title: Does job strain interact with psychosocial factors outside of the workplace in relation to the risk of major depression? The Canadian National Population Health Survey.
abstract: OBJECTIVE
  To investigate whether job strain interacts with psychosocial factors outside of the workplace in relation to the risk of major depression and to examine the roles of psychosocial factors outside of the workplace in the relationship between job strain and the risk of major depression.
  
  
  METHODS
  Data from the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were used. Major depressive episode (MDE) in the past 12 months was assessed by the Composite International Diagnostic Interview-Short Form. Participants who were working and who were between the ages of 18 and 64 years old in 2000/2001 (n = 6,008) were followed to 2006/2007. MDE that occurred from 1994/1995 to 2000/2001 were excluded from the analysis.
  
  
  RESULTS
  High job strain, negative life events, chronic stress and childhood traumatic events were associated with the increased risk of MDE. There was no evidence that job strain interacted with psychosocial factors outside of the workplace in relation to the risk of MDE. The incidence proportion in participants who reported having exposed to none of the stressors, one type of stressor, two types of stressors and three or more types of stressors was 2.6, 4.3, 6.6 and 14.2%, respectively. The odds of developing MDE in participants who were exposed to three or four types of stressors was more than four times higher than the reference group.
  
  
  CONCLUSIONS
  MDE may be facilitated by simultaneous exposure to various stressors. There is a dose-response relationship between the risk of MDE and the number of stressors.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, University of Calgary, Room 127, Heritage Medical Research Building, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada. jlwang@ucalgary.ca
authors.forename: JianLi
authors.initials: J
authors.lastname: Wang
authors.forename: Norbert
authors.initials: N
authors.lastname: Schmitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D017132:Workplace / Q000523:psychology*; D055815:Young Adult
references.citation: Psychol Med. 2003 Oct;33(7):1203-10
references.pmid: 14580075
references.citation: Psychol Med. 1997 Jan;27(1):21-33
references.pmid: 9122302
references.citation: J Epidemiol Community Health. 2010 May;64(5):447-52
references.pmid: 19679710
references.citation: JAMA. 2003 Jun 18;289(23):3135-44
references.pmid: 12813119
references.citation: Epidemiol Rev. 2008;30:118-32
references.pmid: 18587142
references.citation: Psychol Med. 2003 Oct;33(7):1177-84
references.pmid: 14580072
references.citation: Psychol Med. 1997 Jul;27(4):861-73
references.pmid: 9234464
references.citation: Health Rep. 1999 Spring;10(4):69-82(ENG); 73-89(FRE)
references.pmid: 10607414
references.citation: Soc Sci Med. 2004 Apr;58(8):1501-9
references.pmid: 14759693
references.citation: J Occup Med. 1990 Aug;32(8):722-5
references.pmid: 2401929
references.citation: Health Rep. 1998 Winter;10(3):47-62 (ENG); 49-66 (FRE)
references.pmid: 9926346
references.citation: Psychol Med. 2005 Sep;35(9):1241-52
references.pmid: 16168147
references.citation: Front Behav Neurosci. 2009 Nov 06;3:41
references.pmid: 20161813
references.citation: Occup Environ Med. 1999 May;56(5):302-7
references.pmid: 10472303
references.citation: Scand J Work Environ Health. 1998 Jun;24(3):197-205
references.pmid: 9710372
references.citation: Am J Epidemiol. 2006 May 15;163(10):877-87
references.pmid: 16571741
references.citation: J Affect Disord. 2007 Mar;98(3):189-97
references.pmid: 17182105
references.citation: J Nerv Ment Dis. 2004 Feb;192(2):160-3
references.pmid: 14770061
references.citation: Psychol Med. 2004 Nov;34(8):1475-82
references.pmid: 15724878
references.citation: Psychol Med. 2005 Mar;35(3):329-40
references.pmid: 15841869
references.citation: Soc Sci Med. 2007 Jan;64(2):401-10
references.pmid: 17055138
references.citation: Psychol Med. 2006 Oct;36(10):1341-7
references.pmid: 16740176
references.citation: Am J Public Health. 2007 Nov;97(11):2088-93
references.pmid: 17901431
references.citation: Arch Gen Psychiatry. 2003 Aug;60(8):789-96
references.pmid: 12912762
references.citation: Psychol Med. 2005 Jan;35(1):101-11
references.pmid: 15842033
references.citation: Psychol Med. 2005 Jun;35(6):865-71
references.pmid: 15997606
references.citation: JAMA. 1990 Nov 21;264(19):2524-8
references.pmid: 2146410
references.citation: Soc Psychiatry Psychiatr Epidemiol. 2009 Aug;44(8):666-74
references.pmid: 19039509
references.citation: Am J Epidemiol. 2009 May 1;169(9):1085-91
references.pmid: 19318611
references.citation: Arch Gen Psychiatry. 2005 May;62(5):529-35
references.pmid: 15867106
references.citation: Am J Ind Med. 2006 Jul;49(7):514-22
references.pmid: 16634079