Psychosocial working conditions and depressive disorder: disentangling effects of job control from socioeconomic status using a life-course approach

Abstract

Purpose Job control, the combination of skill discretion and decision authority, is considered a central component of the psychosocial working environment. This longitudinal study examines the relation between job control and risk of incident depressive disorder using a life-course approach. Methods We analyze data from The Danish Work Life Course Cohort study, including all Danish individuals aged 15–30 who entered the Danish labor market during 1995–2009 and were free from depressive disorder at entry (955,573 individuals). We measured job control using a job exposure matrix. Depressive disorders were measured using information from nationwide registers of psychiatric in- and outpatient admissions. Using Cox regression models we estimated the prospective association between job control and risk of incident depressive disorders. Analyses accounted for a range of potential confounders prior to workforce entry including socioeconomic status in adolescence and parental psychiatric and somatic diagnoses prior to labor market entry, together with potential confounders in adulthood including income, education, and demographics. Results Lower levels of past year job control were associated with a higher risk of depressive disorder after adjustment for all covariates (HR = 1.27, 95% CI 1.16–1.38). Results stratified by gender showed associations for both men (HR = 1.38, 95% CI 1.19–1.61) and women (HR = 1.19, 95% CI 1.08–1.32). Conclusions: Our findings suggest that the level of job control at work affects the risk of clinically diagnosed depressive disorder, and that this association is not due to confounding by socioeconomic status.

How do employment conditions and psychosocial workplace exposures impact the mental health of young workers? A systematic review

“…Of the nine studies, four were related to employment conditions, capturing contract type and working hours [34][35][36][37]. The five remaining studies captured concepts relevant to psychosocial workplace exposures including workplace sexual harassment [38,39], psychosocial job quality [40], work stressors [41], and job control [42].…”

“…Of the remaining six, one was from France [34], one from Canada [35], one from Turkey [36], one from Egypt [37], one from Australia [40], and one from Denmark. [42] Three studies used a cross-sectional design [34,36,38], while the remaining six used prospective cohorts and employed a longitudinal design. [35,37,[39][40][41][42] Descriptive information related to the studies is shown in Table 1.…”

“…Seven studies were at low risk of bias due to the reported results, and two studies were at serious risk. Of the 9 studies, none were judged as being at low risk of bias, three [39,40,42] were assessed as having a moderate risk of bias, and six studies were assessed as having a serious risk of bias [34][35][36][37][38]41]. The results that follow focus only on those studies at moderate risk of bias.…”

Cohort profile: the Danish Work Life Course Cohort study (DaWCo)

“…Currently, one study based on the DaWCo population, examining the association between job control and depressive disorder has been published 26. The study found an association between job control and subsequent depressive disorder, after adjustment for possible confounding by SES, measured in a life-course perspective.…”

Work and mental health: what do we know and how can we intervene?

“…Considering the above-delineated evidence for an association between adverse working conditions and the risk of developing mental disorders (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) and the ongoing discussion about using work matched to one's "knowledge, skills and circumstances, and undertaken in a safe, healthy and supportive working environment" (13) as a therapeutic tool for individuals with prevalent mental health problems and disorders (13,(15)(16)(17), it is disconcerting that organizational-level, work environment interventions to protect or enhance workers' mental health seem either not to qualify for systematic reviews (18,20) or, if they do, show rather weak or inconsistent results (26,27).…”