Three job-related stress models and depression: a population-based study

Person-centered exploration of work-related stress patterns, predictors, and their association with subhealth in midwives: A cross-sectional study

BACKGROUND

Midwives experience elevated levels of work-related stress. However, there is limited understanding of the patterns of this stress, its sociodemographic and work-related determinants, and its association with sub-health.

METHOD

This multi-center cross-sectional study, conducted in 21 hospitals in Zhuhai City, Guangdong Province, China, involved 300 midwives. Work-related stress levels in midwives were evaluated using the Chinese version of the Nursing Stress Scale, while social, physical and mental sub-health status was measured with the Sub-Health Measurement Scale. Utilizing latent profile analysis, the study aimed to categorize midwives into homogeneous profiles based on patterns of work-related stress.

RESULTS

Among the 300 midwives examined, three distinct profiles were identified: profile 1 (n=57, 19 %), characterized by low work-related stress; profile 2 (n=149, 50 %), representing the moderate work-related stress class; and profile 3 (n=94, 31 %), indicative of high work-related stress. Midwives in the high work-related stress profile tended to be younger, with lower monthly income, lower professional titles, and a higher likelihood of night shift work (all P<0.01). Significant and noteworthy trends were observed in sociodemographic characteristics (age, monthly income, and professional title) and work-related characteristics (night shift status). After controlling for confounders, the work-related stress profile demonstrated a negative association with social, physical and mental sub-health status.

CONCLUSION

This study highlights integrating stress domains and adopting a person-centered approach to examine midwives' work-related stress. Identifying predictors of profile membership and their relationship with sub-health can inform tailored interventions to reduce stress and improve midwives' well-being.

Effort-reward imbalance and common mental disorders among public sector employees of Iran: a cross-sectional analysis

BACKGROUND

The effort-reward imbalance (ERI) model is a widely used theoretical model to measure stress in the workplace. The objective of this study was to investigate the relationship between ERI and three common mental disorders: major depressive disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD).

METHODS

In this cross-sectional analysis, the study sample consisted of 4453 baseline participants of the Employees' Health Cohort Study of Iran (EHCSIR). Trained psychologists utilized the Persian version of the Composite International Diagnostic Interview (CIDI-2.1) during the baseline assessment to identify common mental disorders. Additionally, the validated Persian version of the 23-item ERI questionnaire was employed to assess effort, reward, overcommitment, and effort-reward ratio. To examine the association of ERI components with three common mental disorders (MDD, GAD, and OCD) over the past twelve months, multiple logistic regression analyses were conducted.

RESULTS

The prevalence of effort-reward imbalance in the study sample was 47.1%. Higher ERI score was significantly associated with MDD (OR: 3.43, 95% CI: 2.30-5.13), GAD (OR: 2.42, 95% CI: 1.27-4.63), and OCD (OR: 2.23, 95% CI:1.19-4.19). The study participants who reported higher scores on work overcommitment had a higher likelihood of having MDD (OR: 1.16, 95% CI:1.10-1.23), GAD (OR: 1.07, 95% CI: 1.01-1.14), and OCD (OR: 1.19, 95% CI: 1.09-1.29).

CONCLUSIONS

According to the study's findings, work-related stress, as determined by the ERI model, is a significant factor in the development of common mental disorders among employees in the public sector.

The Relationship Between Work-Related Stress and Depression: A Scoping Review

Objectives

Work-related stress is highly prevalent. Recent systematic reviews concluded on a significant association between common work-related stress measures and depression. Our scoping review aims to explore whether work-related psychosocial stress is generally associated with depression or depressiveness, the extent and methodology of the primary research undertaken on this topic and to elucidate inconsistencies or gaps in knowledge.

Methods

We searched for literature in Pubmed, PsycInfo and Web of Science including full reports in seven languages published between 1999 and 2022 and applied the PRISMA statement for scoping reviews criteria.

Results

Of 463 primarily identified articles, 125 were retained after abstract and full-text screening. The majority report significant associations between work-related stress and depression. Cross-sectional studies are most prevalent. Sufficient evidence exists only for job strain and effort-reward imbalance. Most studies are from Asia, North America and Europe. The health sector is the most studied. Several research gaps such as the lack of interventional studies were identified.

Conclusion

The consistency of most studies on the significant association between work-related stress and depression is remarkable. More studies are needed to improve evidence and to close research gaps.

Too stressed to de-stress? The experience of work stress and recovery among attorneys during the COVID-19 pandemic

It is well-established that legal professionals experience high stress and often high rates of associated health problems. Much less is known about attitudes and behaviours around stress prevention in this occupation. Our study examined views of stress and recovery among 131 U.S. attorneys. In open-ended data, attorneys commonly expressed that their job is very demanding, and it impacts their health. Many respondents felt it was important to manage their stress but had difficulty doing so. Quantitative analyses showed that attitudes about stress (stress-related comparisons, viewing stress as achievement, stress-related impression management, and stigma around stress concerns) demonstrated several significant relationships with perceived stress, recovery experiences, remorse for relaxation, and work-family conflict. Our findings suggest that practical interventions to support the health and well-being of legal professionals may need to target the workload norms, as well as attitudes and beliefs about the normalness of high stress and insufficient recovery.

Mental health of working parents during the COVID-19 pandemic: can resilience buffer the impact of psychosocial work stress on depressive symptoms?

BACKGROUND

The COVID-19 pandemic has confronted working parents with an accumulation of stressors regarding changes in work, family, and social life, putting their mental health at risk. Stressors include altered working conditions such as working from home or changes in working hours as well as the difficulty to reconcile work and childcare due to the closure of childcare facilities. The present study examined the relationship of psychosocial work stress (i.e., work-privacy conflict and effort-reward imbalance at work) and depressive symptoms in working parents and whether this association was moderated by individual resilience.

