Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

Abstract

Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. MethodsWe searched PubMed and Embase for published prospective cohort studies and included available cohorts with unpublished individual-participant data. We used a random-effects meta-analysis to calculate summary estimates across studies.Results We identified ten published cohort studies and included unpublished individual-participant data from 18 studies. In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2 =45.1%, P=0.004). A strong association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association in Europe (1.11, 95% CI 1.00-1.22), and no association in North America (0.97, 95% CI 0.70-1.34) or Australia (0.95,. Differences by other characteristics were small. ConclusionsThis observational evidence suggests a moderate association between long working hours and onset of depressive symptoms in Asia and a small association in Europe.Key terms depression; mental health; overtime; psychological distress; working life; working time. Long working hours and depressive symptomsDepression is a leading cause of years lived with disability, contributing to a significant proportion of disease burden worldwide (1). Given that the burden of mental disorders peaks at working age (1), workingage populatio ns are an important target for prevention. There is growing evidence to suggest a link between work characteristics and the onset of depression, with perceived psychosocial work stress being the most often investigated work exposure (2-7).Recently, studies have also focused on long working hours as a potential risk factor for mental disorders (8). However, although several reviews of this field exist (5, 9-24), the few systematic quantifications of the evidence have been based on published cross-sectional (18,19,25) or published longitudinal studies (26). Given the potential publication bias in studies based on published data (27), an individual-participant metaanalysis of unpublished data would provide important complementary evidence to evaluate the effect of long working hours on mental health. Furthermore, long working hours are more common in Asia and North America than in Europe and the risk of mental health problems is higher among women and individuals with low socioeconomic position than men and those with high socioeconomic status. As determinants and mechanisms that harm and protect mental health may also vary by regio...

Auswirkungen verkürzter Ruhezeiten auf Gesundheit und Work-Life-Balance bei Vollzeitbeschäftigten: Ergebnisse der BAuA-Arbeitszeitbefragung 2017

“…B. Virtanen et al 2018). Auch bezüglich des Einflusses langer Arbeitszeiten auf das Privatleben liegt bereits eine Vielzahl an Erkenntnissen vor.…”

Does paid vacation leave protect against depression among working Americans? A national longitudinal fixed effects analysis

“…Notably, there was heterogeneity in the findings by geographic region, with an association between long working hours and depressive symptoms in Asian countries, a weaker association in Europe, and no association in North America based on three unpublished studies. However, heterogeneity was observed in the studies from North America, which might have masked significant findings (41).…”

“…Long working hours have been prospectively linked to a higher risk of depressive symptoms (RR 1.66, 95% CI 1.06-2.61) among employees working >55 hours/week compared with employees working 35-40 hours/week) (39), and an increased odds of MDD (OR 2.43, 95% CI 1.11-5.30, for those working ≥11 hours/day compared to employees working 7-8 hours/day) (40). A recent systematic review and meta-analysis of the prospective relation between long working hours (generally defined as ≥55 hours per week) and the onset of depressive symptoms based on ten cohort studies estimated an overall positive association (RR 1.14, 95% CI 1.03-1.25) (41). Notably, there was heterogeneity in the findings by geographic region, with an association between long working hours and depressive symptoms in Asian countries, a weaker association in Europe, and no association in North America based on three unpublished studies.…”

Adverse Psychosocial Work Environments and Depression–A Narrative Review of Selected Theoretical Models

“…First, rather than following proposed recommendations for metasynthesis data integration (30,53), the report is restricted to a narrative presentation of its main messages. Second, we focused our review on three theoretical models, thus neglecting additional concepts of a health-adverse psychosocial work environment (e.g., "demand-resources" (54) or single psychosocial workrelated factors (e.g., workplace bullying, 26), long working hours (55). The main reason for this selection was the availability of a cumulative body of empirical findings that reflects a significant interest of the research community in these theoretical approaches.…”