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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”
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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“Indeed, there are a number of studies that have reported a signifi-cant relationship between mental health status and job [24,30,31].”
The Influence of Organizational Factors on Return-to-Work Outcomes
Caveen, M., Dewa, C. S., & Goering, P. N. (2006) · Canadian Journal of Community Mental Health · doi:10.7870/cjcmh-2006-0017 · Cited by 25
“A number of other studies support the finding that a high level of social support from supervisors is predictive of better mental health of employees (Kawakami, Haratani, & Araki, 1992; LaRocco, House, & French, 1980; Parkes, Mendham, & Von Rabenau, 1994; Neidhammer et al., 1998; Stansfeld et al., 1999).”
ResultChen, S.-W., Wang, P.-C., Hsin, P.-L., Oates, A., Sun, I.-W., & Liu, S.-I. (2011) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-010-0538-y · Cited by 22
“The ERI model was developed from the social exchange theory (Siegrist 1998; Siegrist and Marmot 2004), and it suggests that failed reciprocity in terms of high eVort and low reward may elicit depressive disorders and symptoms (Pikhart et al. 2004; Van Vegchel et al. 2005; Stansfeld et al. 1999).”
Methodvan Hoffen, M. F. A., Rijnhart, J. J. M., Norder, G., Labuschagne, L. J. E., & Twisk, J. W. R. (2020) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-020-09931-w · Cited by 32
Nakao, M., Takeuchi, T., & Yoshimasu, K. (2008) · Environmental Health and Preventive Medicine · doi:10.1007/s12199-008-0048-7 · Cited by 23
“According to a British longitudinal study among civil servants [20], psychological morbidity was predicted by high job demands, low decision authority, poor social support at work, and effort–reward imbalance.”
BackgroundBrisson, C., Cantin, V., Larocque, B., Vézina, M., Vinet, A., Trudel, L., & Bourbonnais, R. (2006) · Canadian Journal of Community Mental Health · doi:10.7870/cjcmh-2006-0024 · Cited by 24
Siegrist, J. (2009) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199211913.003.0006 · Cited by 27
Job demands, control and social support as predictors of trajectories of depressive symptoms
Åhlin, J., Rajaleid, K., Jansson‐Fröjmark, M., Westerlund, H., & Hanson, L. L. M. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.04.067 · Cited by 26
McKee, M., West, M. A., Flin, R. H., Grant, A., Johnston, D. W., Jones, M. C., Miles, C. C., Charles, K., Dawson, J., McCann, S., et al. (2010) · Discovery Research Portal (University of Dundee) · Cited by 24
Studying Stress in the Twenty-First-Century: An Update of Stress Concepts and Research
Wheaton, B., & Montazer, S. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316471289.013 · Cited by 24
Mental Health Effects of Changes in Psychosocial Work Characteristics: A Prospective Cohort Study
De Raeve, L., Vasse, R. M., Jansen, N. W. H., van den Brandt, P. A., & Kant, I. (2007) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0b013e31811eadd3 · Cited by 16
“This study confirms and extends the results of earlier studies, which have indicated that changes in psychosocial work characteristics are associated with employees’ health and well-being.(8,13,56) The results of this study show a significant longitudinal relationship between changes in psychological job demands and d…”
ResultMortality and ImmortalityPreprint
Rablen, M. D., & Oswald, A. J. (2007) · SSRN Electronic Journal · doi:10.2139/ssrn.958726 · Cited by 24
Work, Unemployment and Mental Health
Boardman, J., & Rinaldi, M. (2021) · Cambridge University Press eBooks · doi:10.1017/9781911623793.035 · Cited by 24
Work and health: A comparison between Norwegian onshore and offshore employees
Bjerkan, A. M. (2011) · Work · doi:10.3233/wor-2011-1214 · Cited by 23
“perceived control over work tasks), lower decision-making authority, lower levels of social support, perceptions of high psychological job demands and a perceived discrepancy between efforts spent at work and rewards gained from work are associated with increased rates of work-related ill health, such as musculoskelet…”
Ischemic Heart Disease in Female Cleaners
Sjögren, B., Fredlund, P., Lundberg, I., & Weiner, J. A. (2003) · International Journal of Occupational and Environmental Health · doi:10.1179/oeh.2003.9.2.134 · Cited by 23
Main, C. J., Glozier, N., & Wright, I. (2005) · Occupational Medicine · doi:10.1093/occmed/kqi044 · Cited by 23
“In the UK, the widely cited Whitehall study demonstrated that low decision latitude and/or high job demands were associated with the future development of poor mental health, while low social support is associated with both adverse mental health and increased sickness absence [4].”
