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Cited by 219Workplace Health and Well-beingSleep and Work-Related FatigueWorkaholism, burnout, and well-being

Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

Open access
Virtanen, Marianna, Jokela, Markus, Madsen, Ida EH, Magnusson Hanson, Linda L, Lallukka, Tea, Nyberg, Solja T, Alfredsson, Lars, Batty, G David +29 more·2018·Scandinavian Journal of Work, Environment & Health
DOI 10.5271/sjweh.3712
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Abstract

Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. Methods We searched PubMed and Embase for published prospective cohort studies and included available cohorts with unpublished individual-participant data. We used a random-effects meta-analysis to calculate summary estimates across studies. Results We identified ten published cohort studies and included unpublished individual-participant data from 18 studies. In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1–5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence interval (CI) 1.03–1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2 =45.1%, P=0.004). A moderate association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13–2.01), a weaker association in Europe (1.11, 95% CI 1.00–1.22), and no association in North America (0.97, 95% CI 0.70–1.34) or Australia (0.95, 95% CI 0.70–1.29). Differences by other characteristics were small. Conclusions This observational evidence suggests a moderate association between long working hours and onset of depressive symptoms in Asia and a small association in Europe.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis combined published and unpublished individual-participant data from 28 prospective cohort studies (189,729 participants, 35 countries) to quantify the association between long working hours and onset of depressive symptoms. It found an overall modest increased risk (OR 1.14, 95% CI 1.03–1.25), with a stronger association in Asia (OR 1.50) and a small association in Europe (OR 1.11), but no association in North America or Australia.

Key findings

  • Overall multivariable-adjusted OR for long working hours and new-onset depressive symptoms was 1.14 (95% CI 1.03–1.25), with significant heterogeneity (I²=45.1%, P=0.004).
  • By region: Asia OR 1.50 (95% CI 1.13–2.01); Europe OR 1.11 (95% CI 1.00–1.22); North America OR 0.97 (95% CI 0.70–1.34); Australia OR 0.95 (95% CI 0.70–1.29). Asia differed significantly from other regions (P=0.034 heterogeneity test; P=0.041 meta-regression).
  • Published studies showed OR 1.35 (95% CI 1.07–1.71) versus unpublished data OR 1.08 (95% CI 1.00–1.16); occupational cohorts showed OR 1.34 (95% CI 1.10–1.62) versus population-based studies OR 1.07 (95% CI 0.96–1.20).
  • Other subgroup differences were small; no significant differences were found by sex, age group, socioeconomic status, study baseline year, study quality, follow-up length, response rate, loss to follow-up, outcome type, or population prevalence/onset of symptoms.

Methods

  • Systematic review and random-effects meta-analysis following PRISMA; searched PubMed and Embase to January 2017, plus reference lists and cited-reference searches, identifying 10 published prospective cohort studies and including unpublished individual-participant data from 18 studies (28 total).
  • Included 189,729 participants (96,275 men, 93,454 women) from 35 countries, follow-up 1–5 years, with 21,747 new-onset cases; long working hours was most often defined as ≥55 hours/week versus 35–40 hours/week as reference.
  • In individual-participant data studies, ORs were adjusted for age, sex, socioeconomic status, and marital status; published studies used the closest available adjustment. Analyses used random-effects meta-analysis, I², meta-regression, and Egger’s test.

Limitations

  • Paper-stated: exposure was self-reported and measured only once, risking recall bias and misclassification; exposure definitions varied across published studies; outcome assessment varied (psychological distress, depressive symptoms, or clinical depression), though associations were similar across outcome types; only three studies used structured DSM-III/DSM-IV interviews.
  • Paper-stated: observational design cannot establish causality; unmeasured confounding (e.g., work-related factors, alcohol use) cannot be ruled out; most studies were from high-income countries, so findings are not generalizable to low- or middle-income countries.
  • Evident from the text: subgroup differences by publication status and cohort type were based on limited numbers, including only one Asian study in the unpublished group and one in the population-based group, so those subgroup findings may be unstable; mediation by effort–reward or effort–recovery imbalance was not tested.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.5271/sjweh.3712

Cites

94 of 94 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

18 of 51 cited sources checked · 12 supported · 0 flagged · accuracy not yet measured

  • Premisecitation
    § Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

    Although several reviews of this field exist, the few systematic quantifications of the evidence have been based on published cross-sectional or published longitudinal studies.

