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.

The importance of school leaders in school health promotion. A European call for systematic integration of health in professional development

School leaders such as principals are key not only for educational and school quality but also for initiating and sustainably anchoring any innovation in schools. Although there is widespread agreement about the importance of holistic approaches to school health promotion, the role of principals has received increased, but not yet systematic, attention. In this context, it is unclear which leadership competencies are needed and to what extent they are taught. Hence, this paper aims to reflect whether and to what extend health promotion plays a role in preservice and inservice training of principals in Europe. Based on the results we call for a more systematic analysis of existing teaching opportunities and teaching needs for health-promoting leadership, the development of a European competence framework for health-promoting leadership, the development and implementation of a European system that monitors and evaluates the effectiveness of those preservice and inservice training programs, and the development of case-studies to stimulate a mutual learning process.

School inspections and headteachers' mental health

Media attention has highlighted the risk of suicides among headteachers whose schools were downgraded by school inspectors. The authors emphasize the wider problem of mental ill-health among teachers. They argue that more should be done to protect and promote teachers’ mental health—starting with job-specific stress risk assessments. They also argue for a comprehensive review to understand and address the broad factors that place teachers and headteachers at increased risk of mental ill-health.

Job Satisfaction Goes a Long Way: The Mediating Role of Teaching Satisfaction in the Relationship between Role Stress and Indices of Psychological Well-Being in the Time of COVID-19

The COVID-19 pandemic and its containment measures has resulted in drastic changes in the educational landscape. Teachers had to rapidly adapt to shifts in their work-related roles and responsibilities. This situation likely led to role stress and affected the levels of job satisfaction, mental health and general life satisfaction. In this study, we examined the role of teachers' job satisfaction in the relationship between role stress and indices of psychological well-being. The participants were South African school teachers (N = 355) who completed the Role Orientation Questionnaire, the Teaching Satisfaction Scale, the Center for Epidemiological Studies Depression Scale, the trait scale of the State-Trait Anxiety Inventory and the Satisfaction with Life Scale. In addition to descriptive statistics and correlations, path analysis was performed to determine the mediating role of teaching satisfaction. Increased levels of teaching satisfaction were associated with decreased levels of depression and anxiety and increased levels of life satisfaction. Teaching satisfaction also mediated the relationship between role conflict, as well as role ambiguity and anxiety. The results indicated that teaching satisfaction is a critical protective factor for teachers. Thus, improving task significance and enhancing the meaning associated with the teaching profession may help promote the adaptive functioning of teachers.

A Cross-Sectional Study of the Perceived Stress, Well-Being and Their Relations with Work-Related Behaviours among Hong Kong School Leaders during the COVID-19 Pandemic

The health and well-being of school leaders during the COVID-19 pandemic have been largely neglected compared to the health and well-being of students and teachers. This study assessed the magnitude of perceived stress and well-being and the associated factors, including number of working hours, work-related sense of coherence (work-SoC), perceived stress, self-endangering work behaviour, secondary burnout symptoms, and satisfaction with work, among school leaders in Hong Kong, China during the COVID-19 pandemic. This cross-sectional, survey-based study collected demographic data and mental health measurements from 259 eligible school leaders in Hong Kong from April 2021 to February 2022. Pearson's correlation analyses, multilinear regression models, and independent-samples Student's t-tests were performed. The findings revealed that school leaders' perceived stress was negatively correlated with their well-being (r = -0.544, p < 0.01) and work-related SoC (r = -0.327, p < 0.01) but positively correlated with their extensification of work (r = 0.473, p < 0.01), exhaustion related to work situations (r = 0.559, p < 0.01), and psychosomatic complaints (r = 0.439, p < 0.01). In a model that adjusted for gender and age, student leaders with higher subjective well-being scores had a lower level of perceived stress (B = -0.031; 95% confidence interval [CI], -0.59, -0.02; p = 0.034), whereas leaders in schools with a larger student population had a higher level of perceived stress (B = 0.002; 95% CI, 0.000, 0.003; p = 0.030). School leaders with a higher likelihood of performing the self-endangering work behaviour of 'intensification of work' had higher perceived stress levels (B = 1.497; 95% CI, 0.717, 2.278; p < 0.001). School leaders with a higher work-related SoC (B = 4.20; 95% CI, 1.290, 7.106; p = 0.005) had a higher level of well-being. School leaders with higher levels of perceived stress (B = -0.734; 95% CI, -1.423, -0.044; p = 0.037), a higher likelihood of performing the self-endangering work behaviour of 'extensification of work' (B = -4.846; 95% CI, -8.543, -1.149; p = 0.010), and a higher score for exhaustion related to work (B = -10.449; 95% CI, -13.864, -7.033; p = 0.000) showed lower levels of well-being. The finding of a high incidence of stress among school leadership justifies the need for more societal attention to the well-being of school leaders in Hong Kong. It is important that policies and initiatives are designed to enhance the well-being of school leaders and that they are supported in leading the management of schools and coping with stress in school settings.

