Suppressing emotion and engaging with complaining customers at work related to experience of depression and anxiety symptoms: a nationwide cross-sectional study

High Emotional Demands at Work and Poor Mental Health in Client-Facing Workers

This study investigated the association between emotional demands and depression or anxiety in a wide range of jobs. We used data from the third Korean Working Conditions Survey (n = 50,032) for all occupational classifications, with no limitations placed on job title or employment type. Among the full set of regular paid workers in addition to self-employed, unpaid family workers, and informal employees such as independent contractors, 23,989 respondents worked with “customers, passengers, students, or patients” (i.e., clients). Emotional demands were evaluated using two questions: handling angry clients and needing to hide feelings for work performance. Any depression or anxiety over the last 12 months was taken to indicate poor mental health. Multivariable logistic regression modeling was performed to calculate adjusted ORs with 95% confidence intervals for the influence of emotional demands on mental health, adjusting for demographic factors (age, gender, education, income), occupational psychological demands, decision latitude, social support, weekly work hours and job insecurity. The prevalence of emotional demands was higher in self-employed and informal employees than in regular paid employees. The more frequent the exposure to the two emotional demands combined was, the higher the risk of depression or anxiety. High psychological demands, low social support, and low job security each further increased the risk of poor mental health. Emotional demands turned out to be widespread in the entire economy, were not limited to service or sales occupations, and were more evident in precarious work. The contribution of emotional demands and other preventable job stressors to the burden of depression or anxiety in society may be substantial.

Anxiety and dyslipidemia among primary health care professionals: A Cross-sectional study

BACKGROUND: Cross-sectional studies point out important evidence between anxiety and dyslipdemic disorders in health workers. OBJECTIVE: Our main objective was to estimate the association between anxiety and dyslipidemia in Primary Health Care (PHC) nursing professionals in Feira de Santana, Bahia, Brazil. METHODS: A confirmatory cross-sectional study involving 376 PHC nursing professionals. Data collection occurred through the application of a questionnaire containing sociodemographic, labor and lifestyle issues, and the Beck Inventory for anxiety; to evaluate the lipid profile, the HDL-c, LDL-c, and triglycerides markers were evaluated. Descriptive, bivariate analysis and Logistic Regression were performed. RESULTS: The estimated prevalence of moderate/severe anxiety corresponded to 26.1% and dyslipidemia was 54.8%, with a statistically significant association between both of variables stratified by physical activity (PR = 2.69; 95% CI = 1.87–3.85) and (PR = 1.87; 95% CI = 1.53–2.28). CONCLUSIONS: There is a positive association between anxiety and dyslipidemia in Primary Health Care nursing professionals.

Mental health symptoms among dependent contractors in Korea: a cross-sectional study based on the Fifth Korean Working Condition Survey

Background

Recently, there has been a call to improve the holistic welfare of dependent contractors (DCs). Thus, our study examined the relationship between DCs and mental health symptoms and how this relationship was modified by age, sex, and income status of workers.

Methods

A total of 27,980 workers from the Fifth Korean Working Conditions Survey are included in our study. The participants who reported having depression or anxiety over the last 12 months are defined those who had mental health symptoms. We performed exact matching for age group and sex, followed by conditional logistic regression with survey weights. Finally, stratified analyses by age, sex and income level were conducted.

Results

DCs were found to be at increased risk of depression/anxiety compared to other workers. The odds ratio (OR) is 1.52 (95% confidence interval [CI]: 1.06–2.17). In the stratified analyses, vulnerable groups were middle-aged (OR [95% CI]: 1.68 [1.10–2.54]), female (OR [95% CI]: 1.85 [1.20–2.84]), and low-income (OR [95% CI]: 3.18 [1.77–5.73]) workers.

Conclusions

Our study's results reinforce those of other studies that show that DCs are at greater risk of experiencing mental health issues than other workers and that and this risk is greater for middle-aged, female, and low-income workers. These results suggest that appropriate policy efforts should be made to improve the psychological well-being of DCs.

