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BackgroundAdverse 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.MethodWe 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published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium.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.ResultsWe 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 From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression.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risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47–2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04–1.55).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).ConclusionsJob strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.

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Objective To determine the association between self reported job insecurity and incident coronary heart disease.Design A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review.

SummaryThis study tested three contrasting theories about the sequential process of the three dimensions of burnout (i.e., exhaustion, cynicism and professional efficacy) as measured by the Maslach Burnout Inventory-General Survey (MBI-GS). The causal order of the burnout components was investigated by including job stressors as antecedents of burnout in structural equation models (LISREL). The predictive effect of exhaustion on burnout dimensions eight years later was also investigated. The longitudinal models were then tested in two occupational subgroups. The participants were 713 Finnish employees (415 white-collar and 298 blue-collar workers) from an international industry enterprise. The best fitting model of the associations between the three burnout dimensions was obtained by a path model where exhaustion predicted cynicism, and cynicism in turn predicted lack of professional efficacy. The symptoms of exhaustion were persistent over time. There were no differences between the two occupational groups in the process of burnout. Also the work-related antecedents of burnout ( job stressors) were very similar in both groups.