Objectives:The association between depressive symptoms and psycho-organisational work environment has been established in the literature. Some studies have evaluated depressive symptoms in healthcare workers, but little research has been carried out among nurse managers. The aim of the study is to evaluate the depressive symptoms prevalence among nurse managers' population and work environment factors. Material and Methods: A descriptive correlational research design was used. Data were collected from 296 nurse managers in five hospitals in the eastern area of France between 2007 and 2008. Health outcomes were evaluated by measuring depressive symptoms (CES-D scale), the exposure data by assessing psycho-organisational work environment with effort-reward imbalance-model of Siegrist. Multiple logistic regressions were used to describe the strength of the association between depressive symptoms and effort-reward imbalance adjusted for personal and occupational chara cteristics of the nurse managers. Results: Among the nurse managers, a third had depressive symptoms, and 18% presented an effort-reward imbalance (ratio: ≥ 1). A significant association was found between depressive symptoms and effort-reward imbalance (OR = 10.81, 95% CI: 5.1-23, p < 10 -3 ), and with esteem as a reward (OR = 3.21, 95% CI: 1.6-6.3, p < 10 -2 ). Conclusion: In view of the hierarchical situation of nurse managers and their primary roles in hospitals, it is necessary to take prevention measures to improve their work environment and health. nurse managers and showed that personal (lack of coreself evaluation) and situational (effort-reward imbalance ratio) factors were significant predictors of the score of burnout [30]. In France, only 2 studies about the health of nurse managers were published. Fanello et al. [31] analysed the mental health of 97 nurse managers using the standardised mental health questionnaire -GHQ-12 for health -questions to define their social and occupational characteristics and workplace experience. They demonstrated that 1/3 of participants were considered to be in psychological distress, that the lack of reward was associated with psychological distress of nurse managers. The second study was the European Press Next study carried out in France among a population of health care workers including nurse managers [32]. A total of 28% of nurse managers reported suffering from mental diseases. Associations between the organisational work environment, stress and depressive symptoms have been established in the literature in the general population [33][34][35]. To describe the psycho-organisational work environment, different scales were established and validated. The 2 models from Karasek [36,37] and Siegrist [38,39] were translated into French, and their psychometric properties were studied in the French population [40][41][42][43][44]. Several studies showed links between the effort-reward imbalance and depressive symptoms or self-health assessments. The risk of depression ranged from 1.5 to 4.6 with the effo...