Mental Health
Population fraction of physician-diagnosed depression attributable to psychosocial stressors at work: Results of the PROspective Quebec Study on Work and Health Mathilde Lavigne-Robichaud* Mathilde Lavigne-Robichaud Ana Paula Bruno Pena Gralle Denis Talbot alain milot Gilbert-Ouimet, M. Brisson, C. Xavier Trudel
Background: Psychosocial stressors at work are risk factors for the incidence of depression. However, no previous prospective studies examined the fraction of diagnosed depression cases attributable to these work stressors.
Objective: To estimate the fraction of diagnosed depression events attributable to psychosocial stressors at work.
Method: This is a prospective study including 6,846 white-collar workers (1999-2001) free of depression in the year prior to baseline and followed up for 5 years. Psychosocial stressors at work were measured according to the job strain and effort-reward imbalance (ERI) models. Incident depression events were identified in medical databases with universal coverage. Attributable fractions (AFs) were estimated using the Kaplan-Meier method, with multiple imputation and inverse probability weighting applied to address selection and confounding biases.
Results: The estimated AF for job strain over 3 years was 16.8% (95% confidence interval [CI]: -5.2% to 38.9%). The AF for ERI over 3 years was 12.1% (95% CI: 1.5% to 22.8%). The AF for combined exposure to job strain and ERI was 42.0% (95% CI: 16.3% to 67.7%). Over a 5-year period, AFs for all exposures decreased but remained within the margin of the confidence intervals.
Conclusion: In the present study, psychosocial stressors at work were significant contributors to physician-diagnosed depression. Results suggest that a substantial proportion of incident depression cases—up to 42% in some exposure scenarios—could be prevented by reducing the prevalence of psychosocial stressors at work.