Trajectories of job demands and control: risk for subsequent symptoms of major depression in the nationally representative Swedish Longitudinal Occupational Survey of Health (SLOSH)

Julia K Åhlin,Hugo Westerlund,Yannick Griep,Linda L Magnusson Hanson

doi:10.1007/s00420-017-1277-0

Abstract

PurposeDepression is a global health concern. High job demands, low job control, and the combination (high strain) are associated with depression. However, few longitudinal studies have investigated changed or repeated exposure to demands and control related to depression. We investigated how trajectories of exposure to job demands and control jointly influence subsequent depression.MethodsWe included 7949 subjects from the Swedish Longitudinal Occupational Survey of Health, who completed questionnaires of perceived job demands and control, and depressive symptoms from 2006 to 2014. None of them were depressed between 2006 and 2012. Univariate and joint group-based trajectory models identified groups with similar development of demands and control across 2006–2012. Logistic regression estimated the risk for symptoms of major depression in 2014 according to joint trajectory groups.ResultsThe joint trajectory model included seven groups, all with fairly stable levels of demands and control over time. Subjects in the high strain and active (high demands and high control) trajectories were significantly more likely to have subsequent major depressive symptoms compared to those having low strain, controlling for demographic covariates (OR 2.15; 95% Cl 1.24–3.74 and OR 2.04; 95% CI 1.23–3.40, respectively). The associations did not remain statistically significant after adjusting for previous depressive symptoms in addition to demographic covariates.ConclusionsThe results indicate that the levels of job demands and control were relatively unchanged across 6 years and suggest that long-term exposure to a high strain or active job may be associated with increased risk for subsequent depression.

Highlights

Depression is a common, disabling and burdensome mental disorder (Wittchen et al 2011), and a major public health concern.Increased severity of depression has been associated with more disability, unemployment and poorer work performance (Birnbaum et al 2010)
The results indicate that the levels of job demands and control were relatively unchanged across 6 years and suggest that long-term exposure to a high strain or active job may be associated with increased risk for subsequent depression
The distribution of symptoms of major depression was significantly different between the age groups

Summary

Introduction

Depression is a common, disabling and burdensome mental disorder (Wittchen et al 2011), and a major public health concern.Increased severity of depression has been associated with more disability, unemployment and poorer work performance (Birnbaum et al 2010). Depression is a common, disabling and burdensome mental disorder (Wittchen et al 2011), and a major public health concern. The majority of studies draw upon the Demand-Control Model (Karasek 1979) encompassing the psychological demands and control dimensions. Psychological job demands refer to the pace and mental intensity of work, whereas job control (decision latitude) comprises decision authority and skill discretion. The model classifies jobs into four categories: “high-strain,” “low strain,” “active,” and, “passive” jobs (Karasek 1979). “High-strain” jobs are characterised by high demands and low control, whereas “low strain” reflect low demands and high control (Karasek 1979).

Objectives

Methods

Results

Conclusion