Perceived work stress and major depression in the Canadian employed population, 20-49 years old

Turning to religion as a mediator of the relationship between hopelessness and job satisfaction during the COVID-19 pandemic among individuals representing the uniformed services or working in professions of public trust in Poland

INTRODUCTION

During the COVID-19 pandemic individuals performing uniformed service or working in a profession of public trust were particularly exposed to chronic stress. The exposure to stress contributes to a decrease in quality of life across various domains, including professional performance. The perceived mental difficulties can lead to a feeling of hopelessness which, in turn can generate a decrease in job satisfaction. Religiosity is a factor which, in stress-inducing conditions, not only stops the spiral of perceived resource losses but also triggers gains in the resources possessed.

AIM

The aim of the study was to assess the preference for positive religious coping strategies, namely turning to religion as a mediator for the relationship between perceived hopelessness and job satisfaction in the individuals declaring religiosity during the COVID-19 pandemic. The analysis has been performed based on the Conservation of Resources theory (COR).

METHODS

The study encompassed 238 individuals representing the uniformed services or working in professions of public trust in Poland. The Inventory for Measuring Coping with Stress (MINI-COPE) and the Beck Hopelessness Scale (BHS) were used in the research.

RESULTS

The mediating role of turning to religion in relationship between perceived hopelessness and job satisfaction was confirmed only in the group of women. The relationship found in this group indicates that perceived hopelessness is alleviated by turning to religion, which simultaneously leads to an increase in job satisfaction.

CONCLUSION

The obtained results prove that counselling should be standard practice after potentially traumatic events in the workplace; moreover, emotional and/or instrumental support should be offered along with spiritual one.

The Relationship between Job Satisfaction and Depressive Symptoms among Chinese Adults Aged 35-60 Years: The Mediating Role of Subjective Well-Being and Life Satisfaction

The purpose of this study was to assess the serial multiple mediating effects of subjective well-being and life satisfaction between job satisfaction and depressive symptoms among Chinese adults aged 35-60 years. According to the 2018 China Family Panel Study (CFPS), we finally selected 10,609 respondents (5202 females, and 5407 males) aged 35-60 years old as samples for the study. Correlation analysis was carried out to examine the relationship among job satisfaction, subjective well-being, life satisfaction, and depressive symptoms. Linear regression models were established to analyze the relationship between job satisfaction and depressive symptoms. Serial multiple mediation analysis was conducted by the SPSS macro PROCESS program. The results suggested that job satisfaction was negatively correlated with depressive symptoms among Chinese adults aged 35-60 years. Subjective well-being and life satisfaction mediated the relationships between them, respectively. Furthermore, job satisfaction also had indirect impacts on depressive symptoms through the serial mediating effects of subjective well-being and life satisfaction. The findings revealed that increasing job satisfaction could decrease depressive symptoms through promoting subjective well-being and life satisfaction. The study may offer some meaningful implications for improving the mental health and reducing the risk of depressive symptoms among Chinese adults aged 35-60 years.

Work Conditions of Italian Nurses and Their Related Risk Factors: A Cohort Investigatory Study

(1) Background: Nursing is a satisfying employment pathway, as nurses preserve lives, but it is also considered one of the most stressful care professions. Nursing is a lifesaving and highly satisfying profession, yet it is considered one of the most stressful occupations. This study aimed to assess differences in anxiety, depression and stress states among nurses according to gender, work history, shift and body mass index (BMI) characteristics. (2) Methods: An online questionnaire was addressed to all Italian nurses during May 2022, investigating anxiety, depression and stress conditions according to the Depression, Anxiety and Stress Scale-21 Items (DASS-21) and sampling characteristics, such as sex, work experience, shift and BMI values. (3) Results: A total of 408 Italian nurses answered the questionnaire. Significant differences between the following were reported: anxiety levels and work experience, since nurses employed over 6 years reported higher anxiety levels than their younger colleagues (p = 0.035); depression levels and sex (p = 0.017), as females reported higher depression levels than males; and also between depression levels and BMI levels (p = 0.003), as 5.90% of overweight and 2.50% of obese participants reported extremely severe depression. By considering stress levels according to sampling characteristics, significant differences were registered according to BMI levels (p < 0.001), as overweight subjects reported higher stress levels (7.40%) than the other subgroups. Finally, significant associations were recorded between anxiety, depression and stress conditions with sex, work experience, shift and BMI. (4) Conclusions: The data were in agreement with the current literature, indicating that nurses might take care not only of their patients but also of themselves, in both the physical and mental aspects.

Sound Healing: Mood, Emotional, and Spiritual Well-Being Interrelationships

Psychosocial stress, tension, and depression are quite common in many parts of the developed world. Integrative medicine techniques which may potentially increase spiritual and emotional well-being may be useful in combating chronic psychosocial stress, as well as challenges with depression and excessive tension. The present observational study examines the effect of singing-bowl sound healing on emotional and spiritual well-being and particularly examines interrelationships between changes in spiritual well-being with changes in tension and depressed mood post-sound healing. Participants experienced a sound healing environment of vibrational musical instruments such as singing bowls (bell-like instruments), gongs, and other vibrational instruments. Sixty-two participants were examined in an observational study using singing-bowl sound healing. Emotional and spiritual well-being were examined by utilizing standardized questionnaires. Results revealed significant correlations between improvements in scores of spiritual well-being and reductions in scores of tension and depression post-sound healing. Moreover, effects varied by age of the study participants. Specifically, the association between spiritual well-being improvement and depression improvement was strongest for ages 31–40, while spiritual well-being improvement and tension improvement associations were strongest for ages 51–60. Implications for applying sound healing meditations as a potential low-cost, low-technology therapeutic technique are discussed for emotional and spiritual well-being.

Learning from work-from-home issues during the COVID-19 pandemic: Balance speaks louder than words

During the 2019 novel coronavirus disease (COVID-19) pandemic, many employees have switched to working from home. Despite the findings of previous research that working from home can improve productivity, the scale, nature, and purpose of those studies are not the same as in the current situation with the COVID-19 pandemic. We studied the effects that three stress relievers of the work-from-home environment–company support, supervisor’s trust in the subordinate, and work-life balance–had on employees’ psychological well-being (stress and happiness), which in turn influenced productivity and engagement in non-work-related activities during working hours. In order to collect honest responses on sensitive questions or negative forms of behavior including stress and non-work-related activities, we adopted the randomized response technique in the survey design to minimize response bias. We collected a total of 500 valid responses and analyzed the results with structural equation modelling. We found that among the three stress relievers, work-life balance was the only significant construct that affected psychological well-being. Stress when working from home promoted non-work-related activities during working hours, whereas happiness improved productivity. Interestingly, non-work-related activities had no significant effect on productivity. The research findings provide evidence that management’s maintenance of a healthy work-life balance for colleagues when they are working from home is important for supporting their psychosocial well-being and in turn upholding their work productivity.