METHODS

Data of the present study (n = 452) were collected in Germany between May and June 2020 as part of the DREAM_CORONA study. A subsample of working mothers (n = 191) and fathers (n = 261) completed the subscale for work-privacy conflict (WPC) of the Copenhagen Psychosocial Questionnaire, the Effort-Reward Imbalance (ERI) Questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), and the Edinburgh Postnatal Depression Scale (EPDS). Multiple linear regression analyses including moderation were performed, controlling for gender, working hours per week, and a lifetime history of depression as potential confounders.

RESULTS

Both WPC (β = 0.336, p < .001) and ERI (β = 0.254, p < .001) were significantly associated with depressive symptoms. Resilience moderated the relationship between ERI and depressive symptoms (β = - 0.101, p = .018), indicating that higher resilience weakened the relationship. However, this effect was not found regarding the relationship between WPC and depressive symptoms (β = 0.055, p = .167).

CONCLUSIONS

The results highlight the need for measures to reduce psychosocial work stressors such as WPC and ERI during the COVID-19 pandemic on the one hand and to promote resilience on the other hand. The findings partially support the potential protective role of resilience buffering the association between psychosocial stress and mental health in working parents. Longitudinal studies are needed to confirm this effect.

Identifying the Moderating Effect of Hyperconnectivity on the Relationship between Job Demand Control Imbalance, Work-to-Family Conflict, and Health and Well-Being of Office Employees Working in the Oil and Gas Industry, Malaysia

There is an increasing acknowledgment of the added value obtained by integrating technological efforts to engage employees round the clock for organizational productivity. Hyperconnectivity is the demand of time for competitive advantage in businesses, but studies on its impact on the health and well-being of the employees have been neglected in academic research. Hence, in this study, we investigated the effect of hyperconnectivity on health and well-being, and in moderating the effect of work-to-family conflict and job demand control imbalance on the health and well-being of the office employees. An online questionnaire survey was used to collect data from 410 office employees working in the oil and gas industry in Malaysia. Respondents were approached through the LinkedIn forum. Statistical tests, principal component analysis, structural equation modeling, and path analysis were conducted. It is found that hyperconnectivity has a negatively insignificant effect on health and well-being. In addition, hyperconnectivity significantly strengthens the negative effect of job demand control imbalance (22%) and work-to-family conflict (24%) on health and well-being. It is concluded that hyperconnectivity decreases health and expedites other psychosocial hazards related to the health and well-being of the employees. Urgent measures should be taken to reduce unnecessary and frequent online notifications, messages, emails, and phone calls, both during and off-working hours. In this way, the effect of job demand control imbalance and work-to-family conflict can be reduced on the health and well-being of the office employees. Considering the negative consequences of hyperconnectivity, this problem should be addressed in health and safety policies in organizations. Future studies can investigate the effect of hyperconnectivity on job demands and control separately.

Does salivary cortisol secretion mediate the association of work-related stressors with workers' depression?

PURPOSE

The purpose of this study was to verify the mediating role salivary cortisol intensity plays between work organization conditions and depression. This study simultaneously considered psychological and physiological (salivary cortisol) stress indicators on workers' depression in a single model.

METHODS

We relied on cluster sampling of 341 workers in 34 Quebec establishments. Five saliva samples (on awakening, 30 min after awakening, at 2:00 p.m., 4:00 p.m., and bedtime) were collected per day. The weekly collection period spanned a period of 3 days (1 day off and 2 work days). We evaluated the main effects of work organization conditions on salivary cortisol intensity and depression, as well as the mediation effect of salivary cortisol intensity between work organization conditions and depression. To adjust for design effects, the direct and indirect (mediation) associations between the variables were evaluated while accounting for the non-independence of the data.

RESULTS

Skill utilization and job insecurity were associated with salivary cortisol intensity, while psychological demands and job insecurity were associated with higher depression levels. Work-related variables were not found to have an indirect effect on depression via worker's salivary cortisol (AUC) intensity.

CONCLUSION

Work-related stressors examined in this study did not indirectly affect worker's depression levels. Additional studies are necessary to be able to identify all work-related stressors that could potentially increase worker's depression levels through salivary cortisol.

Is Burnout Primarily Linked to Work-Situated Factors? A Relative Weight Analytic Study

It has often been asserted that burnout is primarily linked to occupational-context factors, and only secondarily to individual-level (e.g., personality) and non-work (or general) factors. We evaluated the validity of this view by examining the links between burnout and an array of 22 work-situated (effort-reward imbalance, unreasonable work tasks, unnecessary work tasks, weekly working hours, job autonomy, skill development, performance feedback, and support in work life), work-unrelated (sentimental accomplishment, familial accomplishment, number of child[ren], leisure activities, residential satisfaction, environmental quality, security in daily life, and support in personal life), dispositional (neuroticism, sex, age, and physical condition), and intersecting (work–non-work conflict and non-work–work conflict) variables. The study involved schoolteachers from three different countries: France (N = 4,395), Spain (N = 611), and Switzerland (N = 514). Burnout was assessed with the Maslach Burnout Inventory for Educators. Most of our predictors were assessed based on widely used measures (e.g., neuroticism was assessed with the NEO-Five Factor Inventory). In order to assess sentimental accomplishment and familial accomplishment, we created two self-reported measures, namely, the Sentimental Accomplishment Inventory (SAI; 9 items) and the Familial Accomplishment Inventory (FAI; 9 items). The SAI and the FAI both showed strong reliability and high factorial validity. Exploratory structural equation modeling bifactor analysis and Mokken scaling suggested that both instruments could be considered essentially unidimensional. The study results showed that neuroticism, job strain, skill development, security in daily life, and work–non-work conflict were consistently associated with burnout across the three samples. Sample-specific predictors of burnout included sex, age, unreasonable work tasks, weekly working hours, job autonomy, support in work life, sentimental accomplishment, leisure activities, support in personal life, and non-work–work conflict. Relative weight analysis indicated that neuroticism was the best predictor of burnout in each sample. Our findings suggest that burnout’s nomological network may not be primarily job-related. We conclude that the tendency to de-emphasize individual-level and non-work factors in burnout research is unwise. This tendency may constitute a roadblock in the development of effective interventional strategies. The implications of our findings for burnout’s conceptual status are discussed. The neuroticism-burnout link should be further examined in longitudinal studies.