Factors Related to Psychological Well-Being as Moderated by Occupational Class in Korean Self-Employed Workers

We examined factors related to the psychological well-being of self-employed workers in Korea, and the moderation of these effects by occupational class. This secondary analysis examined the data of 14,454 self-employed individuals from the fifth Korean Working Conditions Survey (2017). In all occupational classes, psychological well-being score was greater in women, and increased with monthly income and the frequency of working at very high speed; there were lower mean scores in those who became self-employed out of necessity rather than personal choice; in addition, the score decreased as the number of musculoskeletal symptoms increased. The relationship of work factors with the psychological well-being of self-employed individuals also differed according to occupational class. In conclusion, our analysis indicated that self-employed workers in different occupational classes respond differently to identical stressors.

Factors related to depressive symptoms in Korean self-employed workers

Background

We examined factors related to depressive symptoms in Korean self-employed workers.

Methods

This secondary analysis examined data of 14,454 self-employed individuals from the fifth Korean Working Conditions Survey (2017). Multiple logistic regression analysis was used to assess the relationship of depressive symptoms with different variables.

Results

Self-employed workers who had a good work-life balance, a good subjective health, and worked 40 to 48 hours or 48 to 60 hours/week were less likely to report depressive symptoms (all p < 0.05). However, those who always interacted with angry clients, had severe exposure to ergonomic risk factors, and were exposed to moderate or severe abusive behaviors were more likely to report depressive symptoms (all p < 0.05). Age, gender, weekly work days, and working at very fast speed were unrelated to depressive symptoms.

Conclusions

Several factors known to be related to depressive symptoms do not lead to depression in self-employed individuals. Different interventions may therefore be needed to prevent depression in self-employed workers.

Emotional Demand and Mental Health in Korean Employees

Background: Emotional demand (ED) at work is related to mental health in the general workforce, not just emotional workers. We investigated the relationships between ED and mental health outcomes, including distress, depressive symptoms (DS), experience of depression (DE), and suicidal ideation (SI) on the entire general workforce using nationally representative data. Methods: 5787 full-time employees were analyzed using cross-sectional design with the fourth Korean National Health and Nutrition Examination Survey (K-NHANES IV). Work-related psychosocial factors and mental health status were measured through face-to-face interviews. Multi-stage and stratified survey designs were considered in the analysis, and the mental health effects of ED were analyzed using multivariable logistic analysis. The Cochran–Armitage trend test was conducted to investigate increases in the relationship between the severity of ED and mental health outcomes. Results: The subjects comprised 3089 men and 2698 women. ED was reported by 36.7% of men and 39.3% of women. The estimated prevalence of distress was 27.5% in men and 34.6% in women. Adjusted odds ratios (ORs) of ED for distress were 2.62 (95% confidence interval (CI) = 2.10–3.28) for men and 2.57 (95% CI = 1.92–3.45) for women. DS was significantly related to ED (men: OR = 1.72, 95% CI = 1.18–2.50; women: OR = 1.91, 95% CI = 1.33–2.74). ED was also significant psychosocial risk factor for DE (men: OR = 1.88, 95% CI = 1.07–3.29; women: OR = 1.77, 95% CI = 1.15–2.75) and SI (men: OR = 1.64, 95% CI = 1.11–2.41; women: OR = 2.31, 95% CI = 1.63–3.28). Conclusions: ED was a risk factor for distress, DS, DE, and SI in the general workforce. Legal and social safety networks should be constructed for workers whose emotions may be hidden at work, as well as workers in emotion-related fields.

An Insight into the Anxiolytic and Antidepressant-Like Proprieties of Carum carvi L. and Their Association with Its Antioxidant Activity

Depression and anxiety are widespread illnesses whose consequences on patients’ social and professional lives are becoming ever more dangerous and severe. The study’s objective is to explore the antidepressant-like and anxiolytic activity of the polyphenolic extract of Carum carvi L. as well as its antioxidant power as they were recently associated. The predictive antidepressant activity was evaluated using the forced swimming and tail suspension test in mice, a preclinical behavioral model widely used to determine the efficacy of antidepressant drugs. As for anxiolytic-like activity, two models were used, namely the light/dark chamber test to measure the animal’s degree of anxiety and the open field test to evaluate both anxiolytic and locomotor activity. The tests results indicate a remarkable antidepressant and anxiolytic-like effect after oral administration of the polyphenolic fraction of C. carvi and interesting antioxidant property. In the extract it has been confirmed the presence of 6 molecules belonging to polyphenols, identified with HPLC analysis. This study confirms and encourages the traditional use of the extract and appeals to further studies to understand its action mechanism.