Prenatal programming of depression: cumulative risk or mismatch in the Ontario Child Health Study?

Consistent with cumulative risk hypotheses of psychopathology, studies examining prenatal adversity and later mental health largely suggest that pre and postnatal stress exposures have summative effects. Fewer data support that a mismatch in stress levels between pre- and postnatal life increases risk (the mismatch hypothesis). In this retrospective cohort study using data from the 1983 Ontario Child Health Study (OCHS), we examined interactions between birth weight status and childhood/adolescent stress to predict major depression in adulthood. Ninety-five participants born at low birth weight (LBW; <2500 g) and 972 normal birth weight (NBW) control participants completed the Composite International Diagnostic Interview Short-Form Major Depression module at 21-34 years of age. A youth risk scale consisting of five stressful exposures (family dysfunction, socioeconomic disadvantage, parental criminality, maternal mental illness, exposure to other life stresses) indexed child/adolescent adversity. Birth weight groups did not differ by childhood risk score nor depression levels. A significant interaction was observed between birth weight and the youth risk scale whereby exposure to increasing levels of exposure to childhood/adolescent adversity predicted increased levels of depression in the NBW group, but lower rates in those born at LBW. Consistent with the mismatch hypothesis, data from a large, longitudinally followed cohort suggest that the mental health of adults born LBW may be more resilient to the adverse effects of childhood/adolescent stress. Taken in the context of previous studies of low birth weight infants, these findings suggest that the nature of associations between gestational stress and later mental health may depend on the magnitude of prenatal stress exposure, as well as the degree of resilience and/or plasticity conferred by their early-life environment.

Associations of multiple occupational exposures with major depressive and generalized anxiety disorders: Findings from the French National Working Conditions Survey

BACKGROUND

There have been numerous studies on the associations between psychosocial work factors and mental health, but very few of them explored the cumulative effects of these factors. The objectives were to study the associations between multiple occupational exposures and two common mental disorders, major depressive episode (MDE) and generalized anxiety disorder (GAD), among employees in France.

METHODS

The data came from the 2016 French National Working Conditions Survey based on a representative sample of 20,430 employees (8579 men and 11,851 women) aged 15-65 years. MDE and GAD were assessed using the MINI (Mini International Neuropsychiatric Interview) standardized diagnostic interview. Occupational exposures included 21 psychosocial work factors grouped into five dimensions, four factors related to working time/hours, and four physical work exposures. Logistic regression modeling for weighted data was performed to evaluate the associations of occupational exposures with MDE and GAD in men and women separately.

RESULTS

The prevalence of MDE and GAD was higher among women (8.6% and 8.7%, respectively) than among men (4.3% and 4.6%). Most psychosocial work factors were associated with MDE and/or GAD. A linear increase in the risk of MDE/GAD with the number of psychosocial work factors was found for each dimension, except workplace violence. The risk of MDE also increased linearly with multiple physical work exposures.

CONCLUSIONS

Our results showed that a wide variety of occupational exposures were associated with clinical depression and anxiety, and that the risk of disease increased with multiple exposures to psychosocial and physical factors at work.

Risk and Resilience Factors During the COVID-19 Pandemic: A Snapshot of the Experiences of Canadian Workers Early on in the Crisis

Research highlights several risk and resilience factors at multiple ecological levels that influence individuals’ mental health and wellbeing in their everyday lives and, more specifically, in disaster or outbreak situations. However, there is limited research on the role of these factors in the early days of the COVID-19 crisis. The present study examined if and how potential risk factors (i.e., reduction in income, job insecurity, feelings of vulnerability to contracting the virus, lack of confidence in avoiding COVID-19, compliance with preventative policies) and resilience factors (i.e., trait resilience, family functioning, social support, social participation, and trust in healthcare institutions) are associated with mental health and well-being outcomes, and whether these resilience factors buffer (i.e., moderate) the associations between risk factors and said outcomes. One to two weeks after the government recommended preventative measures, 1,122 Canadian workers completed an online questionnaire, including multiple wellbeing outcome scales in addition to measures of potential risk and resilience factors. Structural equation models were tested, highlighting that overall, the considered risk factors were associated with poorer wellbeing outcomes, except social distancing which was associated with lower levels of stress. Each of the potential resilience factors was found to have a main effect on one or more of the wellbeing outcomes. Moderation analysis indicated that in general these resilience factors did not, however, buffer the risk factors. The findings confirm that the COVID-19 crisis encompasses several stressors related to the virus as well as to its impact on one’s social, occupational, and financial situation, which put people at risk for lower wellbeing as early as one to two weeks after the crisis began. While several resilience factors emerged as positively related to wellbeing, such factors may not be enough, or sufficiently activated at that time, to buffer the effects of the numerous life changes required by COVID-19. From an ecological perspective, while mental health professionals and public health decision-makers should offer/design services directly focused on mental health and wellbeing, it is important they go beyond celebrating individuals’ inner potential for resilience, and also support individuals in activating their environmental resources during a pandemic.

Working conditions and depression in the French national working population: Results from the SUMER study

OBJECTIVES

The objectives were to explore the associations between various types of occupational exposures and depression in the French national working population, most of the studies in the literature focussing on a limited number of exposures and on symptom scales.

METHODS

The study was based on a nationally representative sample of 25 977 employees, 14 682 men and 11 295 women. Depression was measured using the PHQ-9 instrument and algorithm. Occupational exposures included factors related to both the psychosocial and physical work environment. Weighted logistic regression analyses were performed to study the associations between exposures and outcome with adjustment for covariates among men and women separately.

RESULTS

The prevalence of depression was higher for women than for men (5.70% versus 3.78%). The final models showed that low decision latitude, low reward, bullying, work-family and ethical conflicts for both genders, and high psychological demands, low social support, and long working hours among women were risk factors for depression. No occupational exposure of physical, biomechanical, chemical and biological nature was associated with depression. Sensitivity analyses confirmed the robustness of the results.

CONCLUSIONS

Significant associations were found between psychosocial work exposures and depression, and there were some differences in these associations between genders. This study is one of the first to provide a comprehensive overview of occupational exposures in association with depression. More prevention towards the psychosocial work environment is needed to improve mental health of working populations.

The relationship between stress and maturity in knowledge management

Purpose

This study aims to examine the relationships among organizational stress, disengagement from knowledge sharing and knowledge management maturity in a public institution of higher education in Brazil.

