Skip to main content


Log in

An examination of the long-term impact of job strain on mental health and wellbeing over a 12-year period

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript



Job strain has been implicated in a range of employee health outcomes including psychiatric health. Much of the literature is drawn from studies that utilise cross-sectional designs, whilst the long-term follow-up of participants is limited. We examine the short and long-term risks of job strain for depression and wellbeing over a 12-year period. In particular, we utilise measures of wellbeing to emphasise the importance of discriminating between indices of subjective and psychological wellbeing that complement measures of mental health.


Participants (n = 2530) were aged between 40 and 44 years at baseline and were drawn from the Personality and Total Health (PATH) Through Life Project. Participants were observed once every 4 years for 12 years.


A high strain job was associated with an increased risk of reporting sub-syndromal [RRR = 1.66 (95 % CI 1.23; 2.25), p < 0.001], minor [RRR = 1.92 (95 % CI 1.19; 3.10), p < 0.001] and major depression [RRR = 2.19 (95 % CI 1.30; 3.67), p < 0.001], but strain was not a long-term risk for depression 4 years later. In contrast, strain was a risk for both cross-sectional and longitudinal wellbeing outcomes. Moving into a high strain job was a risk for developing depression [RRR = 1.81 (95 % CI 1.26; 2.59), p < 0.001], but the cumulative exposure to a high strain job was not associated with poorer outcomes in adjusted models.


Overall, our results emphasise the importance of current job strain, and the risk of moving into a high strain job, on adverse mental health and wellbeing outcomes. Effects were not consistent between indices of mental health, subjective or psychological wellbeing, supporting the need to dedifferentiate between wellbeing and mental health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Theorell T, Karasek RA (1996) Current issues relating to psychosocial job strain and cardiovascular disease research. J Occup Health Psychol 1(1):9–26

    Article  CAS  PubMed  Google Scholar 

  2. Brunner EJ, Chandola T, Marmot MG (2007) Prospective effect of job strain on general and central obesity in the Whitehall II study. Am J Epidemiol 165(7):828–837

    Article  PubMed  Google Scholar 

  3. Nyberg ST, Fransson EI, Heikkila K, Alfredsson L, Casini A, Clays E et al (2013) Job strain and cardiovascular disease risk factors: meta-analysis of individual-participant data from 47,000 men and women. PLoS ONE 8(6). doi:10.1371/journal.pone.0067323

  4. Netterstrom B (2014) Job strain and hypertension. Occup Environ Med 71(3):157–158

    Article  PubMed  Google Scholar 

  5. Babu GR, Jotheeswaran AT, Mahapatra T, Mahapatra S, Kumar A Sr, Detels R et al (2014) Is hypertension associated with job strain? A meta-analysis of observational studies. Occup Environ Med 71(3):220–227

    Article  PubMed  Google Scholar 

  6. Faragher EB, Cass M, Cooper CL (2005) The relationship between job satisfaction and health: a meta-analysis. Occup Environ Med 62(2):105–112

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Stansfeld SA, Clark C, Caldwell T, Rodgers B, Power C (2008) Psychosocial work characteristics and anxiety and depressive disorders in midlife: the effects of prior psychological distress. Occup Environ Med 65(9):634–642

    Article  CAS  PubMed  Google Scholar 

  8. John U, Riedel J, Rumpf HJ, Hapke U, Meyer C (2006) Associations of perceived work strain with nicotine dependence in a community sample. Occup Environ Med 63(3):207–211

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Lallukka T, Lahelma E, Rahkonen O, Roos E, Laaksonen E, Martikainen P et al (2008) Associations of job strain and working overtime with adverse health behaviors and obesity: evidence from the Whitehall II study, Helsinki Health study, and the Japanese Civil Servants study. Soc Sci Med 66(8):1681–1698

    Article  PubMed  Google Scholar 

  10. Kouvonen A, Kivimaki M, Vaananen A, Heponiemi T, Elovainio M, Ala-Mursula L et al (2007) Job strain and adverse health behaviors: the Finnish public sector study. J Occup Environ Med 49(1):68–74

    Article  PubMed  Google Scholar 

  11. Stansfeld S, Candy B (2006) Psychosocial work environment and mental health—a meta-analytic review. Scand J Work Environ Health 32(6):443–462

    Article  PubMed  Google Scholar 

  12. Ahola K, Honkonen T, Isometsa E, Kalimo R, Nykyri E, Koskinen S et al (2006) Burnout in the general population. Results from the Finnish Health 2000 study. Soc Psychiatry Psychiatr Epidemiol 41(1):11–17

    Article  PubMed  Google Scholar 

  13. Wang MJ, Mykletun A, Moyner EI, Overland S, Henderson M, Stansfeld S et al (2014) Job strain, health and sickness absence: results from the Hordaland Health study. PLoS ONE 9(4). doi:10.1371/journal.pone.0096025

  14. Suominen S, Vahtera J, Korkeila K, Helenius H, Kivimaki M, Koskenvuo M (2007) Job strain, life events, and sickness absence: a longitudinal cohort study in a random population sample. J Occup Environ Med 49(9):990–996

    Article  PubMed  Google Scholar 

  15. McTernan WP, Dollard MF, LaMontagne AD (2013) Depression in the workplace: an economic cost analysis of depression-related productivity loss attributable to job strain and bullying. Work Stress 27(4):321–338

    Article  Google Scholar 

  16. Dollard MF, Winefield HR, Winefield AH, de Jonge J (2000) Psychosocial job strain and productivity in human service workers: a test of the demand-control-support model. J Occup Organ Psychol 73:501–510