    “However, although several reviews of this field exist (5, 9-24), the few systematic quantifications of the evidence have been based on published cross-sectional (18, 19, 25) or published longitudinal studies ( 26).”
    Quote in the paperSubstantial claim5 of 10 sources checked
    • cites [5] 5. Theorell T, Hammarström A, Aronsson G, Träskman Bendz L, Grape T, Hogstedt C et al. A systematic review including meta-analysis of work environment and depressive symptoms. BMC Public Health 2015 Aug;15(1):738. http:// dx.doi.org/10.1186/s12889-015-1954-4 source
    • cites [9] 9. Bannai A, Tamakoshi A. The association between long working hours and health: a systematic review of epidemiological evidence. Scand J Work Environ Health 2014 Jan;40(1):5-18. http://dx.doi.org/10.5271/sjweh.3388 source

      The Search procedure and Results sections show that this paper systematically reviewed published studies of long working hours and health. The Figure 1 passage says its 19 included studies comprised 7 cross-sectional and 12 prospective cohort studies, so it does not support characterizing this review as based only on cross-sectional studies. The cited passages describe a systematic review, but do not establish that it quantitatively pooled the evidence. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
    • cites [10] 10. Papadopoulos G, Georgiadou P, Papazoglou C, Michaliou K. Occupational and public health and safety in a changing work environment: an integrated approach for risk assessment and prevention. Saf Sci 2010 Oct;48(8):943-9. http://dx.doi.org/10.1016/j.ssci.2009.11.002 source
    • cites [11] 11. Caruso CC. Possible broad impacts of long work hours. Ind Health 2006 Oct;44(4):531-6. http://dx.doi.org/10.2486/ indhealth.44.531

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [12] 12. Caruso CC, Bushnell T, Eggerth D, Heitmann A, Kojola B, Newman K et al. Long working hours, safety, and health: toward a National Research Agenda. Am J Ind Med 2006 Nov;49(11):930-42. http://dx.doi.org/10.1002/ajim.20373 source
    • cites [13] 13. Caruso CC, Hitchcock EM, Dick RB, Russo JM, Schmit JM. Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries, and Health Behaviors. Cincinnati: U. S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 2004. source
    • cites [14] 14. Johnson JV, Lipscomb J. Long working hours, occupational health and the changing nature of work organization. Am J Ind Med 2006 Nov;49(11):921-9. http://dx.doi.org/10.1002/ ajim.20383 source
    • cites [15] 15. Fujino Y, Horie S, Hoshuyama T, Tsutsui T, Tanaka Y. [A systematic review of working hours and mental health burden]. Sangyo Eiseigaku Zasshi 2006 Jul;48(4):87-97. http://dx.doi.org/10.1539/sangyoeisei.48.87 source
    • cites [16] 16. Spurgeon A, Harrington JM, Cooper CL. Health and safety problems associated with long working hours: a review of the current position. Occup Environ Med 1997 Jun;54(6):367-75. http://dx.doi.org/10.1136/oem.54.6.367 source
    • cites [17] 17. van der Hulst M. Long workhours and health. Scand J Work Environ Health 2003 Jun;29(3):171-88. http://dx.doi. org/10.5271/sjweh.720 source

      The Reviews section identifies this paper as a systematic narrative review, supporting its use as an example of an existing review. The Gaps section says it did not take effect sizes into account, so it does not support treating this paper as a systematic quantification of evidence based on published cross-sectional or longitudinal studies. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Premisereasoning
    § Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

    Previous reviews on long working hours and mental health have not addressed whether there are systematic differences in the association between long working hours and mental health between countries and employee groups.

    “These issues have not been addressed in previous reviews on long working hours and mental health.”
    Quote in the paperSubstantial claim5 of 10 sources checked
    • cites [5] 5. Theorell T, Hammarström A, Aronsson G, Träskman Bendz L, Grape T, Hogstedt C et al. A systematic review including meta-analysis of work environment and depressive symptoms. BMC Public Health 2015 Aug;15(1):738. http:// dx.doi.org/10.1186/s12889-015-1954-4 source

      The Background (page unavailable) says previous reviews had not sufficiently addressed gender differences in the relationship between working conditions and depressive symptoms. That supports a narrower gap concerning one employee grouping, but the paper does not make the claimed point about country differences or specifically about long working hours and mental health. Its Results (page unavailable) also report comparisons across occupational groups in this review. (LLM, conf=0.72)