Work Stress and General Trust: The Mediating Effect of Depression and the Moderating Effect of the OXTR Gene rs53576

BACKGROUND

Work stress has been proved to be linked to depression, and both can decrease general trust. Likewise, OXTR gene is currently the gene that is most closely associated with trust. However, few empirical studies have explored the significant role of gene-environment interactions on general trust. In this study, we explored the mediating role of depression in the relationship between work stress and general trust, and the moderating role of the OXTR rs 53576 in the mediation model.

METHODS

364 healthy Han Chinese faculties were recruited from one university in Beijing. Work stress, depression, and general trust were assessed using the House and Rizzo's Work Stress Scale, Self-Rating Depression Scale (SDS), and the General Trust Questionnaire, respectively. Blood samples were collected for OXTR rs53576 genotyping.

RESULTS

Depression mediated the relationship between work stress and general trust. In the mediation model, OXTR rs53576 could only moderated the direct path from work stress to general trust. For AA and GA individuals, depression completely mediated the relationship between work stress and general trust. For GG individuals, depression partly mediated the relationship between work stress and general trust.

LIMITATIONS

This study used a cross-sectional design, only considered Han Chinese faculties, and the role of other genes should be explored.

CONCLUSIONS

Depression has a mediating effect between work stress and general trust. The general trust levels of GG genotype individuals are more prone to be affected by work stress than AA and GA individuals.

Validation of Chinese Multidimensional Depression Assessment Scale (MDAS) in Inner Mongolia pregnant women and risk factors of antenatal depression in Inner Mongolia in the era of one-child policy

BACKGROUND

Pregnancy involves physiological changes in reproductive and endocrine systems, and social role changes that can increase the risk of mental health problems. In China, greater emphasis has been given to postpartum depression and its negative impact on infant development. This study examined depression in pregnant women in Inner Mongolia, who are under the influence of cultural values of collectivism and social factors specific to China. Chinese society adheres firmly to traditional values, while market reform, birth-control policy, together with high parental investment in childcare and rearing construct a unique and sometimes unfavorable environment for Chinese women that may influence their depression expression.

THE AIMS OF THIS STUDY ARE TWOFOLD

First, it validated the Chinese Multidimensional Depression Assessment Scale (MDAS), a holistic self-report questionnaire measuring depression severity in four domains of depression-emotional, somatic, cognitive and interpersonal in pregnant women in Inner Mongolia; second, it examined the influences of demographic characteristics (including age, education and employment), pregnancy characteristics (week of gestation, first pregnancy), self-esteem, social support, social activity, work stress, and work-family balance on depression.

METHODS

A total of 234 pregnant women, mostly in their third trimester, were recruited in an antenatal hospital in Inner Mongolia and self-reported questionnaires were completed.

RESULTS

Using Confirmatory factor analysis (CFA), MDAS gave rise to a best-fit four-factor model corresponding to each subscale when it was first developed. MDAS also reported high Cronbach's alpha (0.96) and good convergent validity. Using hierarchical multiple linear regressions with significant demographic variables controlled for, self-esteem, work-family conflict, and social support were found to be significant predictors for depression.

CONCLUSIONS

MDAS is a valid scale to be used with Chinese pregnant women, especially in more collectivistic geographical areas. Risk factors specific to the Chinese context add insights to the experience of antenatal depression in China and contribute to understanding depression in from a global mental health perspective.

Does Depression Mediate the Effect of Work Organization Conditions on Job Performance?

OBJECTIVE

The present study proposes to shed light on the impact of workers' depression on their work performance.

METHODS

We implemented a path analyses adjusted for design effects resulting from cluster sampling using MPlus software on a sample of 1957 workers. These analyses allowed us to evaluate direct and indirect effects (mediation) while taking into account the nonindependence of observations due to cluster sampling (workers nested in their workplace).

RESULTS

Results indicate that three indirect associations were found to be significant. Psychological demands, work schedule, and job insecurity were indirectly associated with lower levels of professional efficacy/job performance because of their positive associations with depression.

CONCLUSIONS

The results obtained suggest that interventions targeting specific work organization conditions could be warranted.

Association between job-related stress and experience of presenteeism among Korean workers stratified on the presence of depression

Background

Presenteeism refers to the phenomenon of working while sick. Its development can be attributed to not only somatic symptoms but also underlying social agreements and workplace atmosphere. In this study, we analyzed presenteeism among workers from various industries, focusing on job-related stress with stratification on the presence of depression.

