Psychosocial work environment and depression: Epidemiologic assessment of the demand-control model

Abstract

Objectives. This study examined the relation between occupational variables and 3 forms of depression (major depressive episode, depressive syndrome, and dysphoria). It was hypothesized that individuals working in occupations with high psychologic strain (high psychologic demands and low decision authority) would have a higher prevalence of depression relative to those working in occupations with the other 3 possible conditions. Methods. The analysis was based on data for 905 respondents who were employed full-time in the year before the follow-up interview for the Epidemiologic Catchment Area Program in Baltimore, Md, between 1993 and 1996. Psychosocial work environment, socio-demographic variables, and psycho-pathology were assessed in a household interview that included the National Institute of Mental Health Diagnostic Interview Schedule. Subscales for the demand-control model for psychosocial work environment were modified slightly after factor analysis. Results. High job strain was associated with greater prevalence of all 3 forms of depression, especially major depressive episode. The results were stronger for women; for men, being unmarried was the strongest prevalence correlate. Conclusions. Major depressive episode, depressive syndrome, and dysphoria are strongly associated with the psychosocial dimensions of the demand-control model.