Abstract
BackgroundAdverse psychosocial work environments may lead to impaired mental health, but it is still a matter of conjecture if demonstrated associations are causal or biased. We aimed at verifying whether poor psychosocial working climate is related to increase of redeemed subscription of antidepressant medication.MethodsInformation on all antidepressant drugs (AD) purchased at pharmacies from 1995 through 2006 was obtained for a cohort of 21,129 Danish public service workers that participated in work climate surveys carried out during the period 2002–2005. Individual self-reports of psychosocial factors at work including satisfaction with the work climate and dimensions of the job strain model were obtained by self-administered questionnaires (response rate 77,2%). Each employee was assigned the average score value for all employees at his/her managerial work unit [1094 units with an average of 18 employees (range 3–120)]. The risk of first-time AD prescription during follow-up was examined according to level of satisfaction and psychosocial strain by Cox regression with adjustment for gender, age, marital status, occupational status and calendar year of the survey.ResultsThe proportion of employees that received at least one prescription of ADs from 1995 through 2006 was 11.9% and prescriptions rose steadily from 1.50% in 1996 to the highest level 6.47% in 2006. ADs were prescribed more frequent among women, middle aged, employees with low occupational status and those living alone. None of the measured psychosocial work environment factors were consistently related to prescription of antidepressant drugs during the follow-up period.ConclusionThe study does not indicate that a poor psychosocial work environment among public service employees is related to prescription of antidepressant pharmaceuticals. These findings need cautious interpretation because of lacking individual exposure assessments.
Highlights
Adverse psychosocial work environments may lead to impaired mental health, but it is still a matter of conjecture if demonstrated associations are causal or biased
The 21,129 county and municipality employees purchased a total of 789,843 prescribed pharmaceuticals from January 1 1996 through December 31 2006
The average number of redeemed prescriptions per employee with at least one prescription was 17.9, but only 45% received more than one prescription of antidepressant drugs
Summary
Adverse psychosocial work environments may lead to impaired mental health, but it is still a matter of conjecture if demonstrated associations are causal or biased. Another systematic review addressing major depression found moderate evidence that individual perception of high psychological demands and low social support at the job increases the risk of depression [8]. It is still a matter of conjecture if associations demonstrated in these studies are causal or due to selection bias or confounding [9]. Almost all earlier studies are based upon self-reported data on perceived stressors and health outcome These are not independent and introduce the risk of circular reasoning and bias because of common method variance [10,11,12]. This paper demonstrated moderately elevated risk of depression and prescription of antidepressant medication in relation to workplace social capital at the individual level but not at the aggregated work unit level [15]
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