Work and mental health.
BACKGROUND
Studies investigating the psychological correlates of types of occupation have focused on such disorders as stress, depression, suicide and substance abuse. There have also been some models proposed to allow understanding of factors common to different types of occupations. We sought to provide an overview of research related to work and mental health and consider future research directions.


METHODS
A literature search was conducted using the Medline, PsycInfo, Embase and PubMed databases. The key words "occupation" or "work" were searched in combination with the key words "mental health", "risk factors", "disorders", "depression", "suicide", "trauma", "stress" or "substance use".


RESULTS
Studies of "stress" tend to be more applicable to specific workplace issues. While some of the studies relating to onset of depression, suicide, substance abuse and trauma pertain to specific occupational issues and results are often not generalizable, they have progressed our understanding of risk factors to those disorders. There are workplace factors involving exposure to danger and crisis that lead to posttraumatic stress disorder (PTSD), substance abuse (including stimulants) and depersonalization. Workplace risk factors for depression involve situations promoting lack of autonomy, and involving "caring" for others as part of the work role, particularly where there is dependence on others for their livelihood. Risk factors for alcohol abuse include workplaces with access to alcohol and where use of alcohol is sanctioned. There appears to be a bi-directional relationship between personality and work, so that people are drawn to particular occupations, but the occupations then have an effect on them. An interactional model is proposed to consider this.


CONCLUSIONS
The research questions pertaining to mental health are varied and will determine what mental health issues are of interest and the models of work applicable. There need to be more longitudinal studies and consideration of factors which the worker brings to the workplace (psychosocial issues, personality traits), as well as interpersonal issues and consideration of systemic, organizational, political and economic factors, including leadership styles.
Wilhelm
Kay
K
School of Psychiatry and Black Dog Institute, University of New South Wales, Randwick, Sydney, NSW, Australia. kwilhelm@stvincents.com.au
Kovess
Vivianne
V
Rios-Seidel
Carmen
C
Finch
Adam
A
D000437:Alcoholism / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires