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Cited by 800Workplace Health and Well-beingEmployment and Welfare StudiesOccupational Health and Burnout

Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study.

Open access
Stansfeld, S A, Fuhrer, R, Shipley, M J, Marmot, M G·1999·Occupational and Environmental Medicine
DOI 10.1136/oem.56.5.302PMC PMC1757742
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Abstract

OBJECTIVES: The impact of work on the risk of future psychiatric disorder has been examined in few longitudinal studies. This was examined prospectively in a large epidemiological study of civil servants. METHODS: In the Whitehall II study, a longitudinal, prospective cohort study of 6895 male and 3413 female London based civil servants, work characteristics measured at baseline (phase 1: 1985-8) and first follow up (phase 2: 1989) were used to predict psychiatric disorder measured by a 30 item general health questionnaire (GHQ) at phase 2 and phase 3 follow up (phase 3: 1991-3). Work characteristics and GHQ were measured at all three phases. RESULTS: Low social support at work and low decision authority, high job demands and effort-reward imbalance were associated with increased risk of psychiatric disorder as assessed by the GHQ at follow up adjusting for age, employment grade, and baseline GHQ score. CONCLUSIONS: Social support and control at work protect mental health while high job demands and effort-reward imbalance are risk factors for future psychiatric disorder. Intervention at the level of work design, organisation, and management might have positive effects on mental health in working populations.

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Crossref · 10.1136/oem.56.5.302

Cites

32 of 32 references verified0 citation errors · 0 not checkable

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  • Moderate-quality evidence that low coworker support increases the incidence of stress-related disorders, with a pooled OR of 1.29 (95% CI 1.17 to 1.43).

    “In total, five cohort studies demonstrate that there is moderate-quality evidence that low coworkers support1 2 16 21 with a pooled OR 1.29 (95% CI 1.17 to 1.43) and low supervisor support1 2 15 16 21 with a pooled OR 1.27 (95% CI 1.14 to 1.40) increase the incidence of SRD.”

    From Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis (2020) · cites this paper as [16]

    The Results and Table 2 report that low colleague support predicted greater risk of psychiatric disorder, particularly in men. This cohort study does not provide the five-study pooled OR of 1.29 (95% CI 1.17–1.43) or grade the evidence as moderate quality; those are claims about the citing paper's synthesis, not findings of this source. (LLM, conf=0.89)

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  • Moderate-quality evidence that low decision autonomy increases the incidence of stress-related disorders, with a pooled OR of 1.34 (95% CI 1.20 to 1.49).

    “Two cohort studies2 16 demonstrate that there is moderate-quality evidence that low decision autonomy increases the incidence of SRD with a pooled OR of 1.34 (95% CI 1.20 to 1.49) (see table 3).”

    From Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis (2020) · cites this paper as [16]

    The Results report a small increased risk of subsequent GHQ-assessed psychiatric disorder among workers with low decision authority, and Table 1 gives separate estimates for men and women. The paper does not classify these outcomes specifically as stress-related disorders or report the pooled OR of 1.34 (95% CI 1.20 to 1.49) or a moderate-quality evidence rating; those appear to be the citing paper’s synthesis of two studies. (LLM, conf=0.86)

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  • Moderate-quality evidence for no increased incidence of stress-related disorders due to low skill discretion, with an OR of 1.11 (95% CI 0.94 to 1.32).

    “Two cohort studies16 17 demonstrate that there is moderate-quality evidence for no increased incidence of SRD due to low skill discretion, with an OR of 1.11 (95% CI 0.94 to 1.32).”

    From Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis (2020) · cites this paper as [16]

    Table 1 (labelled Discussion in our copy; page unavailable) reports that, after full adjustment, low skill discretion was not clearly associated with GHQ-assessed psychiatric disorder: OR 1.10 (95% CI 1.0 to 1.3) in men and 1.00 (0.8 to 1.2) in women. The paper does not report the cited OR of 1.11 (0.94 to 1.32) or grade the evidence as moderate quality; those parts of the two-study claim cannot be verified from this source alone. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Moderate-quality evidence that effort-reward imbalance increases the incidence of stress-related disorders, with a pooled OR of 1.91 (95% CI 1.70 to 2.15).

    “Six cohort studies16 18 19 24 25 demonstrate that there is moderate-quality evidence that effort-reward imbalance increases the incidence of SRD, with a pooled OR of 1.91 (95% CI 1.70 to 2.15) (see table 3 and figure 2).”

    From Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis (2020) · cites this paper as [16]

  • All studies defined stress-related disorders based on self-report with validated and standardised questionnaires.

    “All studies defined SRD based on self-report with validated and standardised questionnaires, that is, (shortened) GHQ,1 15 16 19 20 22 Kessler 6,3 25 Maslach Burnout Inventory,2 21 Copenhagen Psychosocial Questionnaire-Copenhagen Burnout Inventory,24 27 Setterlind Stress Inventory Profile,17 fatigue inventory,18 Brief Job Stress Questionnaire27 and burnout screening scale.26”

    From Work-related psychosocial risk factors for stress-related mental disorders: an updated systematic review and meta-analysis (2020) · cites this paper as [16]

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Cites

Flagged first, then by citations

1 of the 33 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. [7]7. Siegrist J. Adverse health eVects of high-eVort/low-reward conditions. Journal of Occupational Health Psychology 1996; 1:27-41.
  2. [12]12. North FM, Syme SL, Feeney A, et al. Psychosocial work environment and sickness absence. The Whitehall II study. Am J Public Health 1996;86:332-40.
  3. [22]22. Wall TD, Bolden RI, Borrill CS, et al. Minor psychiatric dis- order in NHS trust staV: occupational and gender diVerences. Br J Psychiatry 1997;171:519-23.
  4. [25]25. Karasek RA, Triantis KP, Chandhry SS. Co-worker and supervisor support as moderation of association between task characteristics and mental strain. Journal of Occupa- tional Behaviour 1982;3:181-200.

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Authors
Stansfeld, S. A., Fuhrer, R., Shipley, M. J., & Marmot, M. G.
Affiliations
  • University College London (GB)
  • The Royal Free Hospital (GB)
ORCID
Venue
Occupational and Environmental Medicine
Publisher
BMJ
Published
1999-05
Volume
56
Issue
5
Pages
302-307
ISSN
  • 0007-1072 (ISSN-L)
  • 1351-0711
  • 1470-7926
DOI
10.1136/oem.56.5.302
PMC
PMC1757742
OpenAlex
W2111757965
Cited by
800
References
33
Citations by year
2026: 5 · 2025: 7 · 2024: 5 · 2023: 13 · 2022: 16 · 2021: 21 · 2020: 22 · 2019: 23 · 2018: 16 · 2017: 58 · 2016: 21 · 2015: 34 · 2014: 31 · 2013: 39 · 2012: 40
FWCI
37.73
Type
journal article
Language
en
Open access
Locations
  • Occupational and Environmental Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • John D. and Catherine T. MacArthur Foundation
  • British Heart Foundation
  • Health and Safety Executive
  • Medical Research Council
  • National Heart, Lung, and Blood Institute (2 RO1 HL 36310, HL36310, R01HL036310)
Topics
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
  • Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
Keywords
mental illness, job characteristics, mental health, social support at work, decision-making power, job demands, effort-reward imbalance, public sector employees, occupational stress, job design, Whitehall II study
MeSH terms
Adult, Mental Disorders, Female, Government Agencies, Humans, Male, Middle Aged, Occupational Diseases, Prospective Studies, Social Support, Work, Work Schedule Tolerance

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