Job strain, burnout, and depressive symptoms: a prospective study among dentists.
BACKGROUND
Burnout has been presented as an antecedent of depression, but longitudinal data are lacking. We investigated whether burnout mediates the association between job strain and depressive symptoms.


METHODS
Two surveys were conducted. In 2003, 71% of Finnish dentists were reached, and the response rate of the 3-year follow-up was 84% (n=2555). Burnout was measured with the Maslach Burnout Inventory and depressive symptoms with the Beck Depression Inventory. The sequences 'job strain-burnout-depressive symptoms' and 'job strain-depressive symptoms-burnout' were investigated with logistic regression analyses.


RESULTS
Of the burnout sufferers without depressive symptoms at baseline, 23% reported depressive symptoms at follow-up. The adjusted odds ratio of burnout for depressive symptoms was 2.6 (95% CI 2.0-3.5). The effect of job strain on depressive symptoms had an OR of 3.4 (95% CI 2.0-5.7), but it disappeared when adjusted for burnout. Of those who had depressive symptoms without burnout at baseline, 63% had burnout at follow-up. The adjusted odds ratio of depressive symptoms for burnout was 2.2 (95% CI 1.4-3.4). The effect of job strain on burnout had an OR of 27.9 (95% CI 6.5-120.2) for the men and 4.9 (95% CI 2.5-9.6) for the women. These effects remained significant after adjustment for depressive symptoms.


CONCLUSIONS
The study was conducted among one occupational group.


CONCLUSIONS
There is a reciprocal relationship between burnout and depressive symptoms. Job strain predisposes to depression through burnout. In comparison, job strain predisposes to burnout directly and via depression.
Ahola
Kirsi
K
Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland. kirsi.ahola@ttl.fi
Hakanen
Jari
J
D000328:Adult; D000368:Aged; D002055:Burnout, Professional; D003815:Dentists / Q000706:statistics & numerical data*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D011584:Psychology; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D017132:Workplace / Q000523:psychology*