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Contribution of Burnout to the Association Between Job Strain and Depression: the Health 2000 Study

Kirsi Ahola, MA
Teija Honkonen, PhD, MD
Mika Kivimaki, PhD
Marianna Virtanen, PhD
Erkki Isometsa, PhD, MD
Arpo Aromaa, PhD, MD
Jouko Lonnqvist, PhD, MD

Learning Objectives

• Define job burnout as measured by the Maslach Burnout Inventory, and list its correlates in this survey of 3270 Finnish employees covering the full range of occupations.
• Outline relationships among job strain (measured by the Job Content Questionnaire), active versus passive work, job burnout, and depressive symptoms/disorders as estimated using the Beck Depression Inventory.
• Compare the strength of associations between job strain on the one hand and, on the other, depressive symptoms and depressive disorders with respect to the significance of job burnout.


Objective: The objective of this study was to investigate the contribution of burnout to the association between job strain and depression. Methods: A representative sample of 3270 Finnish employees aged 30 to 64 years responded to the Maslach Burnout Inventory–General Survey and the Beck Depression Inventory and participated in the Composite International Diagnostic Interview. Results: High strain compared with low strain was associated with 7.4 (95% confidence interval [CI]! 5.6–9.7) times higher odds of burnout, 3.8 (95% CI ! 2.8–5.1) times higher odds of depressive symptoms, and 1.7 (95% CI ! 1.1–2.6) times higher odds of depressive disorders. The risk for depressive symptoms and for depressive disorders of high strain was reduced by 69% or more after adjusting for burnout.Conclusion: Burnout is strongly related to job strain and may in part mediate the association between job strain and depression. ( J Occup Environ Med. 2006;48:1023–1030)

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