Effort-reward imbalance at work and risk of depressive disorders. A systematic review and meta-analysis of prospective cohort studies by Rugulies R, Aust B, Madsen IEH Effort-reward imbalance at work predicted a 1.5-fold increased risk of depressive disorders in this systematic review and meta-analysis of eight prospective cohort studies from Europe, Canada and the USA. This study provides the hitherto strongest evidence for a possible role of effort-reward imbalance in the etiology of depressive disorders. Review Scand J Work Environ Health. 2017;43(4):294-306. doi:10.5271/sjweh.3632 Effort-reward imbalance at work and risk of depressive disorders. A systematic review and meta-analysis of prospective cohort studies Objective The aim of this review was to determine whether employees exposed to effort-reward imbalance (ERI) at work have a higher risk of depressive disorders than non-exposed employees. AffiliationMethods We conducted a systematic review and meta-analysis of published prospective cohort studies examining the association of ERI at baseline with onset of depressive disorders at follow-up. The work was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and a detailed study protocol was registered before literature search commenced (Registration number: CRD42016047581). We obtained a summary estimate for the association of ERI with risk of depressive disorders by pooling the study-specific estimates in a meta-analysis. We further conducted pre-defined sensitivity analyses.Results We identified eight eligible cohort studies, encompassing 84 963 employees and 2897 (3.4%) new cases of depressive disorders. Seven of the eight studies suggested an increased risk of depressive disorders among employees exposed to ERI. The pooled random-effects estimate was 1.49 [95% confidence interval (95% CI) 1.23-1.80, P<0.001], indicating that ERI predicts risk of depressive disorders. The estimate was robust in sensitivity analyses stratified by study quality, type of ERI ascertainment and type depressive disorder ascertainment, respectively. Conclusions Employees exposed to ERI were at increased risk of depressive disorder. Future studies on ERI and depressive disorders should examine if this association is stronger or weaker when ERI is measured repeatedly during follow-up and with other methods than self-report or when depressive disorders are ascertained with clinical diagnostic interviews.

The authors analyzed the impact of psychosocial work characteristics on the incidence of severe depressive symptoms among 4,133 (49% women) employees from a representative sample of the Danish workforce between 1995 and 2000. Psychosocial work characteristics at baseline included quantitative demands, influence at work, possibilities for development, social support from supervisors and coworkers, and job insecurity. Severe depressive symptoms were measured with the five-item Mental Health Inventory of the 36-item Short-Form Health Survey, with a cutoff point of 52. Women with low influence at work (relative risk (RR) = 2.17, 95% confidence interval (CI): 1.23, 3.82) and low supervisor support (RR = 2.03, 95% CI: 1.20, 3.43) were at increased risk for severe depressive symptoms after exclusion of cases at baseline and adjustment for sociodemographic factors, baseline depression score, and health behaviors. Further adjustments for socioeconomic position did not change the result substantially. Additional analyses showed that a one-standard deviation increase on the influence scale resulted in a 27% decreased risk of severe depressive symptoms. Among men, job insecurity predicted severe depressive symptoms (RR = 2.04, 95% CI: 1.02, 4.07). The findings indicate that the work environment influences the risk of developing severe depressive symptoms and that different factors play a role for men and women.

Health circles, the central element of a comprehensive health promotion approach that has been developed in Germany in recent years, emphasize organizational and psychosocial factors while actively involving employees in the process. Through an extensive review the authors identified 11 studies, presenting the results of 81 health circles. The scientific quality of the data is limited: only 3 studies used (nonrandomized) control groups, whereas the remaining studies are based on retrospective before-and-after comparison. Nonetheless, the available data suggest that health circles are an effective tool for the improvement of physical and psychosocial working conditions and have a favorable effect on workers' health, well-being, and sickness absence. More rigorous studies are needed to confirm these results.

Without the insights gained from process data the negative effects of this intervention could not be understood. Sometimes--as it seems happened in this study--more harm can be done by disappointing expectations than by not conducting an intervention.

Aims: To analyse the predictive validity of 18 psychosocial work environment scales from the Copenhagen Psychosocial Questionnaire version II (COPSOQ II) with regard to risk of sickness absence. Methods: The study population consisted of 3188 wage earners (52% women) from a representative sample of Danish residents. Participants received the long version of the COPSOQ II in autumn and winter [2004][2005], including 18 psychosocial work environment scales from the domains ''Demands at work'', ''Work organization and job contents'', and ''Interpersonal relations and leadership''. The study endpoint was register-based sickness absence of 3 weeks or more in the 1-year period following completion of the COPSOQ II. Associations between COPSOQ scales at baseline and sickness absence at follow-up were analysed with Cox proportional hazards models, adjusted for age, gender, prevalence of a health problem at baseline, and occupational grade. Results: Sickness absence during follow-up was predicted by a one standard deviation increase on the scales of cognitive demands (hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.00-1.37), emotional demands (HR 1.28, 95% CI 1.10-1.50), and role conflicts (HR 1.32, 95% CI 1.15-1.52). After applying adjustment for multiple testing, the effect of emotional demands and of role conflict remained statistically significant, but not the effect of cognitive demands. Conclusions: Selected psychosocial work environment factors from the COPSOQ predict register-based sickness absence in the Danish workforce.

The research aim was to select, compare, and analyze interventions and preventive actions from international bus companies to decrease bus drivers' occupational stress and sickness absenteeism. Through networking, international surveys, and literature study, 13 "natural experiments" were identified with an acceptable research design rating. Interventions were both work and person directed. Principles of worker participation were often followed. The variety in intervention programs, outcome measures, case evaluations, and methodological flaws makes it difficult to present a general picture of program effectiveness. However, analyses on more objective and more subjective outcomes do point at positive effects. This study suggests that stress prevention that combines adequate interventions and proper implementation may be beneficial to both the employee and the company.

Job insecurity is a predictor for a decline in health in employed women in Denmark. Among men, a suggestive effect of job insecurity was found in employees aged 50 years or younger with poor labour market chances.

The following articles refer to this text: 2012;38(3):187-290; 2016;42(1):1-98