      Experimental — accuracy not yet measured
    • cites [9] 9. Bannai A, Tamakoshi A. The association between long working hours and health: a systematic review of epidemiological evidence. Scand J Work Environ Health 2014 Jan;40(1):5-18. http://dx.doi.org/10.5271/sjweh.3388 source
    • cites [10] 10. Papadopoulos G, Georgiadou P, Papazoglou C, Michaliou K. Occupational and public health and safety in a changing work environment: an integrated approach for risk assessment and prevention. Saf Sci 2010 Oct;48(8):943-9. http://dx.doi.org/10.1016/j.ssci.2009.11.002 source
    • cites [11] 11. Caruso CC. Possible broad impacts of long work hours. Ind Health 2006 Oct;44(4):531-6. http://dx.doi.org/10.2486/ indhealth.44.531

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [12] 12. Caruso CC, Bushnell T, Eggerth D, Heitmann A, Kojola B, Newman K et al. Long working hours, safety, and health: toward a National Research Agenda. Am J Ind Med 2006 Nov;49(11):930-42. http://dx.doi.org/10.1002/ajim.20373 source
    • cites [13] 13. Caruso CC, Hitchcock EM, Dick RB, Russo JM, Schmit JM. Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries, and Health Behaviors. Cincinnati: U. S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 2004. source
    • cites [14] 14. Johnson JV, Lipscomb J. Long working hours, occupational health and the changing nature of work organization. Am J Ind Med 2006 Nov;49(11):921-9. http://dx.doi.org/10.1002/ ajim.20383 source
    • cites [15] 15. Fujino Y, Horie S, Hoshuyama T, Tsutsui T, Tanaka Y. [A systematic review of working hours and mental health burden]. Sangyo Eiseigaku Zasshi 2006 Jul;48(4):87-97. http://dx.doi.org/10.1539/sangyoeisei.48.87 source
    • cites [16] 16. Spurgeon A, Harrington JM, Cooper CL. Health and safety problems associated with long working hours: a review of the current position. Occup Environ Med 1997 Jun;54(6):367-75. http://dx.doi.org/10.1136/oem.54.6.367 source

      In the review’s mental-health discussion (section labeled “4`6”; page not supplied), the authors explicitly report that overtime was a much greater source of stress for managerial and professional groups than for clerical groups. That undercuts the claim that employee-group differences were not addressed. The passages discuss studies from several countries but do not assess systematic differences between countries. (LLM, conf=0.78)

      Experimental — accuracy not yet measured
    • cites [17] 17. van der Hulst M. Long workhours and health. Scand J Work Environ Health 2003 Jun;29(3):171-88. http://dx.doi. org/10.5271/sjweh.720 source

      In “Gaps in the current literature and recommendations for future research” (page not provided), van der Hulst says that studies in the review rarely examined factors that might change the relationship between long workhours and health. This supports the general point that differences across groups were underexamined, but the passage does not specifically say that previous reviews failed to address differences between countries or employee groups in the association with mental health. (LLM, conf=0.78)

      Experimental — accuracy not yet measured
  • Premisecitation
    § Discussion

    Long working hours has been found to be only modestly associated with risky alcohol use.

    “and long working hours has been found to be only modestly associated with risky alcohol use (30).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [30] 30. Virtanen M, Jokela M, Nyberg ST, Madsen IE, Lallukka T, Ahola K et al. Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data. BMJ 2015 Jan;350:g7772. source
  • Premisecitation
    § Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

    There is potential publication bias in studies based on published data.

    “Given the potential publication bias in studies based on published data (27)”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [27] 27. Kivimäki M, Nyberg ST, Batty GD, Fransson EI, Heikkilä K, Alfredsson L et al.; IPD-Work Consortium. Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. Lancet 2012 Oct;380(9852):1491-7. http://dx.doi.org/10.1016/S01406736(12)60994-5 source
  • Findingown data
    § Long working hours and onset of depressive symptoms

    In other published studies, the odds ratio for the association between long working hours and depressive symptoms was 1.07 (95% CI 0.74-1.55).

    “whereas it was 1.07 (95% CI 0.74-1.55) in other published studies”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 21
  • May combine two claims. 21
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation
    § Search strategy and selection criteria

    The review followed PRISMA guidelines.