Design/methodology/approach

Descriptive and quantitative means were used; in particular, a questionnaire developed by Batista (2012), the Instrument for Knowledge Management Assessment in the Brazilian Public Administration, a scale developed by Ford and Staples (2008) to measure the disengagement from knowledge sharing and the Occupational Stress Scale, developed by Paschoal and Tamayo (2004) were used to collect data. A multivariate analysis was performed, including the use of structural equation modeling to relate the constructs to each other.

Findings

A positive significance was found in the relationships between organizational stress and disengagement from knowledge sharing and between stress and maturity in knowledge management. This finding supports the suggestion of Ford et al. (2015) that health, a key indicator, is directly related to disengagement from knowledge sharing.

Research limitations/implications

This study adopted a cross-sectional design, so a longitudinal or experimental research may discover other insights.

Originality/value

These results will be interesting to managers because stress management initiatives can help guide or identify opportunities to improve maturity in knowledge management and knowledge sharing.

[Prevalence and associated factors of depression symptoms in fathers of children aged 6 months to 17 years in Québec]

OBJECTIVES

In fathers, depression symptoms experienced during pregnancy and after childbirth represent a depression risk factor during the child first months. Since depression can have a huge impact on their subsequent involvement with the child, this issue is worrisome and requires consideration. Until now, however, few studies have dealt with paternal depression and its determinants beyond the perinatal period.

METHOD

This study uses data from a representative provincial survey conducted with 1342 fathers of children aged 6 months to 17 years. It documents the prevalence of moderate and severe depression symptoms with the CES-D scale as well as associated factors.

RESULTS

Findings show prevalence rates ranging from 3% to 10% depending on depression symptom severity and children age. Associated factors include problematic use of alcohol, no employment, stress related to balancing work and family, domestic violence environment, and low revenue and social support.

CONCLUSION

These results are interpreted in light of the role and involvement fathers keep in their child's life. They also stress the importance of identifying depression symptoms in this population beyond the perinatal period while monitoring the symptom intensity.

The Buffering Effect of Character Strengths on Depression

Abstract. The transition from high school to college can be very stressful for Turkish students because they may experience value conflicts and adjustment issues, which can trigger the development of mental health problems. Character strengths can serve as a buffer against psychopathology. The aim of the study was to examine perceived stress and negative attributional style as mediating factors between character strengths and depression among Turkish college students. Bootstrap testing approach was implemented to compute direct and indirect effects and total effect in the mediation analysis. Altogether 235 students from two Turkish universities participated in the study. The results showed that character strengths were associated with lower levels of depression and it was negatively associated with perceived stress and negative attributional style. The results also indicated that perceived stress and negative attribution style completely mediated the relationship between character strengths and depression among Turkish college students. These findings suggested the need to develop empirically supported interventions that can promote character strengths toward reducing stress, negative attributions, and depression in this population.

The role of optimism in the relationship between job stress and depressive symptoms. Longitudinal findings from the German Ageing Survey

BACKGROUND

The aim of the present study was to investigate the effect of job stress on depressive symptoms and whether optimism moderates this relationship longitudinally. Data were used from 2002 until 2014 (wave 2 to 5) of the German Ageing Survey. The sample consists of community-dwelling individuals living in Germany aged from 40 to 95 years (7086 observations in fixed effects regression analysis).

METHODS

A self-report questionnaire was used to measure depressive symptoms (Center for Epidemiologic Studies Depression Scale), job stress (scale 1 to 5) and optimism (Optimism Scale of Brandtstaedter & Wentura).

RESULTS

Adjusting for potential confounders, fixed effects regression analysis revealed that an increase in job stress was associated with an increase in depressive symptoms, whereas an increase in optimism was associated with a decrease in depressive symptoms. Optimism significantly moderated the relation between job stress and depressive symptoms.

LIMITATIONS

The possibility of a small sample selection bias cannot be dismissed.

CONCLUSIONS

The present study highlights the moderating role of optimism in the relation between job stress and depressive symptoms longitudinally. Thus, efforts to increase optimism in individuals might be beneficial in reducing depressive symptoms among individuals with high job stress.

Stress, depression, quality of life and salivary cortisol levels in community health agents

OBJECTIVE

To determine the prevalence of and factors associated with depression and stress with perceived quality of life and the salivary cortisol levels in Community Health Agent (CHA). Materials and Methods Cross-sectional descriptive study of CHAs in Pelotas-RS, Brazil. Data collection, including sociodemographic information and factors related to work and health. Beck Depression Inventory (BDI) II was used to assess depressive symptoms, Inventory of Stress Symptoms Lipp (ISSL) was used for the analysis of stress and the WHOQOL-BREF was used to investigate quality of life. Salivary cortisol was quantified via ELISA test.

RESULTS

The assessments showed that 71.0% are in a state of stress resistance, 30.5% were in the alert state of stress and 32.8% were in the stress state of exhaustion. Depressive episodes (BDI≥12) were observed in 28.2%. The environmental domain had the lowest score for quality of life. We observed significantly higher salivary cortisol levels in CHAs with less than 1 year of service and with the lowest quality of life scores in the environmental subsection.

CONCLUSION

A high prevalence of stress and depression was observed in this sample of CHAs. In addition, the worst levels of quality of life were identified in the environmental subsection. Cortisol levels corroborate these findings regarding quality of life within the environmental domain and began working less than a year previously.

Positive effects of laissez-faire leadership: conceptual exploration

Purpose

– The dominant view of laissez-faire leadership has so far been avoidant or regarded as zero leadership. Consequently, it has been suggested that laissez-faire leadership is likely to lead to negative consequences in subordinates’ performance and attitudes. The purpose of this paper is to argue that this conventional view is biased from the start as it is burdened with the concept that laissez-faire leadership is non-strategic and therefore implies negative consequences. This paper further argues that to be able to unveil the real outcomes of laissez-faire leadership, focus should shift to the behavioral aspect of laissez-faire leadership, or non-involvement of a leader/leadership.

Design/methodology/approach

– This conceptual presentation and presented propositions could stimulate the examination of laissez-faire leadership in more balanced ways.

Findings

– Shifted focus to the behavioral aspect of laissez-faire leadership, or non-involvement of a leader/leadership allows this paper to explore possible positive outcomes, especially with consideration with dynamics of time. While extant studies about laissez-faire leadership have been partial to negative consequences, this paper explores different contexts in which laissez-faire leadership could be positive.

Originality/value

– This paper is one of the first attempts to tease out possible outcomes of laissez-faire leadership, which could be not just negative, by adapting the behavioral aspect of non-involvement of a leader.

