title: Demands, skill discretion, decision authority and social climate at work as determinants of major depression in a 3-year follow-up study.
abstract: OBJECTIVE
  The psychosocial work environment may be a determinant of the development and course of depressive disorders, but the literature shows inconsistent findings. Thus, the aim of this study is to determine longitudinal effects of the job demands-control-support model (JDCSM) variables on the occurrence of major depression among working men and women from the general population.
  
  
  METHODS
  The sample comprised 4,710 working women and men living in Stockholm, who answered the same questionnaire twice, 3 years apart, who were not depressed during the first wave and had the same job in both waves. The questionnaire included JDCSM variables (demands, skill discretion, decision authority and social climate) and other co-variables (income, education, occupational group, social support, help and small children at home, living with an adult and depressive symptoms at time 1; and negative life events at time 2). Multiple logistic regressions were run to calculate odds ratios of having major depression at time 2, after adjustment for other JDCSM variables and co-variables.
  
  
  RESULTS
  Among women, inadequate work social climate was the only significant risk indicator for major depression. Surprisingly, among men, high job demands and low skill discretion appeared as protective factors against major depression.
  
  
  CONCLUSIONS
  The results showed a strong relationship between inadequate social climate and major depression among women, while there were no certain effects for the remaining exposure variables. Among men, few cases of major depression hampered well-founded conclusions regarding our findings of low job demands and high skill discretion as related to major depression.
authors: Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Norrbacka, Plan 7, Karolinska Hospital, 171 73, Stockholm, Sweden. andres.fandino@ki.se
authors: Andrés
authors: A
authors: Fandiño-Losada
authors: Yvonne
authors: Y
authors: Forsell
authors: Ingvar
authors: I
authors: Lundberg
mesh_terms: D000328:Adult; D000465:Algorithms; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007588:Job Satisfaction; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D016017:Odds Ratio; D017009:Professional Autonomy; D011581:Psychological Tests; D012307:Risk Factors; D012737:Sex Factors; D012931:Social Environment; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013548:Sweden