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Repeated Job Strain and the Risk of Depression: Longitudinal Analyses From the Whitehall II Study

A new article has been published by the APHA on the powerful impact of job strain on mental health outcomes such as depression (see Abstract below).
Stephen A. Stansfeld, PhD, Martin J. Shipley, MSc, Jenny Head, MSc, and Rebecca Fuhrer, PhD

Stephen A. Stansfeld is with the Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, UK. Martin J. Shipley and Jenny Head are with the Department of Epidemiology and Public Health, University College London Medical School, London. Rebecca Fuhrer is with the Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.
S. A. Stansfeld conceptualized and designed the study, interpreted the data, and wrote the first draft of the article. M. J. Shipley carried out the analyses and contributed to their interpretation. Jenny Head contributed to the analyses and to their interpretation. Rebecca Fuhrer codesigned the study and contributed to the analyses and the interpretation of the data. All authors contributed to writing the article.


Objectives. We addressed whether repeated job strain and low work social support increase the risk of major depressive disorder (MDD).
Methods. We used work characteristics from Karasek’s Job Strain model, measured on 3 occasions over 10 years in a cohort of 7732 British civil servants, to predict subsequent onset of MDD with the Composite International Diagnostic Interview.
Results. Repeated job strain was associated with increased risk of MDD (odds ratio [OR] = 2.19; 95% confidence interval [CI] = 1.48, 3.26; high job strain on 2 of 3 occasions vs none) in a fully adjusted model. Repeated low work social support was associated with MDD (OR = 1.61; 95% CI = 1.10, 2.37; low work social support on 2 of 3 occasions vs none). Repeated job strain remained associated with MDD after adjustment for earlier psychological distress.
Conclusions. Demonstration of an increased association for repeated job strain adds to the evidence that job strain is a risk factor for depression. Recognition and alleviation of job strain through work reorganization and staff training could reduce depression in employees.


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