Methods

We conducted the study with data from questionnaires filled in by different enterprises enrolled in the Federation of Korean Trade Unions. Workers' depressive symptoms were investigated using the Patient Health Questionnaire-2, while questions on job-related stress and presenteeism were derived from the short form of the Korean Occupational Stress Scale and the official Korean version of the Work-Productivity and Activity Impairment Questionnaire-General Health, respectively. Multilevel logistic analysis was conducted to determine the statistical differences derived from the differences between companies.

Results

In total, 930 participants (753 men and 177 women) from 59 enterprises participated in the research. We conducted multilevel logistic regression to determine the association between the variables and presenteeism, with stratification by the presence of depression. Higher job demands and higher interpersonal conflict showed significantly elevated odds ratios (ORs) in univariate models and in the multivariate multilevel model. In the final model of total population, fully adjusted by general and work-related characteristics, higher job demands (OR: 3.29, 95% confidence interval [CI]: 2.08-5.21) and interpersonal conflict (OR: 1.87, 95% CI: 1.29-2.71) had significantly higher ORs-a tendency that remained in participants without depression.

Conclusions

This study reflected the factors associated with presenteeism among workers from various enterprises. The findings revealed that job-related stress was closely related to presenteeism in both the total population and in the population without depression. Thus, it emphasized interventions for managing job stress among workers to reduce presenteeism in general workers' population.

Depressive symptoms in Chinese assembly-line migrant workers: A case study in the shoe-making industry

INTRODUCTION

Assembly-line migrant workers (AMWs), as a major workforce in China, may be at particularly high risk of depression due to their relative low social economic status and particular job characteristics. However, little is known about the frequency and characteristics of depression among Chinese AMWs. This study investigated the prevalence and correlates of depressive symptoms in Chinese AMWs.

METHODS

In this cross-sectional survey, 915 Chinese AMWs from two shoe-making factories completed a standardized questionnaire to report their socio-demographics, physical health, migration, and work. They also reported their depressive symptoms by completing the Beck Depression Inventory-Short Form (BDI-SF). We conducted multiple logistic regression analysis to identify factors related to depression.

RESULTS

We found that 31.7% of AMWs were clinically depressed (BDI-SF ≥ 8). The multiple regression model included age, self-rated physical health, pain, family relationships, having no good friends at the same factory, and working under high pressure.

DISCUSSION

Our findings suggest that depression is common among Chinese AMWs. We argue that there is an urgent need for health care providers and factory managers to work on the early identification of AMWs, who are at high risk for depression. Psychological and psychiatric treatments are necessary in the Chinese labor-intensive industries.

Burnout, Depression, and Borderline Personality: A 1,163-Participant Study

We examined the association of burnout with borderline personality (BP) traits in a study of 1,163 educational staff (80.9% women; mean age: 42.96). Because burnout has been found to overlap with depression, parallel analyses of burnout and depression were conducted. Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure, depressive symptoms with the PHQ-9, and BP traits with the Borderline Personality Questionnaire. Burnout was found to be associated with BP traits, controlling for neuroticism and history of depressive disorders. In women, burnout was linked to both the "affective insecurity" and the "impulsiveness" component of BP. In men, only the link between burnout and "affective insecurity" reached statistical significance. Compared to participants with "low" BP scores, participants with "high" BP scores reported more burnout symptoms, depressive symptoms, neuroticism, and occupational stress and less satisfaction with life. Disattenuated correlations between burnout and depression were close to 1, among both women (0.91) and men (0.94). The patterns of association of burnout and depression with the main study variables were similar, pointing to overlapping nomological networks. Burnout symptoms were only partly attributed to work by our participants. Our findings suggest that burnout is associated with BP traits through burnout-depression overlap.

The choice that matters: the relative influence of socioeconomic status indicators on chronic back pain- a longitudinal study

Background

In health research, indicators of socioeconomic status (SES) are often used interchangeably and often lack theoretical foundation. This makes it difficult to compare results from different studies and to explore the relationship between SES and health outcomes. To aid researchers in choosing appropriate indicators of SES, this article proposes and tests a theory-based selection of SES indicators using chronic back pain as a health outcome.

Methods

Strength of relationship predictions were made using Brunner & Marmot’s model of ‘social determinants of health’. Subsequently, a longitudinal study was conducted with 66 patients receiving in-patient treatment for chronic back pain. Sociodemographic variables, four SES indicators (education, job position, income, multidimensional index) and back pain intensity and disability were obtained at baseline. Both pain dimensions were assessed again 6 months later. Using linear regression, the predictive strength of each SES indicator on pain intensity and disability was estimated and compared to the theory based prediction.

Results

Chronic back pain intensity was best predicted by the multidimensional index (beta = 0.31, p < 0.05), followed by job position (beta = 0.29, p < 0.05) and education (beta = −0.29, p < 0.05); whereas, income exerted no significant influence. Back pain disability was predicted strongest by education (beta = −0.30, p < 0.05) and job position (beta = 0.29, p < 0.05). Here, multidimensional index and income had no significant influence.

Conclusions

The choice of SES indicators influences predictive power on both back pain dimensions, suggesting SES predictors cannot be used interchangeably. Therefore, researchers should carefully consider prior to each study which SES indicator to use. The introduced framework can be valuable in supporting this decision because it allows for a stable prediction of SES indicator influence and their hierarchy on a specific health outcomes.

The combined effects of job demand and control, effort-reward imbalance and work-family conflicts on the risk of major depressive episode: a 4-year longitudinal study

Purpose

Work-related psychosocial factors may precipitate the onset of depression. In occupational mental health research, there are three widely used theoretical models, namely, job demand and control (JD-C), effort-reward imbalance (ERI) and work-family conflicts (WFC). However, the interaction between these models and their combined effect on the risk of major depression in the workplace is largely unknown. The aim of this study is to examine the longitudinal combined effects of JD-C, ERI and WFC on the risk of major depression in the working population.

