title: Associations between work stress and suicidal ideation: Individual-participant data from six cross-sectional studies.
abstract: Epidemiological evidence suggests that work stress is associated with suicidal ideation (SI). However, only few studies in this area have drawn on well-established theoretical work stress models (i.e., the job-demand-control [JDC] model, the effort-reward-imbalance [ERI] model, and the model of organizational injustice [OJ]). Utilization of such models allows though for theory-based assessments and workplace interventions. Since evidence on those models' relationship with suicide-related outcomes is currently inconclusive (with regard to JDC), markedly sparse (OJ) or lacking (ERI), we aimed to provide additional or initial evidence.
  
  
  
  We drew on original data from six cross-sectional studies, which were conducted in four countries (i.e., South Korea, China, Australia, and Germany). Work stress was measured by established questionnaires and was categorized into tertiles. In each study, SI was assessed by either one or two items taken from validated scales. Associations of work stress with SI were estimated for each study and were pooled across studies using multivariate random-effects logistic modeling.
  
  
  
  In the pooled analyses (n=12,422) all three work stress models were significantly associated with SI with odds ratios fluctuating around 2. For instance, the pooled odds ratios for highest versus lowest work stress exposure in terms of job strain, OJ, and ERI equalled 1.91 (95% confidence interval [CI]=1.52, 2.41), 1.98 (95% CI=1.48, 2.65), and 2.77 (95% CI=1.57, 4.88), respectively. Patterns of associations were largely consistent across the individual studies.
  
  
  
  Our study provides robust evidence of a positive association between work stress and SI.
authors: Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany; Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. Electronic address: Adrian.Loerbroks@uni-duesseldorf.de.
authors: Adrian
authors: A
authors: Loerbroks
authors: Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
authors: Sung-Il
authors: SI
authors: Cho
authors: Asia Pacific Centre for Work Health and Safety, School of Psychology, Social Work and Social Policy, University of South Australia, Magill Campus, Adelaide, Australia.
authors: Maureen F
authors: MF
authors: Dollard
authors: Shandong Academy for Occupational Health and Occupational Medicine, Shandong Academy of Medical Sciences, Jinan, China.
authors: Jianfang
authors: J
authors: Zou
authors: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors: Joachim E
authors: JE
authors: Fischer
authors: School of Nursing, Xinjiang Medical University, Urumqi, China.
authors: Yueying
authors: Y
authors: Jiang
authors: Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors: Peter
authors: P
authors: Angerer
authors: Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany; Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors: Raphael M
authors: RM
authors: Herr
authors: Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors: Jian
authors: J
authors: Li
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012201:Reward; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology*; D017132:Workplace / Q000523:psychology*; D055815:Young Adult
keywords: Effort-reward-imbalance; Job-demand-control; Organizational justice; Suicidal ideation; Work stress