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Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data

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posted on 2016-12-21, 11:58 authored by Ida E.H. Madsen, Solja T. Nyberg, Linda L. Magnusson Hanson, Jane E. Ferrie, Kirsi Ahola, Lars Alfredsson, G. David Batty, Jakob B. Bjorner, Marianne Borritz, Hermann Burr, Jean-François Chastang, Ron de Graaf, Nico Dragano, Mark Hamer, Markus Jokela, Anders Knutsson, Markku Koskenvuo, Aki Koskinen, Constanze Leineweber, Isabelle Niedhammer, Martin L. Nielsen, Maria Nordin, Tuula Oksanen, Jan H. Pejtersen, Jaana Pentti, Inger Plaisier, Paula Salo, Archana Singh-Manoux, Sakari Suominen, Tores Theorell, Salla Toppinen-Tanner, Jussi Vahtera, Ari Vaananen, Mika Kivimaki, Peter J.M. Westerholm, Hugo Westerlund, Eleonor I. Fransson, Katriina Heikkila, Marianna Virtanen, Reiner Rugulies
Background Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression. Methods We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individuallevel data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) consortium. Summary estimates of the association were obtained using random effects models. Individual-level data analyses were based on a pre-published study protocol (F1000Res 2013;2:233). Results We included 6 published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published (Relative Risk [RR]= 1.77, 95% confidence interval [CI] 1.47-2.13) and unpublished datasets (RR=1.27, 95% CI 1.04-1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR=1.25, 95% CI: 0.94-1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR=1.03, 95% CI: 0.81- 1.32). Conclusion Job strain may precipitate clinical depression among employees. Future intervention studies.



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Psychological Medicine


MADSEN, I.E.H. ... et al, 2017. Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data. Psychological Medicine, 47 (8), pp. 1342-1356.


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