Methods

Longitudinal data (2008-2013) were collected on randomly selected participants (n=4200) from the working population of the province of Alberta, Canada, at baseline and 1-, 2-, 3- and 4-year follow-up. Data about JD-C, ERI, WFC and major depression were collected by trained interviewers using a computer-assisted telephone interviewing method. Generalised estimating equations for longitudinal modelling were used.

Results

There was an independent association between high ERI and high WFC at tx and major depression at tx+1 (OR 1.56, 95% CI 1.25 to 1.96; OR 1.33, 95% CI 1.16 to 1.52), respectively. The combined effects of JD-C and ERI, ERI and WFC, and WFC and JD-C on the risk of major depression were as follows: OR 1.71, 95% CI 1.22 to 2.42, OR 2.47, 95% CI 1.99 to 3.49 and OR 2.21, 95% CI 1.48 to 3.30, respectively. The relative excess risks attributable to the interactions were statistically non-significant.

Conclusions

Work-related psychosocial factors are associated with increased risk of major depression over time, but their combined effect is not synergistic. The effects of the factors depicted in the three occupational health models on the risk of major depression appear to be additive.

Association of Job Stressors With Panic Attack and Panic Disorder in a Working Population in Japan: A Cross-Sectional Study

OBJECTIVE

This study aimed to investigate associations of job stressors with panic attack (PA) and panic disorder (PD) among Japanese workers.

METHODS

A cross-sectional online questionnaire survey was conducted of 2060 workers. Job strain, effort/reward imbalance, and workplace social support were measured by the job content questionnaire and effort/reward imbalance questionnaire. These variables were classified into tertiles. PA/PD were measured by self-report based on the mini international neuropsychiatric interview (MINI). Multiple logistic regression was conducted, adjusting for demographic, lifestyle, and health-related covariates.

RESULTS

Data from 1965 participants were analyzed. Adjusted odds ratio (OR) of PA/PD was significantly greater for the group with high effort/reward imbalance compared with the group with low effort/reward imbalance (ORs, 2.64 and 2.94, respectively, both P < 0.05).

CONCLUSION

This study found effort/reward imbalance was associated with having PA/PD among Japanese workers.

The Contribution of Individual, Social and Work Characteristics to Employee Mental Health in a Coal Mining Industry Population

BACKGROUND

Evidence regarding the extent of mental health problems and the associated characteristics within an employee population is necessary to inform appropriate and tailored workplace mental health programs. Mental health within male dominated industries (such as mining) has received recent public attention, chiefly through observations regarding suicide in such populations in Australia and internationally. Currently there is limited empirical evidence regarding the mental health needs in the mining industry as an exemplar of a male dominated workforce, and the relative contribution to such problems of individual, socio-economic and workplace factors. This study aimed to investigate the mental health and associated characteristics among employees in the Australian coal mining industry with a specific focus on identifying modifiable work characteristics.

METHODS

A cross-sectional study was conducted among employees (n = 1457) across eight coal mines stratified by key mine characteristics (state, mine type and employee commute arrangements). Participants completed measures of psychological distress (K10+) and key variables across four categories (socio-demographic characteristics, health history, current health behaviours, work attitudes and characteristics).

RESULTS

Psychological distress levels within this sample were significantly higher in comparison with a community sample of employed Australians. The following factors contributed significantly to levels of psychological distress using hierarchical linear regression analysis: lower social networks; a past history of depression, anxiety or drug/alcohol problems; high recent alcohol use; work role (managers) and a set of work characteristics (level of satisfaction with work, financial factors and job insecurity; perception of lower workplace support for people with mental health problems.

CONCLUSION

This is the first study to examine the characteristics associated with mental health problems in the Australian coal mining industry. The findings indicate the salience of mental health needs in this population, and the associated interplay of personal, social and work characteristics. The work characteristics associated with psychological distress are modifiable and can guide an industry response, as well as help inform the understanding of the role of workplace factors in mental health problems in a male dominated workforce more generally.

Physicians' occupational stress, depressive symptoms and work ability in relation to their working environment: a cross-sectional study of differences among medical residents with various specialties working in German hospitals

OBJECTIVES

This study aimed to analyse and compare differences in occupational stress, depressive symptoms, work ability and working environment among residents working in various medical specialties.

METHODS

435 German hospital residents in medical training working in 6 different medical specialties participated in a cross-sectional survey study. Physicians were asked about their working conditions and aspects of mental health and work ability. The Copenhagen Psychosocial Questionnaire, the Work Ability Index, the ICD-10 Symptom Rating and the Perceived Stress Questionnaire were used to measure working conditions, mental health and work ability.

RESULTS

Results show that up to 17% of the physicians reported high levels of occupational distress and 9% reported high levels of depressive symptoms. 11% of the hospital physicians scored low in work ability. Significant differences between medical specialties were demonstrated for occupational distress, depressive symptoms, work ability, job demands and job resources. Surgeons showed consistently the highest levels of perceived distress but also the highest levels of work ability and lowest scores for depression. Depressive symptoms were rated with the highest levels by anaesthesiologists. Significant associations between physicians' working conditions, occupational distress and mental health-related aspects are illustrated.

CONCLUSIONS

Study results demonstrated significant differences in specific job stressors, demands and resources. Relevant relations between work factors and physicians' health and work ability are discussed. These findings should be reinvestigated in further studies, especially with a longitudinal study design. This work suggests that to ensure physicians' health, hospital management should plan and implement suitable mental health promotion strategies. In addition, operational efficiency through resource planning optimisation and work process improvements should be focused by hospital management.

