TY - JOUR

T1 - Emotional demands at work and risk of hospital-treated depressive disorder in up to 1.6 million Danish employees

T2 - a prospective nationwide register-based cohort study

AU - Madsen, Ida E. H.

AU - Sorensen, Jeppe Karl

AU - Bruun, Julie Eskildsen

AU - Framke, Elisabeth

AU - Burr, Hermann

AU - Melchior, Maria

AU - Sivertsen, Borge

AU - Stansfeld, Stephen

AU - Kivimaki, Mika

AU - Rugulies, Reiner

PY - 2022

Y1 - 2022

N2 - Objective Previous studies on effects of emotional demands on depression have relied on self-reported exposure data and lacked control for potential confounding by pre-employment risk factors for depression. This study used a register-based design to examine the risk of hospital-treated depressive disorder in relation to occupational levels of emotional demands at work, furthermore addressing the role of risk factors for depression before workforce entry.Methods We analyzed data from two Danish register-based cohorts - Job Exposure Matrix Analyses of Psychosocial Factors and Healthy Ageing in Denmark (JEMPAD, N= 1 665 798) (17) and Danish Work Life Course Cohort (DaWCo, N=939 411), which link assessments of emotional demands by job exposure matrices to records of hospital-treated depressive disorder among employees aged 15-59 years at baseline (average follow up: 9.7 years in JEMPAD, 7.3 years in DaWCo). Potential confounders comprised sociodemographics, job control, work-related violence and physical demands at work. In DaWCo, we followed individuals from their entry into the workforce, and also included data on risk factors for depression before workforce entry (eg, parental income, education, and psychiatric diagnoses).Results Employees in occupations with high emotional demands had an increased risk of hospital-treated depressive disorder with confounder-adjusted hazard ratios of 1.32 [95% confidence interval (CI) 1.24.1.41] and 1.19 (95% CI 1.09.1.30) in JEMPAD and DaWCO, respectively. This association remained after controlling for risk factors before workforce entry.Conclusions This study suggests that employees in occupations with high emotional demands are at increased risk of hospital-treated depressive disorder. This increased risk was neither attributable to reporting bias nor explained by the included risk factors for depression recorded before workforce entry.

AB - Objective Previous studies on effects of emotional demands on depression have relied on self-reported exposure data and lacked control for potential confounding by pre-employment risk factors for depression. This study used a register-based design to examine the risk of hospital-treated depressive disorder in relation to occupational levels of emotional demands at work, furthermore addressing the role of risk factors for depression before workforce entry.Methods We analyzed data from two Danish register-based cohorts - Job Exposure Matrix Analyses of Psychosocial Factors and Healthy Ageing in Denmark (JEMPAD, N= 1 665 798) (17) and Danish Work Life Course Cohort (DaWCo, N=939 411), which link assessments of emotional demands by job exposure matrices to records of hospital-treated depressive disorder among employees aged 15-59 years at baseline (average follow up: 9.7 years in JEMPAD, 7.3 years in DaWCo). Potential confounders comprised sociodemographics, job control, work-related violence and physical demands at work. In DaWCo, we followed individuals from their entry into the workforce, and also included data on risk factors for depression before workforce entry (eg, parental income, education, and psychiatric diagnoses).Results Employees in occupations with high emotional demands had an increased risk of hospital-treated depressive disorder with confounder-adjusted hazard ratios of 1.32 [95% confidence interval (CI) 1.24.1.41] and 1.19 (95% CI 1.09.1.30) in JEMPAD and DaWCO, respectively. This association remained after controlling for risk factors before workforce entry.Conclusions This study suggests that employees in occupations with high emotional demands are at increased risk of hospital-treated depressive disorder. This increased risk was neither attributable to reporting bias nor explained by the included risk factors for depression recorded before workforce entry.

KW - Denmark

KW - depression

KW - job exposure matrix

KW - psychosocial

KW - register-based study

KW - stress

KW - COMPASSION FATIGUE

KW - MENTAL-DISORDERS

KW - EPIDEMIOLOGY

KW - ENVIRONMENT

KW - EUROPE

U2 - 10.5271/sjweh.4020

DO - 10.5271/sjweh.4020

M3 - Journal article

C2 - 35262742

VL - 48

SP - 302

EP - 311

JO - Scandinavian journal of work, environment & health

JF - Scandinavian journal of work, environment & health

SN - 0355-3140

IS - 4

ER -