Australian rural, remote and urban community nurses' health promotion role and function

Community nurses have often been 'touted' as potential major contributors to health promotion. Critical literature, however, often states that this has not been the case. Furthermore, most studies examining nurses' role and function have occurred mainly in hospital settings. This is a sequential mixed-methods study of two groups of community nurses from a Sydney urban area (n = 100) and from rural and remote areas (n = 49) within New South Wales, Australia. A piloted questionnaire survey was developed based on the five action areas of the Ottawa Charter for Health Promotion. Following this, 10 qualitative interviews were conducted for both groups, plus a focus group to support or refute survey results. Findings showed that rural and remote nurses had more positive attitudes towards health promotion and its clinical implementation. Survey and interview data confirmed that urban community nurses had a narrower focus on caring for individuals rather than groups, agreeing that time constraints impacted on their limited health promotion role. There was agreement about lack of resources (material and people) to update health promotion knowledge and skills. Rural and remote nurses were more likely to have limited educational opportunities. All nurses undertook more development of personal skills (DPS, health education) than any other action area. The findings highlight the need for more education and resources for community nurses to assist their understanding of health promotion concepts. It is hoped that community nurse leaders will collectively become more effective health promoters and contribute to healthy reform in primary health care sectors.

Work-related depression and associated factors in a shoe manufacturing factory in Haiphong City, Vietnam

OBJECTIVES

To determine the prevalence and associated factors of work-related depression among the employees of a shoe manufacturing factory in Haiphong City, Vietnam.

MATERIAL AND METHODS

We carried out this cross-sectional study among 420 workers in 2012 in Le Lai II Shoe Manufacturing Factory in Haiphong City, Vietnam using Karasek's Job Content Questionnaire (JCQ) and the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV) tool for measuring depression.

RESULTS

The study results show that a relatively high proportion of workers (20.7%) belongs to the high-strain group based on Karasek's model. The prevalence of work-related depression among workers was relatively high (18.8%). The factors associated with depression at work were high psychological demand (adjusted OR = 3.0, 95% CI: 1.1-8.3), low social support (adjusted OR = 4.7, 95% CI: 1.2-12.8), inadequate work protection materials (OR = 4.1, 95% CI: 2.2-10.1) and work absenteeism (OR = 6.2, 95% CI: 2.5-18.9).

CONCLUSIONS

Strengthening the social support network (involving supervisors and co-workers), reducing psychological job demand and assuring work protection materials at the workplace may highly facilitate reducing work-related depression.

Validation of the Karasek-Job Content Questionnaire to measure job strain in Vietnam

The objective of this study was to validate the Karasek-Job Content Questionnaire in Vietnamese. A translation/back-translation of the questionnaire was performed prior to its administration to 344 health personnel in Vietnam. Several psychometric properties of the Vietnamese version of the Karasek-Job Content Questionnaire were assessed. A valid Vietnamese version of the Karasek-Job Content Questionnaire was produced, composed of five subscales based on the original theoretical model: Psychological demands, Social support at work, Decision latitude-Autonomy, Decision latitude-Authority, and Skill discretion. Internal consistency and reliability coefficients for each subscale of the questionnaire were satisfactory. The correlations with depression and work absence indicators were weak but statistically significant, as expected. The Vietnamese version of the Karasek-Job Content Questionnaire will help Vietnamese researchers and clinicians appropriately evaluate and document the job strain of workers in Vietnamese workplaces.

Job characteristics: their relationship to job satisfaction, stress and depression

This study investigated the influences of job characteristics on job satisfaction, stress and depression among South African white collar workers. Participants were managers in full-time employment with large organisations. They completed the Job Diagnostic Survey, the Perceived Stress Scale and the Beck Depression Inventory. A regression approach was used to predict job satisfaction, stress and depression from job characteristics. Job characteristics (skill variety, task identity, task significance, autonomy and feedback) predicted job satisfaction, as well as stress and depression. Job characteristics are weak predictors of perceived stress and depression. Work related factors, such as interpersonal relations and organisational culture, may better predict mental health in work settings.

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.

Perceived needs for and use of workplace accommodations by individuals with a depressive and/or anxiety disorder

OBJECTIVE

To estimate the percentages of need for and use of workplace mental health accommodations, and to identify factors related to the use of accommodations.

METHODS

Participants with a mental disorder, identified from the community, were questioned about need for and use of workplace accommodations (n = 784). Mental disorders were assessed using the World Health Organization's Composite International Diagnostic Interview.

RESULTS

Eighty-three percent needed accommodations; only 30.5% had received accommodations. Having received accommodations was not related to demographic or socioeconomic factors. Participants with a 12-month disorder were less likely to have received accommodations than others.

CONCLUSIONS

A significant proportion of workers with a mental disorder and need for accommodations have not received accommodations at their workplaces. The accommodations needed by this population are not expensive and can potentially be provided by modifying management practices.

Occupational stress in the multicultural workplace

Occupational stress is a well researched topic leading to the development of strong, viable models of workplace stress. However, there is a gap in the literature with respect to the applicability of this research to specific cultural groups, in particular those of immigrant status. The present paper reviews the extant literature regarding occupational stress from a multicultural perspective, evaluates the usefulness for existing models in the multicultural context, and discusses current issues with respect to increasing multiculturalism in the work environment. The authors conclude that workforce diversity is emerging as a pressing issue of organizational life and consequently, that future research needs to continue investigating whether current knowledge regarding workplace stress is fitting with the multicultural diversity of the present-day working population.

Objektive Erfassung von Job Demands und Decision Latitude sowie Zusammenhänge der Tätigkeitsmerkmale mit Erholungsunfähigkeit

Ziel der vorliegenden Studie war die Beantwortung der Frage, ob sich Zusammenhänge von Job Demands und Decision Latitude ( Karasek, 1979 ) mit Fehlbeanspruchungsfolgen auch zeigen, wenn die Tätigkeitsmerkmale mit objektiven Arbeitsanalysemethoden erfasst werden. Zur Operationalisierung der Tätigkeitsmerkmale wurden theoriebasiert Items des Tätigkeitsbewertungssystems TBS ( Pohlandt et al., 2003 ; Rudolph et al., 1987 ) ausgewählt. Die neu gebildeten Skalen Job Demands-TBS und Decision Latitude-TBS wurden in einer Stichprobe von 397 Erwerbstätigen aus verschiedenen Branchen zur Vorhersage von Erholungsunfähigkeit eingesetzt. Simultane konfirmatorische Faktorenanalysen mit den TBS-Items und den FIT-Items ( Richter et al., 2000 ) wurden berechnet. Hierarchische Regressionsanalysen konnten zeigen, dass hohe objektiv und subjektiv erfasste Job Demands sowie geringe subjektiv erfasste Decision Latitude mit Erholungsunfähigkeit einhergehen. Die Erfassung von Job Demands und Decision Latitude mit dem TBS ermöglicht eine vom subjektiven Erleben des Arbeitsplatzinhabers unabhängige Erfassung der Tätigkeitsmerkmale und die direkte Ableitung von Maßnahmen zur Gestaltung gesundheitsförderlicher Arbeitsbedingungen.