    “Following the PRISMA guidelines (28), we carried out systematic searches of the PubMed and Embase databases”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [28] 28. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009 Jul;6(7):e1000097. http://dx.doi.org/10.1371/journal. pmed.1000097 source

  • Classified as probably not a substantial claim.

    Premisecitation
    § Assessment of long working hours

    Previous evidence suggests that working at least 55 hours per week may be harmful for health.

    “With previous evidence suggesting that working ≥55 hours per week may be harmful for health (29, 30)”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [29] 29. Kivimaki M, Jokela M, Nyberg ST, Singh-Manoux A, Fransson EI, Alfredsson L et al. Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals. Lancet 2015 Oct;386(10005):173946. http://dx.doi.org/10.1016/S0140-6736(15)60295-1 source
    • cites [30] 30. Virtanen M, Jokela M, Nyberg ST, Madsen IE, Lallukka T, Ahola K et al. Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data. BMJ 2015 Jan;350:g7772. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

    There is growing evidence to suggest a link between work characteristics and the onset of depression, with perceived psychosocial work stress being the most often investigated work exposure.

    “There is growing evidence to suggest a link between work characteristics and the onset of depression, with perceived psychosocial work stress being the most often investigated work exposure (2-7).”
    Quote in the paperNot a substantial claim3 of 6 sources checked
    • cites [2] 2. Stansfeld S, Candy B. Psychosocial work environment and mental health--a meta-analytic review. Scand J Work Environ Health 2006 Dec;32(6):443-62. http://dx.doi. org/10.5271/sjweh.1050 source

      The Methods and Results (pages not provided) describe a review of psychosocial work characteristics and subsequent common mental disorders, including depression; 10 of the 11 studies in its meta-analysis used a modified Job Content Questionnaire to measure work exposure. This supports the emphasis on perceived psychosocial work conditions, but the review does not establish that perceived psychosocial work stress was the most often investigated exposure specifically for the onset of depression: most included studies measured broader or symptomatic mental-health outcomes. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [3] 3. Bonde JP. Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence. Occup Environ Med 2008 Jul;65(7):438-45. http://dx.doi.org/10.1136/oem.2007.038430 source
    • cites [4] 4. Netterstrøm B, Conrad N, Bech P, Fink P, Olsen O, Rugulies R et al. The relation between work-related psychosocial factors and the development of depression. Epidemiol Rev 2008;30:118-32. http://dx.doi.org/10.1093/epirev/mxn004 source
    • cites [5] 5. Theorell T, Hammarström A, Aronsson G, Träskman Bendz L, Grape T, Hogstedt C et al. A systematic review including meta-analysis of work environment and depressive symptoms. BMC Public Health 2015 Aug;15(1):738. http:// dx.doi.org/10.1186/s12889-015-1954-4 source
    • cites [6] 6. Siegrist J. Chronic psychosocial stress at work and risk of depression: evidence from prospective studies. Eur Arch Psychiatry Clin Neurosci 2008 Nov;258 Suppl 5:115-9. http://dx.doi.org/10.1007/s00406-008-5024-0 source
    • cites [7] 7. Madsen IE, Nyberg ST, Magnusson Hanson LL, Ferrie JE, - Ahola K, Alfredsson L et al.; IPD-Work Consortium. Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data. Psychol Med 2017 Jun;47(8):1342-56. http://dx.doi.org/10.1017/S003329171600355X source

  • May combine two claims.

    Findingown data
    § Long working hours and onset of depressive symptoms

    There were no significant subgroup differences in the association between long working hours and depressive symptoms by study baseline year, study quality, length of follow-up, response rate, loss to follow-up, outcome type, population prevalence of symptoms at baseline, or population onset of symptoms.

    “Meta-regression P-values for other estimates (not shown in the figure) were as follows: study baseline year P=0.458; study quality P=0.440; length of follow-up P=0.958; response rate P=0.805; loss to follow-up P=0.720; outcome type P=0.415; population prevalence of symptoms at baseline P=0.880; population onset of symptoms P=0.308.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

    In the majority of cohorts, long working hours was defined as working at least 55 hours per week.

    “In the majority of cohorts, long working hours was defined as working ≥55 hours per week.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Unpublished individual participant data

    The total number of participants in published studies and individual participant data was 189,729 (96,275 men, 93,454 women) from 35 countries, with 21,747 new-onset depressive symptom cases (average onset 11.5%).

