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A systematic review including meta-analysis of work environment and depressive symptoms.

Theorell T, Hammarström A, Aronsson G, Träskman Bendz L, Grape T, Hogstedt C, Marteinsdottir I, Skoog I, Hall C - BMC Public Health (2015)

Bottom Line: Moderately strong evidence (grade three out of four) was found for job strain (high psychological demands and low decision latitude), low decision latitude and bullying having significant impact on development of depressive symptoms.Limited evidence (grade two) was shown for psychological demands, effort reward imbalance, low support, unfavorable social climate, lack of work justice, conflicts, limited skill discretion, job insecurity and long working hours.These conditions are amenable to organizational interventions.

View Article: PubMed Central - PubMed

Affiliation: Stress Research Institute, Stockholm University, SE-106 91, Stockholm, Sweden. tores.theorell@stressforskning.su.se.

ABSTRACT

Background: Depressive symptoms are potential outcomes of poorly functioning work environments. Such symptoms are frequent and cause considerable suffering for the employees as well as financial loss for the employers. Accordingly good prospective studies of psychosocial working conditions and depressive symptoms are valuable. Scientific reviews of such studies have pointed at methodological difficulties but still established a few job risk factors. Those reviews were published some years ago. There is need for an updated systematic review using the GRADE system. In addition, gender related questions have been insufficiently reviewed.

Method: Inclusion criteria for the studies published 1990 to June 2013: 1. European and English speaking countries. 2. Quantified results describing the relationship between exposure (psychosocial or physical/chemical) and outcome (standardized questionnaire assessment of depressive symptoms or interview-based clinical depression). 3. Prospective or comparable case-control design with at least 100 participants. 4. Assessments of exposure (working conditions) and outcome at baseline and outcome (depressive symptoms) once again after follow-up 1-5 years later. 5. Adjustment for age and adjustment or stratification for gender. Studies filling inclusion criteria were subjected to assessment of 1.) relevance and 2.) quality using predefined criteria. Systematic review of the evidence was made using the GRADE system. When applicable, meta-analysis of the magnitude of associations was made. Consistency of findings was examined for a number of possible confounders and publication bias was discussed.

Results: Fifty-nine articles of high or medium high scientific quality were included. Moderately strong evidence (grade three out of four) was found for job strain (high psychological demands and low decision latitude), low decision latitude and bullying having significant impact on development of depressive symptoms. Limited evidence (grade two) was shown for psychological demands, effort reward imbalance, low support, unfavorable social climate, lack of work justice, conflicts, limited skill discretion, job insecurity and long working hours. There was no differential gender effect of adverse job conditions on depressive symptoms

Conclusion: There is substantial empirical evidence that employees, both men and women, who report lack of decision latitude, job strain and bullying, will experience increasing depressive symptoms over time. These conditions are amenable to organizational interventions.

No MeSH data available.


Related in: MedlinePlus

Flow chart of the literature search, screening, review- and quality assessment
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Fig1: Flow chart of the literature search, screening, review- and quality assessment

Mentions: Figure 1 shows the number of articles that were perused in the different steps. The process also included burnout as outcome. The results of the burnout review will be reported elsewhere. Altogether 20 828 articles were screened in the initial search process, and 488 of those were eligible in the review of depressive symptoms (and 202 for the review of burnout). 324 full text articles with depression as outcome were found not to fill inclusion criteria. Hence, 164 studies remained for relevance assessment. 84 of those were judged as not relevant and hence 80 studies were assessed with regard to quality. 19 were judged to be of high, 40 of moderately high and 21 of low quality. The grading of evidence has been based upon the 59 relevant studies with high/medium high quality. A detailed table showing the full results of the data extraction is available at http://www.sbu.se/upload/Publikationer/Content0/1/223E/Inclusion%20criteria_occupational%20exposure_depression_burnout.pdf.Fig. 1


A systematic review including meta-analysis of work environment and depressive symptoms.

Theorell T, Hammarström A, Aronsson G, Träskman Bendz L, Grape T, Hogstedt C, Marteinsdottir I, Skoog I, Hall C - BMC Public Health (2015)

Flow chart of the literature search, screening, review- and quality assessment
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4522058&req=5

Fig1: Flow chart of the literature search, screening, review- and quality assessment
Mentions: Figure 1 shows the number of articles that were perused in the different steps. The process also included burnout as outcome. The results of the burnout review will be reported elsewhere. Altogether 20 828 articles were screened in the initial search process, and 488 of those were eligible in the review of depressive symptoms (and 202 for the review of burnout). 324 full text articles with depression as outcome were found not to fill inclusion criteria. Hence, 164 studies remained for relevance assessment. 84 of those were judged as not relevant and hence 80 studies were assessed with regard to quality. 19 were judged to be of high, 40 of moderately high and 21 of low quality. The grading of evidence has been based upon the 59 relevant studies with high/medium high quality. A detailed table showing the full results of the data extraction is available at http://www.sbu.se/upload/Publikationer/Content0/1/223E/Inclusion%20criteria_occupational%20exposure_depression_burnout.pdf.Fig. 1

Bottom Line: Moderately strong evidence (grade three out of four) was found for job strain (high psychological demands and low decision latitude), low decision latitude and bullying having significant impact on development of depressive symptoms.Limited evidence (grade two) was shown for psychological demands, effort reward imbalance, low support, unfavorable social climate, lack of work justice, conflicts, limited skill discretion, job insecurity and long working hours.These conditions are amenable to organizational interventions.

View Article: PubMed Central - PubMed

Affiliation: Stress Research Institute, Stockholm University, SE-106 91, Stockholm, Sweden. tores.theorell@stressforskning.su.se.

ABSTRACT

Background: Depressive symptoms are potential outcomes of poorly functioning work environments. Such symptoms are frequent and cause considerable suffering for the employees as well as financial loss for the employers. Accordingly good prospective studies of psychosocial working conditions and depressive symptoms are valuable. Scientific reviews of such studies have pointed at methodological difficulties but still established a few job risk factors. Those reviews were published some years ago. There is need for an updated systematic review using the GRADE system. In addition, gender related questions have been insufficiently reviewed.

Method: Inclusion criteria for the studies published 1990 to June 2013: 1. European and English speaking countries. 2. Quantified results describing the relationship between exposure (psychosocial or physical/chemical) and outcome (standardized questionnaire assessment of depressive symptoms or interview-based clinical depression). 3. Prospective or comparable case-control design with at least 100 participants. 4. Assessments of exposure (working conditions) and outcome at baseline and outcome (depressive symptoms) once again after follow-up 1-5 years later. 5. Adjustment for age and adjustment or stratification for gender. Studies filling inclusion criteria were subjected to assessment of 1.) relevance and 2.) quality using predefined criteria. Systematic review of the evidence was made using the GRADE system. When applicable, meta-analysis of the magnitude of associations was made. Consistency of findings was examined for a number of possible confounders and publication bias was discussed.

Results: Fifty-nine articles of high or medium high scientific quality were included. Moderately strong evidence (grade three out of four) was found for job strain (high psychological demands and low decision latitude), low decision latitude and bullying having significant impact on development of depressive symptoms. Limited evidence (grade two) was shown for psychological demands, effort reward imbalance, low support, unfavorable social climate, lack of work justice, conflicts, limited skill discretion, job insecurity and long working hours. There was no differential gender effect of adverse job conditions on depressive symptoms

Conclusion: There is substantial empirical evidence that employees, both men and women, who report lack of decision latitude, job strain and bullying, will experience increasing depressive symptoms over time. These conditions are amenable to organizational interventions.

No MeSH data available.


Related in: MedlinePlus