Felicidade no trabalho: relações com suporte organizacional e suporte social

O presente estudo teve como objetivo testar o impacto do suporte organizacional e do suporte social sobre o bem-estar no trabalho. Este construto contemplou tanto o afeto quanto a experiência de realização e expressão pessoal no trabalho. Um total de 403 funcionários de uma organização pública do Distrito Federal respondeu à Escala de Bem-Estar no Trabalho e à Escala de Suporte Organizacional Percebido. O primeiro instrumento contempla o afeto do trabalhador, operacionalizado como emoções e humores positivos e negativos no trabalho, e a realização pessoal no trabalho. O segundo instrumento contempla um fator de suporte social e quatro fatores de suporte organizacional: gestão do desempenho, carga no trabalho, suporte material e ascensão, promoção e salários. Os dados foram analisados por meio de regressão múltipla padrão. Os resultados indicaram que o suporte organizacional e o suporte social têm impacto direto no bem-estar. Gestão do desempenho foi o principal preditor de afeto positivo e realização no trabalho. Carga no trabalho foi o principal preditor de afeto negativo no trabalho. Implicações dos resultados e limitações do estudo são discutidas no texto.

Cortisol–ein geeigneter physiologischer Indikator für Belastungen am Arbeitsplatz?

Die vorliegende Studie prüft Zusammenhänge zwischen Arbeitsintensität, Tätigkeitsspielraum, sozialer Arbeitsumgebung (Kooperation/Kommunikation, soziale Unterstützung, soziale Stressoren) und Stresserleben am Arbeitsplatz mit der basalen Cortisolsekretion im Speichel (Tagesprofil, Aufwachreaktion und Variation über den Tag). Insgesamt 46 Erwerbstätige aus dem Bankwesen sammelten an zwei aufeinander folgenden Arbeitstagen je vier Speichelproben (beim Aufwachen, 30 min nach dem Aufwachen, 14 Uhr und unmittelbar vor dem Zubettgehen), aus denen die individuelle Cortisolkonzentration (Mittelwert aus den jeweils zugehörigen Proben) bestimmt wurde. Die Tätigkeitsmerkmale wurden sowohl mittels Fragebögen als auch objektiv, d. h. unabhängig vom Arbeitsplatzinhaber, erhoben. Alter, Geschlecht, Rauchen, Body-Mass-Index, gesundheitliche Beeinträchtigungen sowie eventuelle Abweichungen bei der Probensammlung wurden als mögliche Drittvariablen berücksichtigt. Im Ergebnis zeigte sich, dass subjektiv erlebte, geringe soziale Unterstützung und hohe soziale Stressoren mit einer erhöhten Aufwachreaktion bzw. mit einer erhöhten Variation über den Tag assoziiert waren. Für die Arbeitsintensität, den Tätigkeitsspielraum sowie für die objektiv erhobene Kooperation/Kommunikation waren keine Effekte nachweisbar. Die Ergebnisse lassen vermuten, dass sowohl die Belastungs- als auch deren Erhebungsart für den Nachweis von Effekten im Hinblick auf die Cortisolsekretion bei Erwerbstätigen von Bedeutung sind.

Effects of externally rated job demand and control on depression diagnosis claims in an industrial cohort

This study examined whether externally rated job demand and control were associated with depression diagnosis claims in a heavy industrial cohort. The retrospective cohort sample consisted of 7,566 hourly workers aged 18-64 years who were actively employed at 11 US plants between January 1, 1996, and December 31, 2003, and free of depression diagnosis claims during an initial 2-year run-in period. Logistic regression analysis was used to model the effect of tertiles of demand and control exposure on depression diagnosis claims. Demand had a significant positive association with depression diagnosis claims in bivariate models and models adjusted for demographic (age, gender, race, education, job grade, tenure) and lifestyle (smoking status, body mass index, cholesterol level) variables (high demand odds ratio = 1.39, 95% confidence interval: 1.04, 1.86). Control was associated with greater risk of depression diagnosis at moderate levels in unadjusted models only (odds ratio = 1.47, 95% confidence interval: 1.12, 1.93), while low control, contrary to expectation, was not associated with depression. The effects of the externally rated demand exposure were lost with adjustment for location. This may reflect differences in measurement or classification of exposure, differences in depression diagnosis by location, or other location-specific factors.

Prospective evaluation of the effect of major depression on working status in a population sample

OBJECTIVE

Numerous surveys have reported associations between major depressive episodes (MDEs) and occupational status, but cross-sectional studies cannot quantify the risks of employment transitions nor clarify their temporal direction. The goal of our study was to estimate the impact of MDE on subsequent employment status in a longitudinal community cohort.

METHODS

Data from the National Population Health Survey (NPHS) were used. Proportional hazard models and logistic regression were employed to evaluate the effect of MDE on working status during the 1994 to 2004 interval among respondents who reported working at a job or business at baseline.

RESULTS

MDE was associated with an increased risk of movement to nonworking status. People aged 26 to 45 years with MDEs have more than double the risk of this transition (HR = 2.6; 95% CI 1.8 to 3.6, P < 0.001). The probability of transition to nonworking status was higher, but the relative effect was smaller in people aged 46 to 65 years (HR = 1.2; 95% CI 0.7 to 2.0, P = 0.47). Retirement or perceived lack of availability of work did not contribute to the association.

CONCLUSIONS

MDE is associated with an elevated risk of transition from working to nonworking status, especially in people aged 26 to 45 years.

A conceptual framework for integrating workplace health promotion and occupational ergonomics programs

Musculoskeletal, cardiovascular, and mental health are all associated with the physical and psychosocial conditions of work, as well as with individual health behaviors. An integrated approach to workplace health-promotion programs should include attention to the work environment, especially in light of recent findings that work organization influences so-called lifestyle or health behaviors. Macroergonomics provides a framework to improve both physical and organizational features of work and, in the process, to empower individual workers. The Center for the Promotion of Health in the New England Workplace (CPH-NEW) is a research-to-practice effort examining the effectiveness of worksite programs that combine occupational safety and health--especially ergonomics--with health promotion, emphasizing the contribution of work organization to both. Two intervention studies are underway in three different sectors: health care, corrections, and manufacturing. Each study features participatory structures to facilitate employee input into health goal-setting, program design and development, and evaluation, with the goal of enhanced effectiveness and longer-term sustainability.