Associations Between Consumption of Different Vegetable Types and Depressive Symptoms in Japanese Workers: A Cross-Sectional Study

Purpose

Vegetable intake is an important part of our everyday diet and is associated with many positive health outcomes. Although previous studies have investigated the association between vegetable consumption and depressive symptoms among various populations, no study has examined this association in the adult working population. The present study investigated whether the frequency of consumption of a specific type of vegetable is associated with the prevalence of depressive symptoms in Japanese adult workers.

Participants and Methods

The final participants consisted of 1724 Japanese adults, and a cross-sectional study was conducted to analyze the results. The frequency of vegetable consumption and depressive symptoms was evaluated using a brief-type self-administered diet history questionnaire and the Zung Self-Rating Depression Scale (SDS), respectively. The association between the variables was examined using Poisson regression analysis. Age-stratified analysis was performed, and SDS cut-off values of 45 and 50 were used to perform a sensitivity analysis.

Results

After adjustment for covariates, including age, body mass index, sociodemographic and lifestyle-related variables, health condition, C-reactive protein, and other dietary variables, an inverse association was found between tomato product consumption and the prevalence of depressive symptoms among men (P for trend <0.01); however, no significant association was found for other vegetable types. For women, there was no association between the frequency of consumption of any of the vegetable types and the prevalence of depressive symptoms. The results were confirmed by the age-stratified analysis for both genders.

Conclusion

Consumption of tomato products may help alleviate depressive symptoms, regardless of differences in dietary culture among men.

Relationships between Occupational Stress, Change in Work Environment during the COVID-19 Pandemic, and Depressive and Anxiety Symptoms among Non-Healthcare Workers in Japan: A Cross-Sectional Study

This study aims to clarify the effect of occupational stress and changes in the work environment on non-healthcare workers’ (HCWs) mental health during the third wave of the COVID-19 pandemic in Japan. A web-based, cross-sectional survey was conducted from 16 to 17 December 2020. Data from 807 non-HCWs were included. We evaluated occupational stress using the Generic Job Stress Questionnaire (GJSQ). Depressive and anxiety symptoms were assessed using the Japanese version of the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder 7-item scale, respectively. We collected demographic variables, work-related variables, and the variables associated with COVID-19. The adjusted odds ratios for depressive and anxiety groups were estimated using multivariate logistic regression analyses, adjusted for all the demographic variables, work-related variables, COVID-19-related variables, and the six subdivided GJSQ subscales. The results confirm a relationship between variance in workload, job future ambiguity, social support from coworkers, having contact with COVID-19 patients, and depressive and anxiety symptoms. Paying attention to job future ambiguity, the variance in workload at the workplace and individual perspectives, promoting contact and support among coworkers using online communication tools, and reducing contact with COVID-19 patients, will be useful for decreasing the depressive and anxiety symptoms among non-HCWs.

The relationship between occupational stress, mental health and work ability of coal chemical workers in Xinjiang

OBJECTIVE

To understand the current working ability of coal chemical workers in Xinjiang, and analyze the impact of occupational stress, mental disorders, and their interaction on work ability. To provide a scientific basis for improving the working ability and quality of life of coal chemical workers.

METHODS

In this study, a stratified random sampling method was used to conduct a questionnaire survey of 1,400 workers in six coal mining enterprises from June to December 2019. The Effort-Reward Imbalance Questionnaire (ERI), the Symptoms Checklist 90 (SCL-90), and the Work Ability Index Scale (WAI) were used to evaluate the level of occupational stress, mental disorders, and the ability to work as coal chemical workers.