Factors that Affect Depression and Anxiety in Service and Sales Workers Who Interact With Angry Clients

Introduction

We evaluated depression and anxiety in service and sales workers from Korea who interacted with angry clients to identify factors that mediated and moderated depression and anxiety in these workers.

Methods

This was a secondary analysis of data from the fifth Korean Working Conditions Survey conducted in 2017. A structural equation model was used for mediation and moderation analysis.

Results

Service and sales workers who had more interactions with angry clients had increased risk for depression and anxiety. Experiencing clients' adverse behaviors (acute episodes) mediated the relationship between interacting with angry clients (a chronic situation) on depression and anxiety. Job satisfaction and managers' support moderated the relationship between interacting with angry clients and mental health problems.

Conclusion

We suggest that employers of service and sales workers should recruit staff based on their aptitude for such work, thus ensuring job satisfaction, and train them to deal with angry clients in such a way that they experience less emotional burden. Employers should also make bylaws requiring managers to directly take care of adverse social behavior by clients. Furthermore, a sociocultural campaign to prevent adverse social behavior by clients is also needed.

Psychological well-being of South Korean employees in different occupational classes

We compared the mental health of waged Korean workers in different occupational classes. This was a secondary analysis of data from the fifth Korean Working Conditions Survey, conducted in 2017. Men who were "Unskilled manual workers" were more likely to report poor psychological well-being; however, analysis that adjusted for multiple factors (including work stressors and stress relievers) indicated that status as an "Unskilled manual worker" was not associated with poor psychological well-being. Male and female "Service and Sales workers" were less likely to report poor psychological well-being (aOR = 0.794 and 0.797, respectively). In addition, poor psychological well-being increased as the number of work stressors increased and decreased as the number of stress relievers increased. Work stressors and stress relievers are more deterministic than occupational categories on psychological well-being.

Surface-acting emotional labor predicts depressive symptoms among health care workers over a 2-year prospective study

OBJECTIVE

Surface-acting emotional labor (SaEL) is the requirement to hide or suppress felt emotions to achieve acceptable job performance. It is a common feature of jobs featuring interactions with the public, such as customers or patients. Resulting emotional inauthenticity is associated with psychological strain, but there have been few prospective studies of mental health outcomes.

METHODS

A self-administered questionnaire was distributed in 24 skilled nursing facilities at baseline and 23 facilities 2 years later. Permanent full-time and part-time employees in all jobs were eligible to participate. Respondents in these analyses provided survey information on the frequency of SaEL at baseline and depressive symptoms on both occasions. Those without depression at baseline were deemed at risk. Multivariable logistic regression modeling estimated adjusted odds ratios (aOR) for SaEL, other job features, and demographic characteristics.

RESULTS

A total of 939 eligible participants had no depression at baseline; 15% developed depressive symptoms. About two-thirds were direct care providers, including 38% nursing and medical assistants. Adjusted for potential confounders, workers with intermediate and high SaEL had a higher risk (aORs around 2). Symptom onset was also predicted by high work-family conflict, younger age and low decision latitude at work.

CONCLUSIONS

In this prospective study of long-term care workers, those who reported experiencing high SaEL at the time of the baseline survey were at higher risk of developing depressive symptoms 2 years later. Both exposure and outcome could have suffered some misclassification. Future studies should examine a broader range of strategies for coping with emotional labor demands.

Association of Co-Exposure to Psychosocial Factors With Depression and Anxiety in Korean Workers

INTRODUCTION

This study assessed the association of co-exposure to psychosocial factors with depression and anxiety in Korean workers.

METHODS

All data were from the 2017 Korean Working Conditions Survey.

RESULTS

Males and females who perceived organizational injustice, hid their emotions at the workplace, felt they were paid inappropriately, and had no support from managers were more likely to report depression and anxiety. Males who reported long working hours, no ability to influence decisions, work pressure, and no ability to apply their own ideas at the workplace were more likely to report depression and anxiety. Co-exposure to a greater number of psychosocial factors had stronger associations with depression and anxiety in men and women.

CONCLUSION

Employers should reduce depression and anxiety in their workers by providing comprehensive interventions that protect them from co-exposure to work stressors.