Perceived stress in survivors of suicide: psychometric properties of the Perceived Stress Scale

The purpose of this study was to evaluate the psychometric properties of three versions of the Perceived Stress Scale (PSS; American Sociological Association) in adults who had survived the death of a family member or significant other by suicide. Reliability and validity were examined. Exploratory factor analysis was conducted to assess dimensionality of the underlying constructs. All three versions of the PSS demonstrated acceptable reliability. Two shorter versions retained good psychometric properties and demonstrated convergent and concurrent validity with measures of posttraumatic stress symptoms and mental health quality of life. Factor analysis provided further evidence of their usefulness as brief and valid measures of perceived stress in acutely bereaved adult survivors of suicide. In a sub-sample of closely related survivors, the psychometric properties of the 4-item version of the PSS were retained.

Psychosoziale Merkmale der Arbeit, Überforderungserleben und Depressivität

Die vorliegende Studie untersuchte die im Job-Demand-Control-Support-Modell und Effort-Reward-Imbalance-Modell beschriebenen Tätigkeitsmerkmale in Bezug auf Depressivität in einer Stichprobe von 265 Erwerbstätigen. Anhand konfirmatorischer Faktorenanalysen wurden Gemeinsamkeiten und Unterschiede beider Modelle geprüft. Anschließend wurde die Bedeutung der nachweisbaren Tätigkeitsmerkmale für die Vorhersage von Depressivität getestet und untersucht, inwieweit die Effekte durch Überforderungserleben mediiert werden. Die Analysen zeigten, dass die Modelle sowohl gemeinsame (Arbeitsintensität bzw. berufliche Anforderungen) als auch distinkte Arbeitsmerkmale (Tätigkeitsspielraum, Arbeitsplatzsicherheit, beruflicher Status, soziale Anerkennung) erfassen. Hohe Arbeitsintensität, geringe Arbeitsplatzsicherheit und fehlende soziale Anerkennung standen in signifikantem Zusammenhang mit Depressivität. Anders als erwartet war der berufliche Status positiv mit Depressivität assoziiert, während für den Tätigkeitsspielraum keine signifikanten Effekte nachweisbar waren. Das Pfadmodell bestätigte sowohl direkte als auch durch Überforderungserleben vermittelte Zusammenhänge zwischen den Tätigkeitsmerkmalen und Depressivität (39 % Varianzaufklärung). Die Ergebnisse bieten eine Grundlage für die Identifizierung potenzieller Risikofaktoren für das Auftreten depressiver Symptome am Arbeitsplatz.

Job stress and depressive symptoms among Korean employees: the effects of culture on work

OBJECTIVE

This study was conducted to investigate the association between depressive symptoms and job stress, as measured by the KOSS, among Korean employees in small- and medium-sized enterprises, and examined which components of stress are involved in the risk for depression among males and females.

METHODS

Data were collected from a work-stress survey of full-time employees of small- and medium-sized enterprises in Incheon, South Korea. A total of 3,013 participants were included in the analysis. Job stress was measured using 24 items (7 sub-scales) of the short form of Korean occupational stress scale (KOSS-SF), and depressive symptoms were evaluated using Center for epidemiologic studies depression scale (CES-D).

RESULTS

After adjustment for confounding variables, most of subscales of job stress contributed to an increased risk of depressive symptoms, and job insecurity (male; OR = 2.02, 95%CI: 1.61-2.40, female; OR = 1.95, 95%CI: 1.42-2.70) and occupational climate (male; OR = 1.84, 95%CI: 1.49-2.28, female; OR = 1.78, 95%CI: 1.30-2.49) showed strong associations in both male and female. Other subscales revealed different effects for males and females; for males, job demands (OR = 1.68, 95%CI: 1.43-2.20), inadequate social support (OR = 1.55, 95%CI: 1.23-1.94), and lack of rewards (OR = 1.88, 95%CI: 1.48-2.37) were associated with depressive symptoms, whereas for females, organizational injustice (OR = 1.62, 95%CI: 1.14-2.30) was associated with depressive symptoms.

CONCLUSION

These results indicate that job stress may play a significant role in increasing the risk of depressive symptoms, and that further preventive efforts and research are needed to reduce job stress and address health problems caused by job stress among Korean employees.

Working conditions, self-perceived stress, anxiety, depression and quality of life: a structural equation modelling approach

Background

The relationships between working conditions [job demand, job control and social support]; stress, anxiety, and depression; and perceived quality of life factors [physical health, psychological wellbeing, social relationships and environmental conditions] were assessed using a sample of 698 male automotive assembly workers in Malaysia.

Methods

The validated Malay version of the Job Content Questionnaire (JCQ), Depression Anxiety Stress Scales (DASS) and the World Health Organization Quality of Life-Brief (WHOQOL-BREF) were used. A structural equation modelling (SEM) analysis was applied to test the structural relationships of the model using AMOS version 6.0, with the maximum likelihood ratio as the method of estimation.

Results

The results of the SEM supported the hypothesized structural model (χ² = 22.801, df = 19, p = 0.246). The final model shows that social support (JCQ) was directly related to all 4 factors of the WHOQOL-BREF and inversely related to depression and stress (DASS). Job demand (JCQ) was directly related to stress (DASS) and inversely related to the environmental conditions (WHOQOL-BREF). Job control (JCQ) was directly related to social relationships (WHOQOL-BREF). Stress (DASS) was directly related to anxiety and depression (DASS) and inversely related to physical health, environment conditions and social relationships (WHOQOL-BREF). Anxiety (DASS) was directly related to depression (DASS) and inversely related to physical health (WHOQOL-BREF). Depression (DASS) was inversely related to the psychological wellbeing (WHOQOL-BREF). Finally, stress, anxiety and depression (DASS) mediate the relationships between job demand and social support (JCQ) to the 4 factors of WHOQOL-BREF.

Conclusion

These findings suggest that higher social support increases the self-reported quality of life of these workers. Higher job control increases the social relationships, whilst higher job demand increases the self-perceived stress and decreases the self-perceived quality of life related to environmental factors. The mediating role of depression, anxiety and stress on the relationship between working conditions and perceived quality of life in automotive workers should be taken into account in managing stress amongst these workers.