Employers' perceptions and attitudes toward the Canadian national standard on psychological health and safety in the workplace: A qualitative study

The estimated societal and economic costs of mental illness and psychological injury in the workplace is staggering. Governments, employers and other stakeholders have been searching for policy solutions. This qualitative, exploratory study sought to uncover organizational receptivity to a voluntary comprehensive standard for dealing with psychological health and safety in the workplace. A series of five focus groups were conducted in a large Western Canadian city in November 2013. The seventeen participants were from the fields of healthcare, construction/utilities, manufacturing industries, business services, and finance. They worked in positions of management, consulting, human resources, health promotion, health and safety, mediation, and occupational health and represented organizations ranging in size from 20 to 100,000 employees. The findings confirm and illustrate the critical role that psychological health and safety plays across workplaces and occupations. This standard resonated across the represented organizations and fit with their values. This alignment posed challenges with articulating its added value. There appears to be a need for simplified engagement and implementation strategies of the standard that can be tailored to the nuanced differences between types and sizes of industries. It appears that organizations in the most need of improving psychological health and safety may be the least receptive.

Does workplace health promotion contribute to job stress reduction? Three-year findings from Partnering Healthy@Work

BACKGROUND

Workplace health promotion (WHP) has been proposed as a preventive intervention for job stress, possibly operating by promoting positive organizational culture or via programs promoting healthy lifestyles. The aim of this study was to investigate whether job stress changed over time in association with the availability of, and/or participation in a comprehensive WHP program (Healthy@Work).

METHOD

This observational study was conducted in a diverse public sector organization (~28,000 employees). Using a repeated cross-sectional design with models corroborated using a cohort of repeat responders, self-report survey data were collected via a 40 % employee population random sample in 2010 (N = 3406) and 2013 (N = 3228). Outcomes assessed were effort and reward (self-esteem) components of the effort-reward imbalance (ERI) measure of job stress. Exposures were availability of, and participation in, comprehensive WHP. Linear mixed models and Poisson regression were used, with analyses stratified by sex and weighted for non-response.

RESULTS

Higher WHP availability was positively associated with higher perceived self-esteem among women. Women's mean reward scores increased over time but were not statistically different (p > 0.05) after 3 years. For men, higher WHP participation was associated with lower perceived effort. Men's mean ERI increased over time. Results were supported in the cohort group.

CONCLUSIONS

For women, comprehensive WHP availability contributed to a sense of organizational support, potentially impacting the esteem component of reward. Men with higher WHP participation also benefitted but gains were modest over time and may have been hindered by other work environment factors.

Depressive symptoms and psychosocial aspects of work in bank employees

BACKGROUND

The financial sector has seen an increase in the number of cases of violence and stress, which can result in adverse health outcomes, including depressive symptoms, but studies related to stress at work and depression for these workers are scarce.

AIMS

To investigate the association between exposure to psychosocial work stressors and depressive symptoms in bank employees.

METHODS

A self-administered questionnaire was completed by a sample of bank employees in Pará and Amapá, Brazil. The survey assessed sociodemographic characteristics, mental health (Patient Health Questionnaire-9), Demand-Control-Support and Effort-Reward Imbalance (ERI). Outcomes included two levels of depressive symptoms: major depressive symptoms (MDS) and other forms of depressive symptoms (ODS). Logistic regression models were used to estimate associations between depressive symptoms, the two job stress models and relevant covariates.

RESULTS

Of 2806 eligible subjects, there were 1445 respondents (52% response rate) and the final analyses included 1046 participants. The overall prevalence of depressive symptoms was 32% (MDS = 18%; ODS = 14%), with no statistically significant difference between men and women. High demands, low levels of control and low social support were associated with MDS and/or ODS, adjusted for gender, age and other work-related conditions. High effort/low reward, over-commitment and ERI were also associated with MDS and ODS.

CONCLUSIONS

Psychosocial conditions in banking activity involving high strain, low social support at work, high effort with low reward and over-commitment may represent possible risk factors for depressive symptoms in bank employees.

Squeezing blood from a stone: how income inequality affects the health of the American workforce

Income inequality is very topical-in both political and economic circles-but although income and socioeconomic status are known determinants of health status, income inequality has garnered scant attention with respect to the health of US workers. By several measures, income inequality in the United States has risen since 1960. In addition to pressures from an increasingly competitive labor market, with cash wages losing out to benefits, workers face pressures from changes in work organization. We explored these factors and the mounting evidence of income inequality as a contributing factor to poorer health for the workforce. Although political differences may divide the policy approaches undertaken, addressing income inequality is likely to improve the overall social and health conditions for those affected.

Burnout-depression overlap: a review

Whether burnout is a form of depression or a distinct phenomenon is an object of controversy. The aim of the present article was to provide an up-to-date review of the literature dedicated to the question of burnout-depression overlap. A systematic literature search was carried out in PubMed, PsycINFO, and IngentaConnect. A total of 92 studies were identified as informing the issue of burnout-depression overlap. The current state of the art suggests that the distinction between burnout and depression is conceptually fragile. It is notably unclear how the state of burnout (i.e., the end stage of the burnout process) is conceived to differ from clinical depression. Empirically, evidence for the distinctiveness of the burnout phenomenon has been inconsistent, with the most recent studies casting doubt on that distinctiveness. The absence of consensual diagnostic criteria for burnout and burnout research's insufficient consideration of the heterogeneity of depressive disorders constitute major obstacles to the resolution of the raised issue. In conclusion, the epistemic status of the seminal, field-dominating definition of burnout is questioned. It is suggested that systematic clinical observation should be given a central place in future research on burnout-depression overlap.

