Overview

Abstract (English)

Major depression is one of the most prevalent mental disorders in the general population. The existing literature suggests that work stress is a risk factor for depression. The demand-control model (Karasek and Theorell, 1990) posits that the negative outcomes, such as fatigue and depression, result from the situations in which one’s control over one’s work is low and the psychological demands imposed by one’s work are high. High levels of job insecurity and a low level of support from supervisors and coworkers are associated with an increased risk of adverse health outcomes. A study (Mausner-Dorsch and Eaton, 2000) based on the data of the Epidemiologic Catchment Area study reported that major depressive episode (MDE) was associated with decision authority but not associated with skill discretion or with psychological and physical demands as predicted by the demand-control model. Using the data from the Canadian National Population Health Survey (NPHS), Wang and Patten (2001) found that MDE was associated with decision authority, psychological demands, job insecurity, and social support from supervisors and coworkers but not associated with skill discretion and physical exertion. There was evidence that gender might act as an effect modifier in the observed associations (Wang and Patten, 2001). However, it remains unclear whether work stress is one of the causal factors for depression. The data used in the two analyses described here were cross-sectional. Therefore, a temporal relationship between work stress and MDE could not be established. Although longitudinal studies reported that work stress is predictive of the development of depressive symptoms (Griffin et al., 2002;Niedhammer et al., 1998;Stansfeld et al., 1999), findings related to depressive symptoms may not be applicable to major depression. Using the data of a longitudinal cohort of the Canadian NPHS, the objectives of this analysis were to evaluate 1) the associations between variables that are components of the demand-control model and MDE, and 2) whether the associations vary by demographic and socioeconomic characteristics and psychosocial stresses.

Abstract (French)

Major depression is one of the most prevalent mental disorders in the general population. The existing literature suggests that work stress is a risk factor for depression. The demand-control model (Karasek and Theorell, 1990) posits that the negative outcomes, such as fatigue and depression, result from the situations in which one’s control over one’s work is low and the psychological demands imposed by one’s work are high. High levels of job insecurity and a low level of support from supervisors and coworkers are associated with an increased risk of adverse health outcomes. A study (Mausner-Dorsch and Eaton, 2000) based on the data of the Epidemiologic Catchment Area study reported that major depressive episode (MDE) was associated with decision authority but not associated with skill discretion or with psychological and physical demands as predicted by the demand-control model. Using the data from the Canadian National Population Health Survey (NPHS), Wang and Patten (2001) found that MDE was associated with decision authority, psychological demands, job insecurity, and social support from supervisors and coworkers but not associated with skill discretion and physical exertion. There was evidence that gender might act as an effect modifier in the observed associations (Wang and Patten, 2001). However, it remains unclear whether work stress is one of the causal factors for depression. The data used in the two analyses described here were cross-sectional. Therefore, a temporal relationship between work stress and MDE could not be established. Although longitudinal studies reported that work stress is predictive of the development of depressive symptoms (Griffin et al., 2002;Niedhammer et al., 1998;Stansfeld et al., 1999), findings related to depressive symptoms may not be applicable to major depression. Using the data of a longitudinal cohort of the Canadian NPHS, the objectives of this analysis were to evaluate 1) the associations between variables that are components of the demand-control model and MDE, and 2) whether the associations vary by demographic and socioeconomic characteristics and psychosocial stresses.