Sunday, July 26, 2009

Work Stress Can Make You Crazy

BrooklynDodger(s) comment: The literature may be too big or too small. Over 1000 studies were boiled down to 14. Then, the authors seem to conclude that the 14 were not enough to draw a strong conclusion.

Epidemiologic Reviews 2008 30(1):118-132; doi:10.1093/epirev/mxn004

The Relation between Work-related Psychosocial Factors and the Development of Depression
Bo Netterstrøm1, Nicole Conrad1, Per Bech2, Per Fink3, Ole Olsen4, Reiner Rugulies4 and Stephen Stansfeld5

1 Clinic of Occupational Medicine, Hillerød Hospital, Hillerød, Denmark
2 Psychiatric Research Unit, Hillerød Hospital, Hillerød, Denmark
3 Research Clinic for Functional Disorders, Aarhus University Hospital, Aarhus, Denmark
4 National Research Centre for the Working Environment, Copenhagen, Denmark
5 Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary's School of Medicine and Dentistry, London, United Kingdom

Correspondence to Dr. Bo Netterstrøm, Clinic of Occupational Medicine, Hillerød Hospital, Helsevej 2, DK 3400 Hillerød, Denmark (e-mail:

accepted for publication April 21, 2008.

This review is based on a literature search made in January 2007 on request by the Danish National Board of Industrial Injuries. The search in PubMed, EMBASE, and PsycINFO resulted in more than 1,000 publications. This was reduced to 14 after the titles, abstracts, and papers were evaluated by using the following criteria: 1) a longitudinal study, 2) exposure to work-related psychosocial factors, 3) the outcome a measure of depression, 4) relevant statistical estimates, and 5) nonduplicated publication. Of the 14 studies, seven used standardized diagnostic instruments as measures of depression, whereas the other seven studies used self-administered questionnaires. The authors found moderate evidence for a relation between the psychological demands of the job and the development of depression, with relative risks of approximately 2.0. However, indication of publication bias weakens the evidence. Social support at work was associated with a decrease in risk for future depression, as all four studies dealing with this exposure showed associations with relative risks of about 0.6. Even if this literature study has identified work-related psychosocial factors that in high-quality epidemiologic studies predict depression, studies are still needed that assess in more detail the duration and intensity of exposure necessary for developing depression.

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