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Job strain as a risk factor for clinical depression: Systematic review and meta-analysis with additional individual participant data
National Research Centre for the Working Environment, Denmark.
Finnish Institute of Occupational Health, Helsinki, Finland.
Stress Research Institute, Stockholm University, Stockholm.
University College London, London, United Kingdom.
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2017 (Engelska)Ingår i: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 47, nr 8, s. 1342-1356Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression. Method We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol. Results We included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47-2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04-1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94-1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81-1.32). Conclusions Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.

Ort, förlag, år, upplaga, sidor
2017. Vol. 47, nr 8, s. 1342-1356
Nyckelord [en]
Observational studies, occupational health, work stress
Nationell ämneskategori
Hälsovetenskaper
Identifikatorer
URN: urn:nbn:se:miun:diva-31133DOI: 10.1017/S003329171600355XISI: 000401293800002PubMedID: 28122650Scopus ID: 2-s2.0-85010872142OAI: oai:DiVA.org:miun-31133DiVA, id: diva2:1119213
Tillgänglig från: 2017-07-03 Skapad: 2017-07-03 Senast uppdaterad: 2017-11-29Bibliografiskt granskad

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