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Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study.
Open accessAbstract
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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“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]
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“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]
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“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]
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“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]
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“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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“No statistically significant difference between subgroups of men and women was found.16 18 25”
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“Empirically, lack of control in the workplace is associated with stress and depressive symptoms (Steptoe et al., 2003a; Stansfeld et al., 1999; Karasek and Theorell, 1990), while the degree to which an individual has social support is believed to determine the degree to which they can buffer job…”
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“…et al. 1998), inadequate social support (Niedhammer et al. 1998; Bultmann et al. 2002), higher psychological demands (Niedhammer et al. 1998; Stansfeld et al. 1999; Wang and Patten 2001), eVort–reward imbalances (Stansfeld et al. 1998; Pikhart et al. 2004; Niedhammer et al. 2006), and…”
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“This corresponds with earlier research where different work characteristics were associated with ill-health perceptions [6,7,11,28,29,31].”
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“Many studies have reported the influence of low job control on mental health [Stansfeld et al., 1999; de Jonge et al., 2000;Griffin et al., 2002; Laaksonen et al., 2006]; but in this study, low job control had onlymarginal associationwith job dissatisfaction.”
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“In many studies there is evidence that low levels of social support increase the risk of mental symptoms (Stansfeld et al., 1997; Niedhammer et al., 1998; Paterniti et al., 2002; Stansfeld et al., 1999).”
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“general health (Cheng et al. 2000; Ibrahim et al. 2001) and various problems of mental health (de Jonge et al. 2000; Stansfeld et al. 1999 ).”
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“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.”
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“Furthermore, several longitudinal studies have found evidence for working conditions resulting in mental health problems [21, 22, 35–38].”
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“It has also been reported that social support at work has a buffering effect on depressive symptoms among London civil servants [14], and that social support from family/friends has a buffering effect on depressive symptoms among Japanese physicians [6].”
BackgroundMental ill health and fitness for work
Glozier, N. (2002) · Occupational and Environmental Medicine · doi:10.1136/oem.59.10.714 · Cited by 77
Reported nonreciprocity of social exchange and depressive symptoms
Knesebeck, O. V. D., & Siegrist, J. (2003) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00514-7 · Cited by 76
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Aust, B., Rugulies, R., Skakon, J., Scherzer, T., & Jensen, C. (2006) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2006.01.008 · Cited by 76
“Low influence was significantly associated with reduced mental health in this study and has been found to predict physical and mental health disorders in other studies (Bosma et al., 1997; Rugulies et al., in press; Stansfeld et al., 1999).”
Franche, R., Williams, A., Ibrahim, S. A., Grace, S. L., Mustard, C., Minore, B., & Stewart, D. E. (2006) · Stress and Health · doi:10.1002/smi.1087 · Cited by 81
Psychological Approaches to Mental Illness
Peterson, C. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511984945.008 · Cited by 77
Low Control at Work and the Risk of Suicide in Japanese Men: A Prospective Cohort Study
Tsutsumi, A., Kayaba, K., Ojima, T., Ishikawa, S., & Kawakami, N. (2007) · Psychotherapy and Psychosomatics · doi:10.1159/000099845 · Cited by 78
Dragano, N., Verde, P. E., & Siegrist, J. (2005) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2005.035089 · Cited by 74
Workplace bullying and general health status among the nursing staff of Greek public hospitals
Karatza, C., Zyga, S., Tziaferi, S., & Prezerakos, P. E. (2016) · Annals of General Psychiatry · doi:10.1186/s12991-016-0097-z · Cited by 74
“This tool is simple to use, can be easily completed and rated and has been widely and successfully utilised in myriad mental health studies [23–25].”
MethodHassanzadeh, A., Heidari, Z., Feizi, A., Keshteli, A. H., Roohafza, H., Afshar, H., & Adibi, P. (2017) · Computational and Mathematical Methods in Medicine · doi:10.1155/2017/3457103 · Cited by 73
Nielsen, M. L., Rugulies, R., Christensen, K. B., Smith‐Hansen, L., Bjørner, J. B., & Kristensen, T. S. (2004) · Work & Stress · doi:10.1080/02678370412331324806 · Cited by 73
Muntaner, C., Li, Y., Xue, X., Thompson, T., O'Campo, P. J., Chung, H., & Eaton, W. W. (2005) · Health & Place · doi:10.1016/j.healthplace.2005.09.004 · Cited by 76
“There is also longitudinal evidence linking job demands, lack of autonomy, and monotony at work to affective disorders (Stansfeld et al., 1999; Eaton et al., 2001).”
THE EFFECT OF WORK STATUS AND WORKING CONDITIONS ON MENTAL HEALTH IN FOUR OECD COUNTRIES
Nozal, A. L. (2009) · National Institute Economic Review · doi:10.1177/0027950109345234 · Cited by 80
“For instance, the ‘Whitehall II’ study followed a cohort of British civil servants and found evidence that social support and control at work protect mental health while high job demands and effort-reward imbalance are risk factors for future psychiatric disorder (Stansfeld et al., 1999).”
