Job stress and work environment can contribute to depression

Job stress and a lack of social support in the workplace were associated with major episodes of depression in men, according to a study led by a University of Rochester School of Medicine and Dentistry psychologist.

In women, depression was linked to lack of decision authority on the job and low levels of social support.

The study, which utilized data from the Canadian Community Health Survey 1.2, provides a unique portrait of depression in the workplace because of the large size of the population surveyed — more than 24,000 people — and fact that it did not focus on a specific occupation.

Almost 5 percent of those surveyed — 3.4 percent of the men and 6 percent of the women — met the criteria for having a major depressive episode during a 12-month period.

The study, published in the November issue of the American Journal of Public Health, was led by Emma Robertson Blackmore, Ph.D., assistant professor in the University's Department of Psychiatry.

“Depression in the workplace is a major public health problem that requires intervention yet remains under-recognized and under-treated,” the study's authors said. “Both primary preventive approaches and high-quality treatments by primary care, occupational health and mental health professionals can be used to reduce the burden of depression in the workplace.”

Depression, which is the leading cause of disability worldwide, reduces the productivity of employees, increases the frequency of worker absences and can lead to premature early retirement.

The investigators examined the role of several factors of work stress: decision authority, skill discretion, psychological demands, social support, job security and physical exertion.

High job strain, low levels of social support in the workplace, low job security and increased psychological demands were associated with major depressive episodes among men, according to the study. Among women, lower levels of social support and lack of decision authority were associated with major depressive episodes.

“Research has consistently shown that high levels of social support from spouses, friends or family can be protective against depression,” Blackmore said. “Similarly, having good social support at work — co-workers or an understanding supervisor to talk to who can provide practical or emotional support — appears protective. In some jobs, a high level of work stress is expected, but if it is coupled with other risk factors, the risk of depression increases. In the current economic climate, workers may feel they can not simply leave a job that they are unhappy in.”

Job strain was not associated with major depressive episodes among the women in the study, as it has been in some others. The gender differences in the study could indicate that some issues are more pertinent for men than for women, the investigators said, urging more research.

The Canadian Community Health Survey 1.2 is a large epidemiological national survey. Conducted by Statistics Canada in 2002, it included individuals aged 15 to 75 years who were employed in the preceding year. The number of respondents totaled 24,324. Standardized diagnostic interviews were used to assess depression based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. A large percentage of the survey interviews were conducted in person.

The study led by Blackmore was funded in part by the Canadian Institutes of Health Research. In addition to Blackmore, the authors of the study include: Stephen A. Stansfeld, Ph.D., of the Center for Psychiatry, Barts and the London Queen Mary's School of Medicine and Dentistry, London, England; Iris Weller, Ph.D., and Brandon M. Zagorski, of the Sunnybrook Health Sciences Centre, Toronto , Ontario ; and Sarah Munce and Donna E. Stewart of the Women's Health Program, University Health Network, Toronto.