Psychosocial work environment and depression: epidemiologic assessment of the demand-control model.
OBJECTIVE
This study examined the relation between occupational variables and 3 forms of depression (major depressive episode, depressive syndrome, and dysphoria). It was hypothesized that individuals working in occupations with high psychologic strain (high psychologic demands and low decision authority) would have a higher prevalence of depression relative to those working in occupations with the other 3 possible conditions.


METHODS
The analysis was based on data for 905 respondents who were employed full-time in the year before the follow-up interview for the Epidemiologic Catchment Area Program in Baltimore, Md, between 1993 and 1996. Psychosocial work environment, sociodemographic variables, and psychopathology were assessed in a household interview that included the National Institute of Mental Health Diagnostic Interview Schedule. Subscales for the demand-control model for psychosocial work environment were modified slightly after factor analysis.


RESULTS
High job strain was associated with greater prevalence of all 3 forms of depression, especially major depressive episode. The results were stronger for women; for men, being unmarried was the strongest prevalence correlate.


CONCLUSIONS
Major depressive episode, depressive syndrome, and dysphoria are strongly associated with the psychosocial dimensions of the demand-control model.
Mausner-Dorsch
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Department of Health Policy and Management, Johns Hopkins University School of Public Health, Baltimore, MD 21205, USA. hmausner@jhsph.edu
Eaton
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore / Q000453:epidemiology; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology*; D003659:Decision Making, Organizational; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012931:Social Environment; D011795:Surveys and Questionnaires; D016526:Workload; D017132:Workplace / Q000458:organization & administration* / Q000523:psychology*