Abstract
PurposeJob control, the combination of skill discretion and decision authority, is considered a central component of the psychosocial working environment. This longitudinal study examines the relation between job control and risk of incident depressive disorder using a life-course approach.MethodsWe analyze data from The Danish Work Life Course Cohort study, including all Danish individuals aged 15–30 who entered the Danish labor market during 1995–2009 and were free from depressive disorder at entry (955,573 individuals). We measured job control using a job exposure matrix. Depressive disorders were measured using information from nationwide registers of psychiatric in- and outpatient admissions. Using Cox regression models we estimated the prospective association between job control and risk of incident depressive disorders. Analyses accounted for a range of potential confounders prior to workforce entry including socioeconomic status in adolescence and parental psychiatric and somatic diagnoses prior to labor market entry, together with potential confounders in adulthood including income, education, and demographics.ResultsLower levels of past year job control were associated with a higher risk of depressive disorder after adjustment for all covariates (HR = 1.27, 95% CI 1.16–1.38). Results stratified by gender showed associations for both men (HR = 1.38, 95% CI 1.19–1.61) and women (HR = 1.19, 95% CI 1.08–1.32). Conclusions: Our findings suggest that the level of job control at work affects the risk of clinically diagnosed depressive disorder, and that this association is not due to confounding by socioeconomic status.
Highlights
Depressive disorder is highly prevalent and causes considerable suffering for individuals affected [1, 2] as well as financial loss for employers and society [3, 4] through lost work hours, reduced work functioning and disability [5,6,7,8]
Individuals working in occupations with lower levels of job control in the past year had a higher risk of depressive disorder (HR = 1.62, 95% CI 1.49–1.76) compared to individuals in jobs with higher levels of job control after accounting for Children in the household
We found a hazard ratio for depressive disorder of 1.15 for employees with the low past year job control compared to employees with high job control after adjusting for accumulated level of job control and covariates (Table 2, Model 1)
Summary
Depressive disorder is highly prevalent and causes considerable suffering for individuals affected [1, 2] as well as financial loss for employers and society [3, 4] through lost work hours, reduced work functioning and disability [5,6,7,8]. Depressive disorder is etiologically complex with multiple risk factors involving biological, environmental and psychological factors [9,10,11,12]. A growing body of research suggests that poor psychosocial working conditions increase the risk of depressive disorders [13,14,15]. Among the many factors characterizing the psychosocial working environment, the most widely examined factor in relation to depression is job control [13, 14], one of the two dimensions of the demand/control model [16]. Job control is a combination of the skill discretion (possibilities of development) and decision authority (influence) of a job. These aspects of work are often interrelated and thought to mutually reinforce effects of each other [17]
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