title: Changes in psychosocial work environment and depressive symptoms: a prospective study in junior physicians.
abstract: BACKGROUND
  We examined the impact of changes in the psychosocial work environment on depressive symptoms in a sample of junior physicians, a high risk group for stress and mental disorders.
  
  
  METHODS
  This is a three-wave prospective study in 417 junior physicians during their residency in German hospitals. The psychosocial work environment was measured by the Effort-Reward Imbalance (ERI) Questionnaire at Waves 1 and 2, and the depressive symptoms were assessed with the State-Trait Depression Scales at all three waves. Multivariate linear regression was applied for prospective associations between ERI across Waves 1 and 2, and baseline-adjusted depressive symptoms at Wave 3.
  
  
  RESULTS
  Compared with the ERI scores at Wave 1, at Wave 2, and mean scores between the two waves, the baseline-adjusted ERI change scores between the two waves showed slightly better statistical power, predicting depressive symptoms at Wave 3 (β = 0.78, 95% CI = 0.38-1.18 for increased ERI per SD, β = 0.64, 95% CI = 0.22-1.06 for increased effort per SD, β = -0.65, 95% CI = -1.06 to -0.24 for increased reward per SD, and β = 0.68, 95% CI = 0.27-1.09 for increased overcommitment per SD).
  
  
  CONCLUSIONS
  Negative changes in the psychosocial work environment, specifically increased ERI, are associated with depressive symptoms in German junior physicians. Reducing the non-reciprocity of working life, particularly improving reward at work, may have beneficial effects on prevention of mental health problems in the hospital workplace.
authors.affiliation: Institute of Occupational and Social Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany; Institute of Medical Sociology, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Matthias
authors.initials: M
authors.lastname: Weigl
authors.forename: Jürgen
authors.initials: J
authors.lastname: Glaser
authors.forename: Raluca
authors.initials: R
authors.lastname: Petru
authors.forename: Johannes
authors.initials: J
authors.lastname: Siegrist
authors.forename: Peter
authors.initials: P
authors.lastname: Angerer
mesh_terms: D000328:Adult; D003863:Depression / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D007396:Internship and Residency; D007588:Job Satisfaction; D016014:Linear Models; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000523:psychology*; D011446:Prospective Studies; D012201:Reward; D012931:Social Environment; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014940:Work Schedule Tolerance / Q000523:psychology; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000523:psychology
keywords: changes; depression; effort-reward imbalance; junior physicians; prospective study