Classic and emergent psychosocial work factors and mental health

BACKGROUND

Little is known about associations between emergent psychosocial work factors and mental health.

AIMS

To explore associations between classical and emergent psychosocial work factors and depression and anxiety symptoms in employees in France.

METHODS

A national cross-sectional study (the SUrveillance Médicale des Expositions aux Risques professionnels (SUMER) survey) assessed psychosocial work factors including psychological demands, decision latitude, social support, reward and its sub-dimensions (esteem, job security and job promotion), bullying, verbal abuse, physical violence and sexual assault, long working hours, shift and night work, unsociable work days, predictability and demands for responsibility. We also measured depression and anxiety symptoms using the Hospital Anxiety and Depression scale. We used gender-stratified generalized linear models to adjust for age, occupation and economic activity.

RESULTS

A total of 26883 men and 20079 women participated (response rate 87%). Low decision latitude, high psychological demands, low social support, low reward, bullying and verbal abuse were associated with depression and anxiety in both genders (β coefficients from 0.14 to 1.40). In men, low predictability was associated with both depression and anxiety (β = 0.12 [95% confidence interval (CI) 0.01, 0.24] and 0.19 [95% CI 0.06, 0.32]) and long working hours were associated with anxiety (β = 0.48 [95% CI 0.27, 0.69]). The strongest associations were observed for bullying, reward (especially esteem) and psychological demands. Using a less conservative approach, we found more factors to be significantly associated with mental health symptoms.

CONCLUSIONS

Most psychosocial work factors studied are associated with depression and/or anxiety symptoms. Comprehensive prevention policies may help to reduce exposure to psychosocial work factors, including emergent ones, and improve mental health at work.

Job stress and mental health among nonregular workers in Korea: What dimensions of job stress are associated with mental health?

Although nonregular workers experience higher job stress, poorer mental health, and different job stress dimensions relative to regular workers, little is known about which job stress dimensions are associated with poor mental health among nonregular workers. This study investigated the association between job stress dimensions and mental health among Korean nonregular workers. Data were collected from 333 nonregular workers in Seoul and Gyeonggi Province, and logistic regression analysis was conducted. Results of the study indicated that high job insecurity and lack of rewards had stronger associations with poor mental health than other dimensions of job stress when controlling for sociodemographic and psychosocial variables. It is important for the government and organizations to improve job security and reward systems to reduce job stress among nonregular workers and ultimately alleviate their mental health issues.

The association between occupational stress and depressive symptoms and the mediating role of psychological capital among Chinese university teachers: a cross-sectional study

BACKGROUND

Depression is a major public health problem that affects both individuals and society. Previous studies report that university teachers are particularly susceptible to high levels of occupational stress and depressive symptoms. The aims of this study were to explore the association between occupational stress and depressive symptoms in a group of university teachers, and assess the mediating role of psychological capital between these variables.

METHODS

A cross-sectional study was performed between November 2013 and January 2014. Teachers from six universities were randomly sampled in Shenyang. The Center for Epidemiologic Studies Depression Scale, effort-reward imbalance scale, and psychological capital questionnaire (PCQ-24), as well as questions about demographic and working factors, were administered in questionnaires distributed to 1,500 university teachers. Completed questionnaires were received from 1,210 participants. Hierarchical linear regression analysis was used to examine the mediating role of psychological capital.

RESULTS

In the present study, 58.9% (95% CI (Confidence Intervals): 56.1% to 61.7%) of university teachers had a CES-D score equal to or above the cut-off of 16. Both effort-reward ratio (ERR) and scores of over-commitment were positively associated with depressive symptoms, whereas psychological capital was negatively associated with depressive symptoms among university teachers. Psychological capital partially mediated the relationship between occupational stress and depressive symptoms.

CONCLUSIONS

Among Chinese university teachers, occupational stress may be a risk factor for depressive symptoms, whereas psychological capital might be protective against depressive symptoms. Our results suggest that college administrators could support the development of psychological capital in their staff to alleviate depressive symptoms.

Prevalence rates for depression by industry: a claims database analysis

PURPOSE

To estimate and interpret differences in depression prevalence rates among industries, using a large, group medical claims database.

METHODS

Depression cases were identified by ICD-9 diagnosis code in a population of 214,413 individuals employed during 2002-2005 by employers based in western Pennsylvania. Data were provided by Highmark, Inc. (Pittsburgh and Camp Hill, PA). Rates were adjusted for age, gender, and employee share of health care costs. National industry measures of psychological distress, work stress, and physical activity at work were also compiled from other data sources.

RESULTS

Rates for clinical depression in 55 industries ranged from 6.9 to 16.2 %, (population rate = 10.45 %). Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress and low levels of physical activity.

CONCLUSIONS

Additional research is needed to help identify industries with relatively high rates of depression in other regions and on the national level, and to determine whether these differences are due in part to specific work stress exposures and physical inactivity at work.

CLINICAL SIGNIFICANCE

Claims database analyses may provide a cost-effective way to identify priorities for depression treatment and prevention in the workplace.

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.