    “In total, the number of participants in published studies and individual participant data was 189 729 (96 275 men, 93 454 women) from 35 countries. The number of cases with new-onset depressive symptoms was 21 747 (the average onset 11.5%).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data
    § Quality assessment

    The three studies that lost quality score points did so due to lack of confounder adjustments and inadequate exposure.

    “The three studies lost score points due to lack of confounder adjustments and inadequate exposure.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Quality assessment

    Study quality scores ranged between 7 and 11 out of 14, and all but three of the 28 studies were considered high/acceptable quality.

    “The scores ranged between 7-11 out of the best possible 14 points; the best (11 points) in the present analysis being assigned to the studies by Shields (56) and Niedhammer et al (60). Of the 28 studies, all but three (54, 55, 58) were considered being of high /acceptable quality, that is, having no components with serious threat of bias.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § Literature search results

    None of the excluded studies suggested an association between working hours and mental health.

    “None of these studies suggested an association between working hours and mental health.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

    The review identified ten published cohort studies and included unpublished individual-participant data from 18 studies.

    “We identified ten published cohort studies and included unpublished individual-participant data from 18 studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Long working hours and onset of depressive symptoms

    The Egger test did not show evidence for publication bias among the ten published estimates or among the subgroup of Asian-origin studies.

    “The Egger test of publication bias did not show evidence for publication bias neither among the ten published estimates nor among the subgroup of Asian-origin studies.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data
    § Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

    Differences in the association between long working hours and depressive symptoms by characteristics other than geographic region, publication status, and population type were small.

    “Differences by other characteristics were small.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Assessment of long working hours

    The European Union Directive recommends a limit of 48 hours per week.

    “with the European Union Directive recommending a limit of 48 hours per week (82)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [82]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Discussion

    In the ideal scenario, working long hours is voluntary and leads to increased rewards; the unfavorable scenario involves involuntary long working hours combined with low rewards.

    “In the ideal scenario, working long hours is voluntary and leads to increased rewards; the unfavorable scenario involves involuntary long working hours combined with low rewards (84).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [84]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data
    § Search strategy and selection criteria

    Two authors independently reviewed titles and abstracts and carried out full-text review against inclusion criteria.

    “Two authors independently reviewed titles and abstracts of the articles and, for selected publications, carried out fulltext review against inclusion criteria.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Premisecitation
    § Discussion

    In Japan, sense of community is a fundamental feature of society, and an important endeavor in individuals is to be in harmony with the community including working community rather than achieving individualistic goals.

    “In addition, in Japan, sense of community is a fundamental feature of the society, and an important endeavor in individuals is to be in harmony with the community including working community - rather than achieving one's individualistic goals (87).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [87]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisenone given
    § Discussion

    All previous meta-analyses were exclusively based on published data and their ability to examine subgroup differences was limited.

    “However, all previous meta-analyses were exclusively based on published data and their ability to examine subgroup differences was limited.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation
    § Discussion

    Two previous meta-analyses published in 1997 and 2008, mainly based on cross-sectional data, reported a weak linear correlation between hours worked and mental strain, consistent with the present findings.

    “Of the three previous meta-analyses of the association between long working hours and mental health, two were published in 1997 (18) and 2008 (19), and were mainly based on cross-sectional data. They reported a weak linear correlation between hours worked and”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [18] 18. Sparks K, Cooper C, Fried Y, Shirom A. The effects of hours of work on health: a meta-analytic review. J Occup Organ Psychol 1997;70(4):391-408. http://dx.doi. org/10.1111/j.2044-8325.1997.tb00656.x source
    • cites [19] 19. Ng TW, Feldman TC. Long work hours: a social identity perspective on meta-analysis data. J Organ Behav 2008;29(7):853-80. http://dx.doi.org/10.1002/job.536 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Discussion

    The effort-recovery model posits that long working hours may reduce the time for recovery to an extent that increases the risk of fatigue and associated mental health symptoms.

    “Another theoretical framework, the effort-recovery model (85) posits that long working hours may reduce the time for recovery to an extent that increases the risk of fatigue and associated mental health symptoms.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [85]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation
    § Discussion

    A more recent meta-analysis identified seven published prospective studies and a summary estimate indicating an increased but statistically nonsignificant risk of clinical depressive disorder associated with long working hours (RR=1.08).

