title: Psychosocial work environment and hospital admissions due to mental disorders: a 15-year prospective study of industrial employees.
abstract: BACKGROUND
  Low levels of job control and social support may increase the risk of mental disorders, particularly depression, but the evidence is mostly based on self-reports. We examined whether components of job control and work-related social support predict medically-certified mental disorders.
  
  
  METHODS
  13868 forest company employees with no previous hospital admissions for mental disorders responded to questionnaires on decision authority, skill discretion, co-worker and supervisor support. They were followed-up for hospital admissions due to mental disorders (ICD-9 codes 290 to 319), using national hospital discharge records (577 hospitalized, mean follow-up 15.1 years).
  
  
  RESULTS
  In analyses adjusted for confounders, high skill discretion was associated with a reduced risk of hospital admission for mental disorders (HR 0.74, 95% CI 0.58-0.95). High decision authority was associated with an elevated risk (HR 1.48, 95% CI 1.17-1.87). Diagnosis-specific analyses showed high skill discretion to associate with a reduced risk of both depressive and non-depressive non-alcohol-related mental disorders. High decision authority was a risk factor for alcohol-related and depressive disorders. Good co-worker support was associated with a reduced risk of non-depressive non-alcohol-related mental disorders. Supervisor support was not associated with any mental disorders.
  
  
  CONCLUSIONS
  We used a single time point estimate in an industrial sample comprising largely of men.
  
  
  CONCLUSIONS
  Contrary to previous research on job control, high decision authority increased the risk of depressive and alcohol-related disorders, which suggest a need to reconsider the strategies for prevention and clinical practise in regard to psychosocial work environment and mental health.
authors.affiliation: Finnish Institute of Occupational Health, Work Organizations, Helsinki, Finland. matti.joensuu@ttl.fi
authors.forename: Matti
authors.initials: M
authors.lastname: Joensuu
authors.forename: Ari
authors.initials: A
authors.lastname: Väänänen
authors.forename: Aki
authors.initials: A
authors.lastname: Koskinen
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D003657:Decision Making; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005387:Finland; D016468:Forestry; D006608:Hierarchy, Social; D006801:Humans; D007221:Industry; D007389:Internal-External Control; D007588:Job Satisfaction; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D012931:Social Environment; D012944:Social Support; D055815:Young Adult