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

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published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individuallevel data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) consortium.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 From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression.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risk of clinical depression in both published (Relative Risk [RR]= 1.77, 95% confidence interval [CI] 1.47-2.13) and unpublished datasets (RR=1.27, 95% CI 1.04-1.55).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

Age-standardized incidence rates per 10,000 individuals for hospitalizations for cancers in men and women, Finland 1976–2010.

<p>Age-standardized incidence rates per 10,000 individuals for hospitalizations for cancers in men and women, Finland 1976–2010.</p

Age-standardized incidence rates per 10,000 individuals for all-cause hospitalizations in men and women, Finland 1976–2010.

<p>Age-standardized incidence rates per 10,000 individuals for all-cause hospitalizations in men and women, Finland 1976–2010.</p

Age-standardized incidence rates per 10,000 individuals for hospitalizations for cardiovascular disease in men and women, Finland 1976–2010.

<p>Age-standardized incidence rates per 10,000 individuals for hospitalizations for cardiovascular disease in men and women, Finland 1976–2010.</p

Age-standardized incidence rates per 10,000 individuals for hospitalizations for musculoskeletal disorders in men and women, Finland 1976–2010.

<p>Age-standardized incidence rates per 10,000 individuals for hospitalizations for musculoskeletal disorders in men and women, Finland 1976–2010.</p

The total number of hospitalizations by cohort in men and women and the mean age and the mean follow-up time in each cohort, Finland 1976–2010.

<p>The total number of hospitalizations by cohort in men and women and the mean age and the mean follow-up time in each cohort, Finland 1976–2010.</p

Age-standardized incidence rates per 10,000 individuals for hospitalizations for mental and behavioral disorders in men and women, Finland 1976–2010.

<p>Age-standardized incidence rates per 10,000 individuals for hospitalizations for mental and behavioral disorders in men and women, Finland 1976–2010.</p

Age-adjusted Proportional Hazard Ratios (HR) and their 95% Confidence Intervals for Hospitalization in Relation to the First Cohort in Seven Consecutive Cohorts, Finland, 1976–2010.

<p>Age-adjusted Proportional Hazard Ratios (HR) and their 95% Confidence Intervals for Hospitalization in Relation to the First Cohort in Seven Consecutive Cohorts, Finland, 1976–2010.</p

Supplemental Material for Distinctive role of income in the all-cause mortality among working age migrants and the settled population in Finland: A follow-up study from 2001 to 2014

<p>Supplemental material, spub-ri-2017-0136-File005 for Distinctive role of income in the all-cause mortality among working age migrants and the settled population in Finland: A follow-up study from 2001 to 2014 by Kishan Patel, Anne Kouvonen, Aki Koskinen, Lauri Kokkinen, Michael Donnelly, Dermot O’Reilly and Ari Vaananen in Scandinavian Journal of Public Health</p

Multivariable-adjusted associations of job strain with Crohn's disease or ulcerative colitis (adjusted for age, sex, socioeconomic position, smoking and BMI).

<p>Multivariable-adjusted associations of job strain with Crohn's disease or ulcerative colitis (adjusted for age, sex, socioeconomic position, smoking and BMI).</p