Prevalence of somatic and psychiatric morbidity across occupations in Switzerland and its correlation with suicide mortality: results from the Swiss National Cohort (1990-2014)

BACKGROUND

Suicide is a major and complex public health problem. In Switzerland, suicide accounts for about 1000 deaths yearly and is the fourth leading cause of mortality. The first nationwide Swiss study of suicides identified eight male and four female occupations with statistically significant excess of suicide compared to the general Swiss population. Working time, self-employer status, low socio-economic status and low skill level required for occupation were associated with increase in suicide risk. Presently, we aim to compare the distribution of suicide risk across occupations with the prevalence of somatic and psychiatric morbidity in Swiss working-aged adults. We hypothesized that some diseases would cluster in particular occupations, indicating potential work-relatedness of suicides found in these occupations.

METHODS

We used the Swiss National Cohort (SNC) and included 10575 males and 2756 females deceased by suicide between 1990 and 2014. We estimated the prevalence of 16 categories of concomitant diseases in each occupation, using national mortality records, and assessed the homogeneity of diseases distribution across occupations. For diseases, which prevalence varied significantly across occupations, we analyzed the correlation with the distribution of suicide risk, estimated as the standardized mortality ratio (SMR) of suicide.

RESULTS

Mental and behavioral disorders were the most commonly reported concomitant diseases in our population. In men, the prevalence of these disorders and more specifically, the prevalence of substance-related and addictive disorders, and of psychotic disorders varied significantly across occupations and was correlated with the SMR of suicide. The prevalence of malignant neoplasms and the prevalence of diseases of the musculoskeletal system and connective tissue also varied significantly across male occupations, while in women, such a variation was observed for neoplasms of uncertain or unknown behavior and diseases of the nervous system and sense organs, without being correlated with the SMR of suicide.

CONCLUSION

Some of the identified morbidities can be occupation-related and could negatively affect the working capacity and the employability, which in turn could be related to the suicide. Disentangling concomitant diseases according to their work-relatedness and relationship with the suicide risk is important for identifying occupation-related suicides, understanding their characteristics, and developing appropriated interventions for their prevention.

Anxiety, Depression and Sleep Disturbance among Customer-Facing Workers

BACKGROUND

Mental health problems are a growing issue among customer-facing workers. This study aimed to investigate the workers' symptoms of anxiety, depression, and sleep disturbance caused by customer complaints and the suppression of one's emotions at work.

METHODS

This study used the data from the fifth Korean Working Conditions Survey 2017 database. The subjects comprised 23,128 workers (men, 11,007; women, 12,121). The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multiple logistic regression models, to determine the effect of the exposure level of engaging with angry clients and suppressing one's emotions at work on mental health.

RESULTS

Among the workers engaging with angry customers, compared to the "Rarely" group as a reference point, the "Always" group showed elevated OR values (at [95% CI]) of 1.52 (1.10-2.10), 1.86 (1.05-3.27), 4.43 (3.11-6.33), 3.74 (2.51-5.55), 3.89 (2.65-5.70) for men workers; and 2.86 (1.94-4.22), 2.55 (1.73-3.75), 3.75 (2.82-4.98), 3.81 (2.84-5.09), 3.84 (2.88-5.12) for women workers, for depression, anxiety, difficulty falling asleep, waking up during sleep, and extreme fatigue after waking up, respectively. For suppressing one's emotions at work, the OR values of the "Always" group were 2.32 (1.53-3.51), 2.46 (1.73-3.50), 2.54 (1.88-3.43), 2.64 (1.92-3.64), 2.42 (1.81-3.24) for men workers; and 2.23 (1.53-3.25), 2.31 (1.61-3.33), 2.26 (1.72-2.96), 1.53 (1.19-1.97), 2.15 (1.62-2.85) for women workers, for depression, anxiety, and difficulty falling asleep, waking up during sleep, and extreme fatigue after waking up, respectively.

CONCLUSION

The emotional labor demanded from customer-facing workers, incurred by facing customer complaints and suppressing one's emotions at work, was found to be significantly associated with the development of depression, anxiety, and sleep disturbance symptoms among the Korean working population.

Mental health by gender-specific occupational groups: Profiles, risks and dominance of predictors

BACKGROUND

We defined gender-specific profiles of mental ill-health for the main occupational groups using three outcomes; antidepressant use, sickness absence (SA) due to depression, and suicides. We also examined which occupational groups had the highest risk of the outcomes, and compared the importance of their predictors.