BackgroundPromoting Positive Mental Health and Well-Being: Practice and Policy
Barry, M. M. (2012) · Springer eBooks · doi:10.1007/978-94-007-5195-8_16 · Cited by 25
Wadsworth, E. J. K., Chaplin, K., Allen, P. H., & Smith, A. P. (2010) · The Open Occupational Health & Safety Journal · doi:10.2174/1876216601002010009 · Cited by 22
“In the last two to three decades there has been a large body of research on work characteristics and their association with both negative job outcomes, such as stress and dissatisfaction, and with physical and mental health [1,2,3].”
BackgroundLauber, C., & Bowen, J. L. (2010) · International Review of Psychiatry · doi:10.3109/09540261003716405 · Cited by 22
“Social status and demographics include marital status (widowed, divorced, single), older age, gender (male or female depending on the employment background) and low education (Dewa, Goering, Lin, & Paterson, 2002; Dewa, Hoch, Goering, Lin, & Paterson, 2003a; Dewa, Hoch, Lin, Paterson, & Goering, 2003b; Ginexi, Howe, &…”
BackgroundGómez, M. A. L., Sabbath, E. L., Boden, L. I., Williams, J. A. R., Hopcia, K. L., Hashimoto, D. M., & Sorensen, G. (2019) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001736 · Cited by 25
“Previous studies have established a relationship of both coworker and supervisor support with mental health 41 with another longitudinal study, showing that conflict at work increased the likelihood of onset of psychological distress without observing any buffering effects from either supervisor or…”
Trudel, L., Vonarx, N., Simard, C., Freeman, A. R., Vézina, M., Brisson, C., Vinet, A., Bourbonnais, R., & Dugas, N. (2009) · Work · doi:10.3233/wor-2009-0933 · Cited by 22
“Several studies have demonstrated the link between effort-reward imbalance and psychological distress [34,64, 70].”
El estrés laboral: un nuevo factor de riesgo. ¿Qué sabemos y qué podemos hacer?
Fernández-López, J. A., Siegrist, J., Rödel, A., & Hernández-Mejía, R. (2003) · Atención Primaria · doi:10.1016/s0212-6567(03)70715-x · Cited by 28
The work environment, stress and well-being
Wadsworth, E. J. K., Chaplin, K., & Smith, A. P. (2010) · Occupational Medicine · doi:10.1093/occmed/kqq139 · Cited by 22
Beutel, M. E., Knickenberg, R. J., Krug, B., Mund, S., Schattenburg, L., & Zwerenz, R. (2006) · International Journal of Group Psychotherapy · doi:10.1521/ijgp.2006.56.3.285 · Cited by 22
Center for Demography and Ecology
Velyvis, K. A., Thompson‐Colón, T., & Winsborough, H. H. (2006) · Cited by 22
Watanabe, M., Irie, M., & Kobayashi, F. (2004) · Journal of Occupational Health · doi:10.1539/joh.46.78 · Cited by 21
Effort-Reward Imbalance and Affective Disorders
Rugulies, R., Aust, B., & Madsen, I. E. H. (2016) · Aligning perspectives on health, safety and well-being · doi:10.1007/978-3-319-32937-6_6 · Cited by 22
Kawaharada, M., Yoshioka, E., Saijo, Y., FUKUI, T., Ueno, T., & Kishi, R. (2009) · Industrial Health · doi:10.2486/indhealth.47.173 · Cited by 21
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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