Job Strain and Major Depression

American Journal of Epidemiology 2009 169(9):1085-1091; doi:10.1093/aje/kwp037

ORIGINAL CONTRIBUTIONS

Changes in Perceived Job Strain and the Risk of Major Depression: Results From a Population-based Longitudinal Study

JianLi Wang, Norbert Schmitz, Carolyn Dewa and Stephen Stansfeld

Correspondence to Dr. JianLi Wang, Room 127, Heritage Medical Research Building, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1 (e-mail: jlwang@ucalgary.ca).

Received for publication August 14, 2008. Accepted for publication January 26, 2009.

Major depression is a prevalent mental disorder in the working population. Improving the work environment may reduce the risk of major depression. The authors examined data from the longitudinal cohort of the Canadian National Population Health Survey from 1994–1995 to 2004–2005. Survey participants were classified into 4 groups by changes in job strain status from 1994–1995 to 2000–2001 (no change in low job strain, no change in high job strain, changing from high to low job strain, and changing from low to high job strain). The incidence proportion of major depressive episodes in each of the 4 groups was 4.0%, 8.0%, 4.4%, and 6.9%, respectively. Participants who reported a change from high to low job strain had a risk of major depression similar to those exposed to persistently low job strain. Among those exposed to persistent high job strain, only participants who reported good or excellent health at baseline had a higher risk of major depression, but those who reported fair or poor health did not. Reducing job strain may have positive impacts on the risk of depression. Self-rated health is a strong predictor of depression and plays an important role in the relation between job strain and depression.

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BrooklynDodger(s) comment: Job strain is measured by instruments which everyone knows are not perfect. Nevertheless, mental illness is the leading illness cause of time off the job by active employees. High and increasing job strain contribute to a high incidence outcome. Depression can be considered a potentially fatal disease.