Prevalence and associated factors of depressive symptoms among Chinese underground coal miners

Although underground coal miners are quite susceptible to depressive symptoms due to a highly risky and stressful working environment, few studies have focused on this issue. The purpose of the study was to evaluate the prevalence of depressive symptoms and to explore its associated factors in this population. A cross-sectional survey was conducted in a coal-mining population in northeast China. A set of self-administered questionnaires was distributed to 2500 underground coal miners (1,936 effective respondents). Depressive symptoms, effort-reward imbalance (ERI), overcommitment (OC), perceived physical environment (PPE), work-family conflict (WFC), and some demographic and working characteristics were measured anonymously. The prevalence of depressive symptoms was 62.8%, and the mean level was 20.00 (9.99). Hierarchical linear regression showed that marital status, education, monthly income, and weekly working time were significantly associated with depressive symptoms. A high level of depressive symptoms was significantly associated with high ERI, PPE, WFC, and OC. Accordingly, most Chinese underground coal miners probably have depressive symptoms that are mainly predicted by some occupational psychosocial factors. Efforts should be made to develop strategies to reduce ERI and OC, improve physical working environment, and care for workers' family well-being, thereby mitigating the risk of depression among Chinese underground coal miners.

Job stress and work-related musculoskeletal symptoms among intensive care unit nurses: a comparison between job demand-control and effort-reward imbalance models

BACKGROUND

The aims of this study were to compare job demand-control (JDC) and effort-reward imbalance (ERI) models in examining the association of job stress with work-related musculoskeletal symptoms and to evaluate the utility of a combined model.

METHODS

This study analyzed cross-sectional survey data obtained from a nationwide random sample of 304 intensive-care unit (ICU) nurses. Demographic and job factors were controlled in the analyses using logistic regression.

RESULTS

Both JDC and ERI variables had strong and statistically significant associations with work-related musculoskeletal symptoms. Effort-reward imbalance had stronger associations than job strain or iso-strain with musculoskeletal symptoms. Effort-reward imbalance alone showed similar or stronger associations with musculoskeletal symptoms compared to combined variables of the JDC and ERI models.

CONCLUSIONS

The ERI model appears to capture the magnitude of the musculoskeletal health risk among nurses associated with job stress at least as well and possibly better than the JDC model. Our findings suggest that combining the two models provides little gain compared to using effort-reward imbalance only.

Work-related Stress, Caregiver Role, and Depressive Symptoms among Japanese Workers

Background

In Japan, more than 60% of employees are reported to suffer from anxiety and stress. Consequently, Japanese society has begun to address such important issues as psychogenic disability and job-related suicide. Furthermore, given the aging of society and the surge in the number of elderly people requiring care, it is necessary to adequately and proactively support employees who care for their elderly relatives. The purpose of the present study was to investigate caregiver burden in caring for elderly relatives and work-related stress factors associated with mental health among employees.

Methods

We studied 722 men and women aged 18–83 years in a cross-sectional study. The K10 questionnaire was used to examine mental health status.

Results

The proportion of participants with a high K10 score was 15% (n = 106). Having little conversation with their supervisor and/or coworkers significantly increased the risk of depression [odds ratio (OR) 1.8], as did high job overload (OR 2.7) and job dissatisfaction (OR 3.8), compared with employees who frequently conversed with their supervisor and/or coworkers. Caring for elderly relatives as a prominent characteristic of an employee was a significant risk factor for depression (OR 2.1).

Conclusion

The present study demonstrated that employees who were caring for elderly relatives were significantly associated with an increased risk of depression. To prevent depressive disorders, it may be important to focus on reducing the work-caregiving role conflict, as well as enhancing employees' job control and better rewarding their efforts in the workplace.

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.

Psychosocial work environment among Swedish audiologists

OBJECTIVE

The study examined the self-reported psychosocial work environment for audiologists working in three practice types (public, completely private, and private but publicly funded).

DESIGN

A cross-sectional e-mail survey using the demand-control-support questionnaire, a short version of the effort-reward imbalance (ERI) questionnaire, and descriptive data.

STUDY SAMPLE

Five-hundred Swedish licensed audiologists.

RESULTS

Overall, the results indicate differences in psychosocial work environment pertaining to the practice types. These differences are small and the type explains few percent of the variability accounted in the measures of psychosocial work environment. Social support seems important for the psychosocial work environment and is considered a reward in itself. Using the demand-control model, 29% of the audiologists reported working in a high-stress psychosocial work environment. Using the ERI-ratio to estimate the imbalance between effort and reward it was shown that that 86% of the participants experienced an unfavorable work situation where the rewards do not correspond to the efforts made.

CONCLUSIONS

The organizational framework has minor effect on self-reported psychosocial work environment for Swedish licensed audiologists. The percentage of unfavorable ERI-ratios seen in Swedish audiologists seems conspicuously high compared to other working populations in general, but also compared to other health service workers.

A population-based longitudinal study on work environmental factors and the risk of major depressive disorder

To investigate the relation between work environmental factors and the risk of major depressive disorder (MDD) over 1 year, the authors conducted a population-based longitudinal study of randomly selected employees in Alberta, Canada (January 2008 to November 2011). Participants without a current or lifetime diagnosis of MDD at baseline (n = 2,752) were followed for 1 year. MDD was assessed using the World Health Organization’s Composite International Diagnostic Interview-Auto 2.1. The overall 1-year incidence of MDD was 3.6% (95% confidence interval: 2.8, 4.6); it was 2.9% (95% confidence interval: 1.9, 4.2) in men and 4.5% (95% confidence interval: 3.3, 6.2) in women. The relations between work environmental factors and MDD differed by sex. In men, high job strain increased the risk of MDD in those who worked 35–40 hours per week; job insecurity and family-to-work conflict were predictive of MDD. Women who worked 35–40 hours per week and reported job insecurity, a high effort-reward imbalance, and work-to-family conflict were at a higher risk of developing MDD. Job strain, effort-reward imbalance, job insecurity, and work-to-family conflicts are important risk factors for the onset of MDD and should be targets of primary prevention. However, these work environmental factors appear to operate differently in men and in women.