Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study.

Abstract

Objectives-The impact of work on the risk of future psychiatric disorder has been examined in few longitudinal studies. This was examined prospectively in a large epidemiological study of civil servants. Methods-In the Whitehall II study, a longitudinal, prospective cohort study of 6895 male and 3413 female London based civil servants, work characteristics measured at baseline (phase 1: 1985-8) and first follow up (phase 2: 1989) were used to predict psychiatric disorder measured by a 30 item general health questionnaire (GHQ) at phase 2 and phase 3 follow up (phase 3: 1991-3). Work characteristics and GHQ were measured at all three phases. Results-Low social support at work and low decision authority, high job demands and eVort-reward imbalance were associated with increased risk of psychiatric disorder as assessed by the GHQ at follow up adjusting for age, employment grade, and baseline GHQ score. Conclusions-Social support and control at work protect mental health while high job demands and eVort-reward imbalance are risk factors for future psychiatric disorder. Intervention at the level of work design, organisation, and management might have positive eVects on mental health in working populations. (Occup Environ Med 1999;56:302-307)

Mortality and immortality: The Nobel Prize as an experiment into the effect of status upon longevity

“…It is argued that lower levels of SES raise levels of psychological stress, and that this happens primarily through the association of low SES with low levels of job control (Marmot et al, 1991) and low levels of fall-back social support (Putnam, 2000;Marmot et al, 1991). Empirically, lack of control in the workplace is associated with stress and depressive symptoms (Steptoe et al, 2003a;Stansfeld et al, 1999;Karasek and Theorell, 1990), while the degree to which an individual has social support is believed to determine the degree to which they can buffer job strain (Falk et al, 1992;Johnson and Hall, 1988). Wilkinson (2000) proposes that perceived low social standing is linked with feelings of shame, humiliation, disrespect, and social anxiety.…”

Retirement as a Relief? The Role of Physical Job Demands and Psychological Job Stress for Effects of Retirement on Self-Rated Health

“…Thus, continuous high job stress can cause a person to remain feeling tense, unable to sleep or concentrate. Stress at work then spills over into other domains of life, causing lower levels of life satisfaction (Hayes and Weathington, 2007), more depressive symptoms (Paterniti et al, 2002), and even psychiatric disorders (Stansfeld et al, 1999). See Nieuwenhuijsen et al (2010) for a systematic review of how job stress causes psychological health deprivation.…”

Common Mental Disorders in the Workforce: Recent Findings from Descriptive and Social Epidemiology

“…Effort includes responsibility, workload, and time pressures, whereas reward includes money, esteem, and career opportunities (such as promotion and job security). We located one relevant longitudinal study meeting our inclusion criteria (43). A perceived effort-reward imbalance increased psychiatric risk in the civil service cohort, especially among men, where the risk was more than doubled.…”

“…High social support (social integration, low isolation) may buffer this effect. In a general population panel study (42) and 3 workplace cohort studies (43)(44)(45) involving a total of more than 30 000 participants, jobs with low autonomy (skill discretion) and those with high demands increased the psychiatric risk by 24% to 63%. Two of these studies used middle-aged respondents from specific industries (the civil service and the gas and electricity sector) (43,44).…”

“…Depression symptoms related to concentration and tiredness or sleep were each associated with impaired functioning in mental-interpersonal skills, time demands, and output. Table 4 presents longitudinal studies that examined the association of selected indicators of nature of work with a standardized mental health outcome measure (23,(40)(41)(42)(43)(44)(45). Underemployment was defined as involuntary part-time work or working for a wage at or below the poverty level (40,41).…”