RESULTS

The results showed that WAI scores had statistically significant differences between gender, age, length of service, shift, education, marital status, and monthly income (P < 0.05). The ability to work and its dimensions were inversely correlated with occupational stress, and mental disorders (P < 0.001). Occupational stress and mental disorders are risk factors affecting the ability to work. Workers with high occupational stress^* mental disorders (OR = 10.666, 95% CI: 6.443-17.658) are 10.666 times more likely to be at risk for developing poor work ability than low occupational stress^* no mental disorders. Structural equation models show that occupational stress and mental health conditions had a direct impact on work ability, and mental health conditions were the mediators of the relationship between occupational stress and work ability.

CONCLUSION

Occupational stress, mental disorders, and their interaction are risk factors affecting the ability of coal chemical workers to work. Occupational stress can indirectly affect the ability to work through mental health conditions.

Oral health-related quality of life is associated with the prevalence and development of depressive symptoms in older Japanese individuals: The Ohasama Study

OBJECTIVE

This prospective study investigated the cross-sectional association between impaired oral health-related quality of life (OHRQoL) and the prevalence of depressive symptoms, and the longitudinal association between impaired OHRQoL and development of depressive symptoms among older adults.

BACKGROUND

Previous studies have shown a relationship between poor oral health and depression among older adults; however, findings are inconsistent.

MATERIALS AND METHODS

Participants were 669 community-dwelling older Japanese individuals aged≥55 years (mean: 67.8 ± 7.2 years). Data of 296 participants were used for longitudinal analyses. OHRQoL was evaluated using the Oral Impacts on Daily Performances scale. Impaired OHRQoL was defined as the presence of at least one impact on the scale. Depressive symptoms were assessed using the Japanese version of the Zung self-rating depression scale with a cut-off score of 40.

RESULTS

The cross-sectional logistic regression model demonstrated that impaired OHRQoL was significantly associated with depressive symptoms (odds ratio [OR], 5.17; 95% confidence interval [CI], 2.99-8.95) independent of age, sex, body mass index, hypertension, cerebrovascular/cardiovascular disease, smoking, drinking alcohol, education, cognitive function, objective oral health (dentition status) and oral health behaviour (dental visit within 1 year). Similarly, impaired OHRQoL predicted the development of depressive symptoms within 4 years in a fully adjusted longitudinal model (OR, 6.00; 95% CI, 1.38-26.09).

CONCLUSION

Impaired OHRQoL was identified as a potential comorbidity of depressive symptoms and a predictor for depressive disorder later in life. OHRQoL may be a useful clinical outcome for elder patients with regard to their mental and oral health.

Daily dietary isoflavone intake in relation to lowered risk of depressive symptoms among men

BACKGROUND

The relationship between isoflavone intake and depressive symptoms has been examined among premenopausal and postmenopausal women but not among men. Therefore, we investigated whether isoflavone intake is associated with depressive symptoms among men.

METHODS

This cross-sectional study was conducted between 2008 and 2011. A total of 1335 Japanese men aged 19-83 participated in the present study. Isoflavone intake was measured using the Brief-type Self-administered Diet History Questionnaire (BDHQ). Depressive symptoms were assessed using the Self-rating Depression Scale (SDS), and two cut-off values (i.e., 40 and 50) were used. Multiple logistic regression analysis was conducted to examine the association between isoflavone intake and depressive symptoms.

RESULTS

When the cut-off value for SDS was specified as 40, the odds ratios (ORs) for depressive symptoms were higher for the categories that were characterized by high rather than low levels of isoflavone intake in the crude model (p = 0.002). This association remained unchanged (p = 0.029) when potential cofounds were controlled for in Model 3. Multivariate linear regression analysis also showed a significant inverse association between isoflavone intake and SDS scores (p = 0.027; final adjusted model).

LIMITATIONS

Cross-sectional study is difficult to draw any conclusions about causality CONCLUSIONS: The findings suggest that a high level of dietary isoflavone intake is associated with a lower prevalence of depressive symptoms among men. Therefore, isoflavone intake may have a beneficial effect on men's mental health.