Abstract
High job demands, low job control, and their combination (job strain) may increase workers' risk of depression. Previous research is limited by small populations, not controlling for previous depression, and relying on the same informant for reporting exposure and outcome. This study aims to examine the relationship between objectively measured workplace factors and the risk of developing clinical depression among the Swedish working population while controlling for previous psychiatric diagnoses and sociodemographic factors. Control, demands, and job strain were measured using the Swedish Job Exposure Matrix (JEM) measuring psychosocial workload linked to around 3 million individuals based on their occupational titles in 2005. Cox regression models were built to estimate associations between these factors and diagnoses of depression recorded in patient registers. Lower job control was associated with an increased risk of developing depression (HR 1.43, 95% CI 1.39-1.48 and HR 1.27, 95% CI 1.24-1.30 for men and women with the lowest control, respectively), and this showed a dose-response relationship among men. Having high job demands was associated with a slight decrease in depression risk for men and women. High strain and passive jobs (both low control jobs) were associated with an increased risk of depression among men, and passive jobs were associated with an increased risk among women. High job control appears important for reducing the risk of developing depression even when accounting for previous psychiatric diagnoses and sociodemographic factors. This is an important finding concerning strategies to improve occupational and in turn mental health.
Highlights
Depressive disorders are one of the leading causes of morbidity globally [Global Burden of Disease (GBD) 2017 Disease and Injury Incidence and Prevalence Collaborators, 2018; World Health Organization, 2017]
The present study aims to investigate the relationship between the psychosocial work environment exposures of job control, job demands, and job strain and the risk of developing depression during a 10-year follow-up period using aggregated job exposure data and patient registry information on the Swedish working population age 30–60 in 2005, taking into account previous psychiatric diagnoses, family situation, birth country, socioeconomic position (SEP) during childhood, and parents’ mental health
Stratifying by age group showed virtually no change in the associations. In this register-based study of approximately 3 million Swedish workers, we found that for both men and women, lower job control, measured by decision authority at work, was associated with an increased risk of depression during the follow-up period, even after adjusting for pre-baseline psychiatric diagnoses, background sociodemographic factors, and other factors related to the working environment
Summary
Depressive disorders are one of the leading causes of morbidity globally [Global Burden of Disease (GBD) 2017 Disease and Injury Incidence and Prevalence Collaborators, 2018; World Health Organization, 2017]. Depression represents a large cost to individuals, and the people around them and society as a whole For this reason, a better understanding of potentially modifiable risk factors is crucial in order to devise strategies for the prevention and improvement of depression. This study aims to examine the relationship between objectively measured workplace factors and the risk of developing clinical depression among the Swedish working population while controlling for previous psychiatric diagnoses and sociodemographic factors. High job control appears important for reducing the risk of developing depression even when accounting for previous psychiatric diagnoses and sociodemographic factors. This is an important finding concerning strategies to improve occupational and in turn mental health
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