    “A more recent meta-analysis identified seven published prospective studies and a summary estimate which indicated an increased (RR=1.08) but statistically nonsignificant risk of clinical depressive disorder associated with long working hours (26).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] 26. Watanabe K, Imamura K, Kawakami N. Working hours and the onset of depressive disorder: a systematic review and meta-analysis. Occup Environ Med 2016 Dec;73(12):87784. doi:10.1136/oemed-2016-103845 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Discussion

    According to the effort-reward imbalance model, health risks of long working hours are smaller if efforts at work are rewarded by economic rewards, promotion, esteem, and high job security.

    “According to the effort-reward imbalance model (83), health risks of long working hours are smaller if efforts at work (long hours) are rewarded by economic rewards, promotion, esteem, and high job security.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [83]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning
    § Discussion

    Recall bias may artificially inflate the observed associations only if the error in the number of hours worked is systematically correlating with mental health status.

    “recall bias may artificially inflate the observed associations only if the error in the number of hours worked is systematically correlating with mental health status”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Discussion

    Sub-clinical depression has been shown to be a more important indicator of health than previously thought.

    “However, sub-clinical depression has been shown to be a more important indicator of health than previously thought (91)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [91]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data
    § Quality assessment

    Two authors assessed study quality using Cochrane's Tool to Assess Risk of Bias in Cohort Studies.

    “Two authors assessed study quality using Cochrane's 'Tool to Assess Risk of Bias in Cohort Studies' in the following domains”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning
    § Quality assessment

    In all studies, baseline cases were excluded to allow assessment of onset of depressive symptoms.

    “In all studies, the baseline cases were excluded in order to allow assessment of onset of depressive symptoms to be examined.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation
    § Discussion

    Previous studies show that long working hours are associated with high job demands and high control (active job) rather than high strain jobs (high demands with low control).

    “However, previous studies show that long working hours are associated with high job demands and high control (”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [92]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [93]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationcitation
    § Discussion

    Low job control and job strain are unlikely confounders of the association between long working hours and depressive symptoms.

    “making low job control and job strain unlikely confounders.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation
    § Quality assessment

    Publication bias in published studies was tested using a funnel plot and Egger's test for small-study effects.

    “We tested for publication bias in published studies by using the funnel plot of the estimates against their standard errors and Egger's test for small-study effects (32).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] 32. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997 Sep;315(7109):629-34. http://dx.doi.org/10.1136/ bmj.315.7109.629 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data
    § Discussion

    There was variation in how depressive symptoms were assessed across studies.

    “There was also variation in how depressive symptoms were assessed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning
    § Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data

    This review is the first large-scale study of the association between long working hours and onset of depressive symptoms, using large prospective data including cohort studies with both published and unpublished data.

    “With large prospective data including cohort studies with both published and unpublished data, this review is the first large-scale study of the association between long working hours and onset of depressive symptoms.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given
    § Unpublished individual participant data

    Each included study had existing approval from its relevant local or national ethics committee, and all participants had given informed consent.

    “Each study has existing approval from their relevant local or national ethics committee, and all participants had given informed consent.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given
    § Quality assessment

    In cohort studies with individual participant data, odds ratios were adjusted for age, sex, socioeconomic status, and marital status; for published studies, models closest to that set of adjustments were used.

    “In cohort studies with individual participant data, the OR were adjusted for age, sex, socioeconomic status, and marital status. For published studies, we used models that were closest to that set of adjustments.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data
    § Long working hours and onset of depressive symptoms

    A stronger association between long working hours and depressive symptoms in Asia than in other countries was found both in all studies and within published studies.

    “Thus, a stronger association in Asia than in other countries was found both in all studies and within published studies.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given
    § Discussion

    Bias due to unmeasured confounding cannot be ruled out in observational studies, which can only provide insights into association, not causality.

    “Furthermore, bias due to unmeasured confounding cannot be ruled out in observational studies, which can of course only provide insights into association, not causality.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given
    § Discussion

    Exposure to working hours was based on self-reports in all included studies and measured only once.

    “Exposure to working hours was based on self-reports in all studies and measured only once.”
    Quote in the paperSubstantial claim
35 of 35

  • The paper relies on this without support.

    Long working hours are more common in Asia and North America than in Europe.

    “Furthermore, long working hours are more common in Asia and North America than in Europe”

  • The paper relies on this without support.