METHODS

From a random register cohort of Finnish working age population, individuals in the six largest occupational groups in 2004 for men and women were included (N = 414 357). We used register data to define the first antidepressant purchase (i.e. use), the first long-term SA spell for depression, and suicide between Jan 1st 2005 and Dec 31st 2014. We assessed the risk of each outcome by occupational group with logistic regression models, and used dominance analysis to compare the relative importance of predictors.

RESULTS

In all six occupational groups for women, the prevalence of antidepressant use and SA for depression was higher than in the men's occupational groups. The opposite was observed for suicides. The risk of antidepressant use was lower, but the risk of suicide was 2-times higher among men in low vs. high-skilled occupations. Among women, a lower skill-level was associated with a higher risk of SA due to depression. Gender was the most important predictor of all outcomes.

LIMITATIONS

We lacked information on history of medication use or health problems prior to follow-up.

CONCLUSIONS

Gendered occupational status was an underlying factor explaining distinctive mental health profiles in the working population. Occupational class-dependent behavioural patterns related to mental health existed among men.

Mental disorders among workers in the healthcare industry: 2014 national health insurance data

Background

Numerous studies have shown that healthcare professionals are exposed to psychological distress. However, since most of these studies assessed psychological distress using self-reporting questionnaires, the magnitude of the problem is largely unknown. We evaluated the risks of mood disorders, anxiety disorders, sleep disorders, and any psychiatric disorders in workers in healthcare industry using Korea National Health Insurance (NHI) claims data from 2014, which are based on actual diagnoses instead of self-evaluation.

Methods

We used Korea 2014 NHI claims data and classified employees as workers in the healthcare industry, based on companies in the NHI database that were registered with hospitals, clinics, public healthcare, and other medical services. To estimate the standardized prevalence of the selected mental health disorders, we calculated the prevalence of diseases in each age group and sex using the age distribution of the Korea population. To compare the risk of selected mental disorders among workers in the healthcare industry with those in other industries, we considered age, sex, and income quartile characteristics and conducted propensity scored matching.

Results

In the matching study, workers in healthcare industry had higher odds ratios for mood disorders (1.13, 95% CI: 1.11–1.15), anxiety disorders (1.15, 95% CI: 1.13–1.17), sleep disorders (2.21, 95% CI: 2.18–2.24), and any psychiatric disorders (1.44, 95% CI: 1.43–1.46) than the reference group did. Among workers in healthcare industry, females had higher prevalence of psychiatric disorders than males, but the odds ratios for psychiatric disorders, compared to the reference group, were higher in male workers in healthcare industry than in females.

Conclusions

The prevalence of mood disorders, anxiety disorders, sleep disorders, and all psychiatric disorders for workers in the healthcare industry was higher than that of other Korean workers. The strikingly high prevalence of sleep disorders could be related to the frequent night-shifts in these professions. The high prevalence of mental health problems among workers in healthcare industry is alarming and requires prompt action to protect the health of the “protectors.”

Association of Emotional Labor, Self-efficacy, and Type A Personality with Burnout in Korean Dental Hygienists

The purpose of this study was to examine the relationship between emotional labor and burnout, and whether the levels of self-efficacy and type A personality characteristics increase the risk of burnout in a sample of Korean female dental hygienists. Participants were 807 female dental hygienists with experience in performing customer service for one year or more in dental clinics, dental hospitals, or general hospitals in Korea. Data were collected using a structured self-administered questionnaire. A hierarchical multiple linear regression analysis was used to examine the effects of emotional labor on burnout, and to elucidate the additive effects of self-efficacy and type A personality on burnout. The results showed that "overload and conflict in customer service," "emotional disharmony and hurt," and "lack of a supportive and protective system in the organization" were positively associated with burnout. With reference to the relationship between personality traits and burnout, we found that personal traits such as self-efficacy and type A personality were significantly related to burnout, which confirmed the additive effects of self-efficacy and type A personality on burnout. These results indicate that engaging in excessive and prolonged emotional work in customer service roles is more likely to increase burnout. Additionally, an insufficient organizational supportive and protective system toward the negative consequences of emotional labor was found to accelerate burnout. The present findings also revealed that personality traits such as self-efficacy and type A personality are also important in understanding the relationship between emotional labor and burnout.