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published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individuallevel data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) consortium.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 From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression.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risk of clinical depression in both published (Relative Risk [RR]= 1.77, 95% confidence interval [CI] 1.47-2.13) and unpublished datasets (RR=1.27, 95% CI 1.04-1.55).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

Teucrium viscidum Blume var. miquelianum Hara

原著和名: ツルニガクサ科名: シソ科 = Labiatae採集地: 千葉県 四街道市 栗山 (下総 四街道市 栗山)採集日: 1987/7/29採集者: 萩庭丈壽整理番号: JH031831国立科学博物館整理番号: TNS-VS-98183

Results (odds ratios and 95% CI) from logistic regression analyses on the association between self-reported (SR) and clinically validated (CV) psychotic experiences and three-year incidence of arrest in a general population sample and two subsamples.

<p>Results (odds ratios and 95% CI) from logistic regression analyses on the association between self-reported (SR) and clinically validated (CV) psychotic experiences and three-year incidence of arrest in a general population sample and two subsamples.</p

Baseline characteristics.

<p>Baseline characteristics.</p

Measures.

<p>Measures.</p

Sociodemographic characteristics of subjects with and without MUS and explained physical symptoms (N = 6,506), in unweighted numbers and weighted column percentages.

<p>NONE: No explained physical symptoms, no MUS</p><p>PHYonly: explained physical symptoms, no MUS</p><p>MUSonly: MUS, no explained physical symptoms</p><p>MUS+PHY: both MUS and explained physical symptoms</p><p>Sociodemographic characteristics of subjects with and without MUS and explained physical symptoms (N = 6,506), in unweighted numbers and weighted column percentages.</p

3-year incidence of (comorbid) common mental disorders.

<p>The analyses were adjusted for sex, age, partner status, employment situation and level of education.</p><p>NONE: No explained physical symptoms, no MUS</p><p>PHYonly: explained physical symptoms, no MUS</p><p>MUSonly: MUS, no explained physical symptoms</p><p>MUS+PHY: both MUS and explained physical symptoms</p><p>Percentages: weighted data</p><p>OR: odds ratio</p><p>95% CI: 95% confidence interval</p><p>The number at risk varies per category, because only first incidence cases were used.</p><p>* When PHYonly, MUSonly and MUS+PHY were respectively used as the reference group, the only significant difference was found between PHYonly and MUS+PHY for any incident mood disorder.</p><p>3-year incidence of (comorbid) common mental disorders.</p

12-month prevalence of (comorbid) common mental disorders (n = 6,506).

<p>The analyses were adjusted for sex, age, partner status, employment situation and level of education.</p><p>NONE: No explained physical symptoms, no MUS</p><p>PHYonly: explained physical symptoms, no MUS</p><p>MUSonly: MUS, no explained physical symptoms</p><p>MUS+PHY: both MUS and explained physical symptoms</p><p>Percentages: weighted data</p><p>OR: odds ratio</p><p>95% CI: 95% confidence interval</p><p>* When PHYonly, MUSonly and MUS+PHY were respectively used as the reference group, the only significant difference was found between PHYonly and MUS+PHY for any substance use disorder.</p><p>12-month prevalence of (comorbid) common mental disorders (n = 6,506).</p