Self-perceived depression, anxiety, stress and their relationships with psychosocial job factors in male automotive assembly workers

Depression, anxiety and stress have been recognized as important mental outcome measures in stressful working settings. The present study explores the prevalence of self-perceived depression, anxiety and stress; and their relationships with psychosocial job factors. A cross-sectional study involving 728 male automotive assembly workers was conducted in two major automotive assembly plants in Malaysia using the validated Malay versions of the Depression Anxiety Stress Scales (DASS) and Job Content Questionnaire (JCQ). Based on the DASS cut-off of > or =78 percentile scores, the prevalence of self-perceived depression, anxiety and stress was 35.4%, 47.2% and 31.1%, respectively. Four (0.5%), 29 (4.0%) and 2 (0.3%) workers, respectively, reported extremely severe self-perceived depression, anxiety and stress. Multiple linear regression analyses, controlling for age, education, salary, duration of work and marital status, revealed that psychological job demand, job insecurity and hazardous condition were positively associated with DASS-Depression, DASS-Anxiety and DASS-Stress; supervisor support was inversely associated with DASS-Depression and DASS-Stress. We suggest that reducing psychological job demand, job insecurity and hazardous condition factors may improve the self-perceived depression, anxiety and stress in male automotive assembly workers. Supervisor support is protective for self-perceived depression and stress.

Two models of job stress and depressive symptoms. Results from a population-based study

BACKGROUND

Evidence indicates that an adverse psychosocial work environment contributes to the explanation of depressive symptoms. Research was mainly informed by two theoretical models, the demand-control and the effort-reward imbalance model. Yet, a comparative analysis of the two models, using original scales, has not yet been conducted in an unselected working population.

METHODS

A total of 1,811 working men and women from the baseline screening of an epidemiological cohort study were interviewed (job stress, depressive symptoms [CES-D], health behaviours, medical history, socio-demographic characteristics). Logistic regression models were calculated to estimate associations between depressive symptoms, the two job stress models and relevant covariates.

RESULTS

Analyses showed significantly increased multivariate odds ratio (OR) of job strain and effort-reward imbalance. When the two models were mutually adjusted control [OR, 95% CI=1.9, 1.3-2.7], effort-reward imbalance [OR, 95% CI=3.4, 2.1-5.1] and overcommitment OR, 95% CI=3.9, 2.7-5.8] were independently associated with depressive symptoms Additional tests of interaction between the models revealed relatively highest level of depressive symptoms in employees who simultaneously reported low control and high overcommitment.

CONCLUSIONS

Components of an adverse psychosocial work environment are associated with depressive symptoms in an unselected working population. Policy implications of accumulated evidence on this relation should be addressed.

The impact of work environment on mood disorders and suicide: Evidence and implications

The purpose of this paper is to review the evidence estimating an impact of occupational factors on mood disorders and suicide, and the efficacy of interventions. This review is based on literature searches using Medline and Psych INFO from 1966 to 2007 (keywords: work stress, job insecurity, job strain, shift work, violence, occupational health, mood disorders, depression, and suicide). To establish the relationship between occupational variables and mood disorders, we focused on clinically significant disorders rather than depressive symptoms. During the last decade, prospective epidemiological studies have suggested a predictive association between the work environment and mood disorders. Recently, increasing numbers of clinical trials have shown favorable effect size of intervention and suggested preferable return-on-investment results. However, low awareness and social stigma still decrease workers access to treatment. Mental health professionals in conjunction with employers have to devise a creative system to make the quality care being offered more accessible to employees. In addition, further outcome data is needed to evaluate the benefit of managing mood disorders in the workplace, and to foster awareness of positive implications for employees, employers, their families, and the society at large. In addition, the work environment, with its chemical (e.g. chemosensory factors, pollutants), physical (e.g. lighting, noise, temperature, outdoor views and activities), biological (e.g., chronobiological factors, allergens, infectious agents), psychological (e.g. demand-control, effort-reward balance), social (e.g. cohesiveness, support), and organizational (e.g. leadership styles) component should meet minimal standards, and may improve with striving towards the optimum.

Mothers' health and work-related factors at 11 weeks postpartum

PURPOSE

Many new mothers return to work soon after childbirth. This study examines personal and work-related factors associated with the postpartum health of employed women 11 weeks after childbirth.

METHODS

Using a prospective cohort design, we recruited 817 Minnesota mothers into the study while they were hospitalized for childbirth in 2001. Telephone interviews were conducted at 5 and 11 weeks postpartum. Eligible women were 18 years or older, employed, and spoke English and gave birth to a singleton infant. Multivariate models using instrumental variables (2-stage least squares) were used to estimate personal and employment characteristics associated with women's physical and mental health and postpartum symptoms.

RESULTS

At 11 weeks postpartum, 661 participants (81% of enrollees) completed a full interview, and 50% of participants had returned to work. On average, women reported 4.1 (SD 3.2) childbirth-related symptoms, most frequently fatigue (43%). Factors significantly associated with better health outcomes included better preconception health, the absence of prenatal mood problems, more control over work and home activities, more social support at work and home, and less job stress.

CONCLUSIONS

The findings suggest postpartum women need to be evaluated regarding their fatigue levels and mental and physical symptoms. Women whose fatigue or postpartum symptoms limit daily role function may find it helpful to have health care clinicians counsel them on strategies to decrease job stress, increase social support at work and home, and certify their use of intermittent family and medical leave to help them manage their symptoms.

Gender differences in depression and chronic pain conditions in a national epidemiologic survey

The authors explored gender differences in the prevalence of depression in four chronic pain conditions and pain severity indices in a national database. In 131,535 adults, the prevalence of depression in women (9.1%) was almost twice that of men (5%). One-third (32.8%) had a chronic pain condition (fibromyalgia, arthritis/rheumatism, back problems, and migraine headaches). The prevalence of depression in individuals with chronic pain conditions was 11.3%, versus 5.3% in those without. Women reported higher rates of chronic pain conditions and depression and higher pain severity than men. Depression and chronic pain conditions represent significant sources of disability, especially for women.

A survey of quality of life and depression for police officers in Kaohsiung, Taiwan

OBJECTIVE

The enormous job stress of police work may result in depression, which is highly correlated with work disability and poor quality of life. We investigated the quality of life, the probability of depression, and the related risk factors for police officers in Kaohsiung, Taiwan.

METHODS

We used the 12-item Short-Form Health Survey (SF-12) and the Disaster-Related Psychological Screening Test (DRPST) to assess the quality of life and prevalence of depression for 832 police officers in Kaohsiung.

