanese Society of Hygiene, 2008.

Occupation and Health: A Review of Selected Literature

Occupational therapy is based on the belief that people can influence the state of their health through what they do. However, there appears to be a shortage of evidence to support this belief. This paper describes a review of selected literature on the effects of occupation on health. The aims were to review how occupation and health are defined in the occupational therapy literature; to find synonyms for these two terms to enable a search for relevant literature; to review evidence for a relationship between what people do and their health; and to identify factors that mediate the relationship between occupation and health.

The review had five main findings: occupation and health are defined in a variety of ways by occupational therapists; there is a wealth of literature, representing a number of disciplines and a wide range of research, that explores the relationship between occupation and health; engaging in occupation carries both potential health benefits and risks to health; there is limited knowledge of the ways in which occupation influences health; and the impact of occupation on health is mediated by a complex range of factors. These findings have implications for occupational therapy research, practice and education.