Working hours and the onset of depressive disorder: a systematic review and meta-analysis

Watanabe, Kazuhiro; Imamura, Kotaro; Kawakami, Norito

doi:10.1136/oemed-2016-103845

Cited by 47 publications

(60 citation statements)

References 31 publications

(42 reference statements)

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“…Of these, six studies met the inclusion criteria and a further four were identified from referred publication searches, hand search, and from the reference lists of published reviews. We excluded metaanalyses (but extracted relevant studies from those) (18,19,25,26), reviews (5, 8-17, 21, 23), and books (20,22,24). We also excluded studies with overlapping data with selected studies (33)(34)(35)(36)(37)(38)(39)(40), those without adjustment for baseline mental health (41)(42)(43), and those prospective studies in which exposure and outcome were temporally overlapping (44,45).…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…They reported a weak linear correlation between hours worked and "mental strain", which is consistent with our findings. A more recent meta-analysis identified seven published prospective studies and a summary estimate which indicated an increased (RR=1.08) but statistically nonsignificant risk of clinical depressive disorder associated with long working hours (26). However, all previous meta-analyses were exclusively based on published data and their ability to examine subgroup differences was limited.…”

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

“…However, although several reviews of this field exist (5,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24), the few systematic quantifications of the evidence have been based on published cross-sectional (18,19,25) or published longitudinal studies (26). Given the potential publication bias in studies based on published data (27), an individual-participant metaanalysis of unpublished data would provide important complementary evidence to evaluate the effect of long working hours on mental health.…”

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Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

Virtanen¹,

Jokela²,

Madsen³

et al. 2018

Scand J Work Environ Health

145

111

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Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. MethodsWe searched PubMed and Embase for published prospective cohort studies and included available cohorts with unpublished individual-participant data. We used a random-effects meta-analysis to calculate summary estimates across studies.Results We identified ten published cohort studies and included unpublished individual-participant data from 18 studies. In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2 =45.1%, P=0.004). A strong association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association in Europe (1.11, 95% CI 1.00-1.22), and no association in North America (0.97, 95% CI 0.70-1.34) or Australia (0.95,. Differences by other characteristics were small. ConclusionsThis observational evidence suggests a moderate association between long working hours and onset of depressive symptoms in Asia and a small association in Europe.Key terms depression; mental health; overtime; psychological distress; working life; working time. Long working hours and depressive symptomsDepression is a leading cause of years lived with disability, contributing to a significant proportion of disease burden worldwide (1). Given that the burden of mental disorders peaks at working age (1), workingage populatio ns are an important target for prevention. There is growing evidence to suggest a link between work characteristics and the onset of depression, with perceived psychosocial work stress being the most often investigated work exposure (2-7).Recently, studies have also focused on long working hours as a potential risk factor for mental disorders (8). However, although several reviews of this field exist (5, 9-24), the few systematic quantifications of the evidence have been based on published cross-sectional (18,19,25) or published longitudinal studies (26). Given the potential publication bias in studies based on published data (27), an individual-participant metaanalysis of unpublished data would provide important complementary evidence to evaluate the effect of long working hours on mental health. Furthermore, long working hours are more common in Asia and North America than in Europe and the risk of mental health problems is higher among women and individuals with low socioeconomic position than men and those with high socioeconomic status. As determinants and mechanisms that harm and protect mental health may also vary by regio...

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Section: Literature Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

Virtanen¹,

Jokela²,

Madsen³

et al. 2018

Scand J Work Environ Health

145

111

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“…If the included studies report ORs, RRs or HRs, we will calculate log-transformed ORs, RRs or HRs and determine SEs based on 95% CIs. These parameters will be used in the meta-analysis and for examining publication bias by means of a funnel plot and Egger’s test with statistical software, R V.3.4.1 38 39. We will employ a random-effects model40 to summarise the results using R V.3.4.1 with the ‘meta’ and ‘metafor’ packages 41…”

Section: Methods and Analysismentioning

confidence: 99%

Psychosocial factors at work and inflammatory markers: protocol for a systematic review and meta-analysis

et al. 2018

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IntroductionChronic inflammation may be a mediator for the development of cardiovascular disease (CVD), metabolic diseases and psychotic and neurodegenerative disorders. Meta-analytic associations between work-related psychosocial factors and inflammatory markers have shown that work-related psychosocial factors could affect the flexibility and balance of the immune system. However, few systematic reviews or meta-analyses have investigated the association between work-related psychosocial factors and inflammatory markers. Based on prospective studies, the present investigation will conduct a comprehensive systematic review and meta-analysis of the association between work-related psychosocial factors and inflammatory markers.Methods and analysisThe systematic review and meta-analysis will include published studies identified from electronic databases (PubMed, EMBASE, PsycINFO, PsycARTICLES, Web of Science and Japan Medical Abstracts Society) according to recommendations of the Meta-analysis of Observational Studies in Epidemiology guideline. Inclusion criteria are studies that: examined associations between work-related psychosocial factors and increased inflammatory markers; used longitudinal or prospective cohort designs; were conducted among workers; provided sufficient data for calculating ORs or relative risk with 95% CIs; were published as original articles in English or Japanese; and were published up to the end of 2017. Study selection, data extraction, quality assessment and statistical syntheses will be conducted by 14 investigators. Any inconsistencies or disagreements will be resolved through discussion. The quality of studies will be evaluated using the Risk of Bias Assessment Tool for Non-randomized Studies.Ethics and disseminationThe investigation study will be based on published studies, so ethics approval is not required. The results of this study will be submitted for publication in a scientific peer-reviewed journal. The findings may be useful for assessing risk factors for increased inflammatory markers in the workplace and determining future approaches for preventing CVD, metabolic diseases and psychotic and neurodegenerative disorders.PROSPERO registration numberCRD42018081553.

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Sociomedical problems of overwork‐related deaths and disorders in Japan

Takahashi

2019

Journal of Occupational Health

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Objectives Cerebrovascular and cardiovascular diseases (CCVDs) and mental disorders, including suicide, are prevalent among overworked individuals in Japan. The 2014 legislation regarding the prevention of overwork‐related deaths and disorders has accelerated the research in this field and ultimately the implementation of preventive actions. Methods To understand the current problematic situations, the Research Center for Overwork‐Related Disorders of the National Institute of Occupational Safety and Health, Japan, conducted analyses of compensated claims for overwork‐related CCVDs and mental disorders that were recognized from January 2010 to March 2015. Results The majority of CCVD cases were the men in their 50s. Transport and postal activities was the highest risk industry. Cerebrovascular cases were higher than cardiovascular ones. Long working hours was the principal factor for CCVDs. The mental disorder cases comprised approximately 70% men and affected younger age groups (peak in the third decade) with various industries at risk. In men, there was an almost equal number of F3 (Mood [affective] disorders) and F4 (Neurotic, stress‐related, and somatoform disorders) diagnoses according to the 10th revision of the International Classification of Diseases and Related Health Problems. A larger number of women were diagnosed to have F4. The mental disorder cases were associated not only with long working hours, but also with injuries and disasters as well as interpersonal conflict at work. Conclusions Multiple, simultaneous actions need to be made by employees, employers, researchers, and the authorities to achieve the goal of reducing the number of workers suffering from the overwork‐related CCVDs and mental disorders.

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Working hours and the onset of depressive disorder: a systematic review and meta-analysis

Abstract: Prospero CRD42015020003; Results.

Cited by 47 publications

References 31 publications

Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

Psychosocial factors at work and inflammatory markers: protocol for a systematic review and meta-analysis

Sociomedical problems of overwork‐related deaths and disorders in Japan

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