RESULTS

The estimated rate of probable major depression was 21.6% (180/832). Those with an educational level of university or above and nondepressed police officers had higher scores in every subscale for quality of life. Police officers older than 50 had higher scores in the mental aspects of quality of life. Family problems and job stress related to achievement, peer pressure about performance, and heavy workloads were predictive factors for depression.

CONCLUSION

Police officers might have a higher estimated rate of depression than previously thought, and those with depression have a poorer quality of life.

Perceived work stress, imbalance between work and family/personal lives, and mental disorders

BACKGROUND

Occupational mental health research has been focusing on the relationship between work stress and depression. However, the impacts of work stress on anxiety disorders and of imbalance between work and family life on workers' mental health have not been well studied. This analysis investigated the association between levels of perceived work stress and of imbalance between work and family/personal lives and current mood/anxiety disorders.

METHOD

This was a cross-sectional study using data from the Canadian Community Health Survey-Mental Health and Well-being (CCHS-1.2) (n=36,984). Mood and anxiety disorders were measured using the World Mental Health-Composite International Diagnostic Interview.

RESULTS

The 1-month prevalence of mood and anxiety disorders among those with a work stress score at the 75th percentile value and above was 3.6% and 4.0%. Among those who reported that their work and family/personal lives "never" balanced in the past month, the 1-month prevalence of mood and anxiety disorders was 21.2% and 17.9%. In multivariate analyses, work stress and imbalance between work and family/personal lives were independently associated with mood and anxiety disorders. There was no evidence that perceived work stress interacted with imbalance between work and family/personal lives to increase the likelihood of having mental disorders. Gender was associated with anxiety disorders, but not with major depressive disorder and mood disorders.

CONCLUSIONS

Work stress and imbalance between work and family/personal lives may be part of the etiology of mood and anxiety disorders in the working population. Community based longitudinal studies are needed to delineate the causal relationships among work stress, imbalance between work and family/personal lives and mental disorders.

Mental health and related disability among workers: a population-based study

BACKGROUND

In past decades, the nature of work has undergone significant changes including increased psychological demands and job instability. A stressful psychosocial work environment has been shown to have adverse effects on workers' mental and physical health. This goal of this study is to estimate the prevalence of psychiatric syndromes and related disability in a population-based sample of employed adults and investigate associations between psychiatric syndromes and related disability.

METHODS

A random-digit dial provincial wide mental health survey was conducted in Alberta, Canada (n = 5,383). The telephone interview included the Mini International Neuropsychiatric Interview (MINI) and the World Health Organization's Disability Assessment Schedule (WHO-DAS-II). In this analysis, participants who were currently employed were included (n = 4,149).

RESULTS

In this population, 6.2% had had at least one MINI-defined psychiatric diagnosis with clinically significant interference. Without consideration of the clinical interference criterion, the prevalence of psychiatric syndromes was higher (33.5%). Psychiatric syndromes were strongly associated with disability. A dose-response relationship between the number of diagnoses and disability was found.

CONCLUSIONS

Interventional strategies in the workplace should focus on mental disorders at both the clinical and sub-clinical levels.

Managing depression-related occupational disability: a pragmatic approach

OBJECTIVE

To identify the crucial issues that arise for psychiatrists and other physicians when dealing with occupational disability in their patients with depression and to suggest practical strategies for responding more effectively to the challenges of this aspect of patient functioning.

METHOD

We identify fundamental concepts in the occupational disability domain and draw crucial distinctions. The wider context for occupational disability is articulated, involving the workplace environment and the disability insurance industry. Research with direct relevance to clinical decision making in this area is highlighted. We make pragmatic suggestions for effective management of occupational disability in patients with depression.

RESULTS

To successfully manage issues of occupational disability, psychiatrists and other physicians must understand the distinction between impairment and disability. To make this decision fairly and accurately, the adjudicator requires particular types of information from the physician, with requirements varying across short-term or long-term disability claims; failing to provide relevant information may cause substantial stress or financial harm to the patient. Balanced and collaborative decision making regarding whether and for how long to take work absence will greatly help to maintain occupational function in the long-term. Realistic expectations and support of the patient's sense of personal competence foster recovery of occupational function.

CONCLUSION

Management of depression-related disability is challenging. Thoughtful evaluation of the patient's functional status, careful response to the requirements of disability determination, and a focus on functional recovery yield substantial benefits.

The role of sense of belonging and social support on stress and depression in individuals with depression

This longitudinal study examined the role of sense of belonging, social support, and spousal support on the relationship between perceived stress and symptoms of depression in 90 men and women who had a history of depression (n = 51) and who did not have (n = 39) a history of depression. Data were obtained at 3, 6, and 9 months after initial entry into the study. A series of regression analysis procedures revealed a mediation effect, but not a moderation effect, of sense of belonging and perceived social support on the relationship between perceived stress and depression in only the depressed group. Spousal support had neither a direct effect nor an interaction effect on the perceived stress-depression relationship in the depressed group. For the comparison group, perceived stress did not correlate significantly with the symptoms of depression. Repeated measures analysis of variance showed that increased perceived stress and lower sense of belonging had significant direct effects on the severity of depression and the effects were consistent over the period of 9 months. Social support and spousal support had only indirect effects that fluctuated over time. The results emphasize that interventions geared toward stress reappraisal and promotion of sense of belonging should yield direct and stable effects of decreasing depression.

Psychosocial factors at work and depression in three countries of Central and Eastern Europe

Psychosocial factors at work have been found to predict a range of health outcomes but their effect on mental health outcomes has not been extensively studied. This paper explores the relationship between psychosocial factors at work and depression in three countries of Central and Eastern Europe. The data come from a cross-sectional study of working men (n = 645) and women (n = 523) aged 45-64 years, randomly selected from population registers in Novosibirsk (Russia), Krakow (Poland) and Karvina-Havirov (Czech Republic). The questionnaire included questions on the effort and reward at work, job control, the full CES-D scale of depression, and a range of other characteristics. Linear regression was used to estimate the association between depression score and work characteristics: the logarithm of the effort-reward ratio, and continuous job control score. The means of the depression score were 10.5 for men and 14.2 for women. After controlling for age, sex and country, effort-reward ratio (logarithmically transformed) was strongly related to depression score; a 1 SD increase in the log transformed effort-reward ratio was associated with an increase in the depression of 2.0 points (95% CI 1.5; 2.4), and further adjustment did not materially change the effect. Job control was inversely associated with depression score in Poland and the Czech Republic (not in Russia) but the association was largely eliminated by controlling for socioeconomic characteristics. This study suggests that the effort-reward imbalance at work is related to prevalence of depression in these central and eastern European populations.