    The risk of mental health problems is higher among women and individuals with low socioeconomic position than among men and those with high socioeconomic status.

    “and the risk of mental health problems is higher among women and individuals with low socioeconomic position than men and those with high socioeconomic status.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • CBPR engages the public and community providers-among other stakeholders-who both influence and are affected by the research topic.

    “CBPR engages the public and community providers- among other stakeholders- who both influence and are affected by the research topic (35).”

    From Research Publication Challenges Faced by Dentists in India: A Narrative Review of Multilevel Barriers (2026) · cites this paper as [35]

    The Unpublished individual participant data section describes data sources and participant consent, not community-based participatory research. Searches for CBPR and for public or community-provider stakeholder engagement found no passage in our copy addressing the claim; the Discussion’s mention of a working community concerns work culture instead. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Working-hour categories were not used in all unpublished datasets

    Minor

    The paper says the same working-hour categories, including a 35-40-hour reference group and a ≥55-hour highest group, were used in all unpublished datasets. It then says the Helsinki Health Study, one of those datasets, used a 30-40-hour reference group and a >50-hour highest group.

1 of 1

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Authors
Virtanen, M., Jokela, M., Madsen, I. E., Magnusson Hanson, L. L., Lallukka, T., Nyberg, S. T., Alfredsson, L., Batty, G. D., Bjorner, J. B., Borritz, M., Burr, H., Dragano, N., Erbel, R., Ferrie, J. E., Heikkilä, K., Knutsson, A., Koskenvuo, M., Lahelma, E., Nielsen, M. L., Oksanen, T., Pejtersen, J. H., Pentti, J., Rahkonen, O., Rugulies, R., Salo, P., Schupp, J., Shipley, M. J., Siegrist, J., Singh-Manoux, A., Suominen, S. B., Theorell, T., Vahtera, J., Wagner, G. G., Wang, J. L., Yiengprugsawan, V., Westerlund, H., & Kivimäki, M.
Affiliations
  • Uppsala University (SE)
  • University of Helsinki (FI)
  • Finnish Institute of Occupational Health (FI)
  • Region Stockholm (SE)
  • University College London (GB)
  • National Research Centre for the Working Environment (DK)
  • Federal Institute for Occupational Safety and Health (DE)
  • Heinrich Heine University Düsseldorf (DE)
  • West German Heart and Vascular Center Essen (DE)
  • London School of Hygiene & Tropical Medicine (GB)
  • Mid Sweden University (SE)
  • University of Copenhagen (DK)
  • University of Turku (FI)
  • German Institute for Economic Research (DE)
  • Stockholm University (SE)
Corresponding author
Virtanen, Marianna
ORCID
Venue
Scandinavian Journal of Work, Environment & Health
Publisher
Scandinavian Journal of Work, Environment and Health
Published
2018-02-08
Volume
44
Issue
3
Pages
239-250
ISSN
  • 0355-3140 (ISSN-L)
  • 1795-990X
DOI
10.5271/sjweh.3712
OpenAlex
W2785409727
Semantic Scholar
42a1eea10cca23e5a464e72f166877165a57ce5b
Cited by
219
References
95
Citations by year
2026: 18 · 2025: 22 · 2024: 37 · 2023: 32 · 2022: 30 · 2021: 35 · 2020: 20 · 2019: 18 · 2018: 6
FWCI
4.29
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Scandinavian Journal of Work Environment & Health (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
  • UTUPub (University of Turku) (submittedVersion, other-oa)
  • University Library of Skövde (University of Skövde) (submittedVersion, other-oa)
  • KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Econstor (Econstor) (submittedVersion, cc-by)
  • Työväentutkimus Vuosikirja (submittedVersion)
  • ANU Open Research (Australian National University) (submittedVersion, cc-by)
Funders
  • Työsuojelurahasto
  • NordForsk (75021, K013351, 311492)
  • Medical Research Council (MR/K013351/1, K013351, 311492, 258598)
  • Economic and Social Research Council (ES/J023299/1)
Topics
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Social Sciences › Psychology › Social Psychology › Workaholism, burnout, and well-being
Keywords
long working hours, depressive symptoms, depression onset, occupational stress, workplace mental health, individual patient data, cross-national comparison
MeSH terms
Asia, Depression, Europe, Female, Humans, Male, North America, Prospective Studies, Work Schedule Tolerance, Risk Assessment, Observational Studies as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-18.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-18.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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