Working conditions predict incidence of long-term spells of sick leave due to depression: results from the Belstress I prospective study.
BACKGROUND
During the last few years, a high incidence of sick leave due to depression has been reported, resulting in important economic and social impacts. Only a limited number of studies investigating the influence of psychosocial working conditions on sick leave have been prospective and have utilised a valid methodology, while none have studied sick leave due to depression. In this study, the impact of adverse psychosocial working conditions is analysed on the risk for long-term sick leave due to depression.


METHODS
This study resulted from the large-scale Belstress I study on the relationship between perceived job stress and health problems. Subjects were Belgian employees selected from 11 large companies (n = 9396). Using a longitudinal design, the association between the three Karasek stress dimensions (job control, psychological demand, and social support) was explored, separately and combined according to the demand-control and demand-control-support models and the incidence of long-term sick leave for depression as diagnosed by the family physician.


RESULTS
After adjusting for age, occupational categories, living situation, and baseline depression score, 'passive jobs' (OR 2.67; 95% CI 1.15 to 6.19) and 'high strain' jobs (OR 3.23; 95% CI 1.40 to 7.43) predicted sick leave due to depression at follow-up in men. Job control predicted sick leave due to depression in both men (OR 2.43; 95% CI 1.27 to 4.66) and women (OR 2.21; 95% CI 1.05 to 4.68).


CONCLUSIONS
This study provides evidence that the psychosocial working environment influences long-term sick leave due to depression. Efforts to improve skill discretion and decision authority at work could help prevent depression.
Clumeck
N
N
Department of Psychiatry, Erasmus Hospital, Université Libre de Bruxelles, Route de Lennik 808, Brussels, Belgium. nicolasclumeck@yahoo.fr
Kempenaers
C
C
Godin
I
I
Dramaix
M
M
Kornitzer
M
M
Linkowski
P
P
Kittel
F
F
D000328:Adult; D001530:Belgium / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D011569:Psychiatric Status Rating Scales; D018582:Sick Leave / Q000706:statistics & numerical data*; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D017132:Workplace / Q000523:psychology / Q000592:standards