BackgroundFinnes, A., Ghaderi, A., Dahl, J., Nager, A., & Enebrink, P. (2019) · Journal of Occupational Health Psychology · doi:10.1037/ocp0000097 · Cited by 67
Soklaridis, S., Ammendolia, C., & Cassidy, D. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.08.017 · Cited by 76
Musculoskeletal pain and effort-reward imbalance- a systematic review
Koch, P., Schablon, A., Latza, U., & Nienhaus, A. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-37 · Cited by 82
Organizational Climate, Occupational Stress, and Employee Mental Health
Arnetz, B. B., Lucas, T., & Arnetz, J. E. (2010) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e3181ffo5b · Cited by 73
Reducing social inequalities in health: work-related strategies
Siegrist, J. (2002) · Scandinavian Journal of Public Health · doi:10.1177/14034948020300030801 · Cited by 69
Fleischmann, M. S., Xue, B., & Head, J. A. (2019) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbz042 · Cited by 77
Marital Status and Mental Health
Williams, K., Frech, A., & Carlson, D. L. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511984945.020 · Cited by 70
Marchand, A., Demers, A., & Durand, P. (2006) · Human Relations · doi:10.1177/0018726706067595 · Cited by 77
“The Whitehall Study is limited to civil servants (Stansfeld et al., 1999), the GAZEL cohort study follows workers in two French enterprises (Niedhammer et al., 1998) and the Maastricht cohort study tracks workers from 45 organizations with an initial response rate of 45 percent and only 27.4…”
BackgroundMethodResultInfluentialWorkplace Prevention and Promotion Strategies
Vézina, M., Bourbonnais, R., Brisson, C., & Trudel, L. (2004) · A Nudge Too Far? A Nudge at All? On Paying People to Be Healthy · doi:10.12927/hcpap..16822 · Cited by 67
Mikkelsen, A., Øgaard, T., & Landsbergis, P. A. (2005) · Work & Stress · doi:10.1080/02678370500167808 · Cited by 69
“In various new studies the demands and control measurement instruments have been expanded and new items included (de Jonge et al, 2001 ; Kristensen, Bjorner, Christensen, & Borg, 2004 ; Kristensen & Borg, 2001 ; Mikkelsen, Saksvik, Eriksen, & Ursin, 1999 ; Stansfeld, Fuhrer, Shipley, & Marmot, 1999 ).”
Arial, M., Gonik, V., Wild, P. P., & Danuser, B. (2009) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-009-0500-z · Cited by 72
“These results are also consistent with the literature on psychosocial risks in general (Stansfeld et al. 1999).”
ResultPlaisier, I., de Graaf, R., de Bruijn, J. G. M., Smit, J. H., van Dyck, R., Beekman, A. T. F., & Penninx, B. W. J. H. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.07.016 · Cited by 66
“a risk factor for developing depressive disorders (Stansfeld et al., 1999; Plaisier et al., 2007; Bonde, 2008).”
Andrés, A. R., Collings, S. C., & Qin, P. (2009) · European Journal of Public Health · doi:10.1093/eurpub/ckp183 · Cited by 68
Fiabilidad y validez del Copenhagen Burnout Inventory para su uso en España
Ruiz, E. M., Gómez-Quintero, H. B., & Lluís, S. M. I. (2013) · Revista Española de Salud Pública · doi:10.4321/s1135-57272013000200006 · Cited by 65
Zurlo, M. C., Pes, D., & Siegrist, J. (2010) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-010-0512-8 · Cited by 65
“... investigations, where effort-reward imbalance at work predicts negative physical outcomes like poor well-being (de Jonge et al. 2000), cardiovascular disease (Bosma et al. 1998; Peter et al. 2002), changes in cardiovascular risk parameters (Siegrist et al. 1997), musculoskeletal pains (Joksimovic et al. 2002), and…”
BackgroundResultPoor Mental Health Associated with Job Dissatisfaction among School Teachers in Japan
Nagai, M., Tsuchiya, K. J., Toulopoulou, T., & Takei, N. (2007) · Journal of Occupational Health · doi:10.1539/joh.49.515 · Cited by 64
Escribà‐Agüir, V., & Pérez‐Hoyos, S. (2007) · Stress and Health · doi:10.1002/smi.1131 · Cited by 64
Bourbonnais, R., Brisson, C., Vézina, M., Mâsse, B. R., & Blanchette, C. (2006) · Relations industrielles · doi:10.7202/012156ar · Cited by 64
Job stress and depressive symptoms among Japanese fire fighters
Saijo, Y., Ueno, T., & Hashimoto, Y. (2007) · American Journal of Industrial Medicine · doi:10.1002/ajim.20460 · Cited by 64
Hayes, B., Prihodová, L., Walsh, G., Doyle, F., & Doherty, S. A. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-025433 · Cited by 69
“High ERI is strongly associated with an increased risk of mental health disorders and with poor self-rated health.(8) 9 39 40 The percentage of the population in whom effort was not balanced by reward was calculated to determine a crude estimate of the prevalence of occupational stress, although the cut-off for ER doe…”
BackgroundExtra Status and Extra Stress: Are Promotions Good for Us?
Johnston, D. W., & Lee, W.-S. (2013) · Industrial and Labor Relations Review · doi:10.1177/001979391306600102 · Cited by 66
“In reviewing empirical studies of the job demand-control model, Van der Doef and Maes (1999) find considerable support for the notion that the most negative psychological well-being was found in employees working in high demands-low control jobs.”
Background
Metadata
- Authors
- Stansfeld, S. A., Fuhrer, R., Shipley, M. J., & Marmot, M. G.
- Affiliations
- University College London (GB)
- The Royal Free Hospital (GB)
- 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
- 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
- bronze
- doi.org
- 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 › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Employment and Welfare Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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