    Article  Google Scholar 

  17. Soderberg M, Harenstam A, Rosengren A, Schioler L, Olin AC, Lissner L et al (2014) Psychosocial work environment, job mobility and gender differences in turnover behaviour: a prospective study among the Swedish general population. BMC Public Health 14:605. doi:10.1186/1471-2458-14-605

  18. Lamontagne A, Sanderson K, Cocker F (2010) Estimating the economic benefits of eliminating job strain as a risk factor for depression. VHPF (VicHealth), Carlton

    Google Scholar 

  19. Stansfeld SA, Shipley MJ, Head J, Fuhrer R (2012) Repeated job strain and the risk of depression: longitudinal analyses from the Whitehall II study. Am J Public Health 102(12):2360–2366

    Article  PubMed  PubMed Central  Google Scholar 

  20. Wang J, Schmitz N, Dewa C, Stansfeld S (2009) Changes in perceived job strain and the risk of major depression: results from a population-based longitudinal study. Am J Epidemiol 169(9):1085–1091

    Article  PubMed  Google Scholar 

  21. Tyssen R, Hem E, Gude T, Gronvold NT, Ekeberg O, Vaglum P (2009) Lower life satisfaction in physicians compared with a general population sample: a 10-year longitudinal, nationwide study of course and predictors. Soc Psychiatry Psychiatr Epidemiol 44(1):47–54

    Article  PubMed  Google Scholar 

  22. Ryff CD (1989) Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J Pers Soc Psychol 57(6):1069–1081

    Article  Google Scholar 

  23. Huppert FA, Marks N, Clark A, Siegrist J, Stutzer A, Vittersø J et al (2009) Measuring well-being across Europe: description of the ESS well-being module and preliminary findings. Soc Indic Res 91(3):301–315

    Article  Google Scholar 

  24. Jorm AF, Ryan SM (2014) Cross-national and historical differences in subjective well-being. Int J Epidemiol 43(2):330–340

    Article  PubMed  Google Scholar 

  25. Huppert FA, So TTC (2013) Flourishing across Europe: application of a new conceptual framework for defining well-being. Soc Indic Res 110(3):837–861

    Article  PubMed  PubMed Central  Google Scholar 

  26. Ryan RM, Deci EL (2001) On happiness and human potentials: a review of research on hedonic and eudaimonic well-being. Annu Rev Psychol 52:141–166

    Article  CAS  PubMed  Google Scholar 

  27. Headey B, Warren D (2008) Families, incomes and jobs. In: MIoAEaS (ed) Research. Volume 3: A statistical report on waves 1 to 5 of the HILDA Survey. Commonwealth of Australia, Melbourne

  28. Baird BM, Lucas RE, Donnellan MB (2010) Life satisfaction across the lifespan: findings from two nationally representative panel studies. Soc Indic Res 99(2):183–203

    Article  PubMed  PubMed Central  Google Scholar 

  29. Jorm AF (2000) Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychol Med 30(1):11–22

    Article  CAS  PubMed  Google Scholar 

  30. Henderson AS, Jorm AF, Korten AE, Jacomb P, Christensen H, Rodgers B (1998) Symptoms of depression and anxiety during adult life: evidence for a decline in prevalence with age. Psychol Med 28(6):1321–1328

    Article  CAS  PubMed  Google Scholar 

  31. Anstey KJ, Christensen H, Butterworth P, Easteal S, Mackinnon A, Jacomb T et al (2012) Cohort profile: the PATH through life project. Int J Epidemiol 41(4):951–960

    Article  PubMed  Google Scholar 

  32. Connor KM, Davidson JRT (2003) Development of a new resilience scale: the Connor–Davidson Resilience Scale (CD-RISC). Depress Anxiety 18(2):76–82

    Article  PubMed  Google Scholar 

  33. Burns RA, Anstey KJ (2010) The Connor–Davidson Resilience Scale (CD-RISC): testing the invariance of a uni-dimensional resilience measure that is independent of positive and negative affect. Pers Indiv Differ 48(5):527–531

    Article  Google Scholar 

  34. Liu DWY, Fairweather-Schmidt AK, Roberts RM, Burns R, Anstey KJ (2014) Does resilience predict suicidality? A lifespan analysis. Arch Suicide Res 18(4):453–464

    Article  CAS  PubMed  Google Scholar 

  35. Pearlin LI, Schooler C (1978) The structure of coping. J Health Soc Behav 19(1):2–21

    Article  CAS  PubMed  Google Scholar 

  36. Watson D, Clark LA, Tellegen A (1988) Development and validation of brief measures of positive and negative affect—the Panas Scales. J Pers Soc Psychol 54(6):1063–1070

    Article  CAS  PubMed  Google Scholar 

  37. Diener E, Emmons RA, Larsen RJ, Griffin S (1985) The Satisfaction with Life Scale. J Pers Assess 49(1):71–75

    Article  CAS  PubMed  Google Scholar 

  38. Pavot W, Diener E, Colvin CR, Sandvik E (1991) Further validation of the satisfaction with life scale—evidence for the cross-method convergence of well-being measures. J Pers Assess 57(1):149–161

    Article  CAS  PubMed  Google Scholar 

  39. Spitzer RL, Kroenke K, Williams JBW, Primary PHQ (1999) Validation and utility of a self-report version of PRIME-MD—the PHQ primary care study. JAMA J Am Med Assoc 282(18):1737–1744

    Article  CAS  Google Scholar 

  40. Kroenke K, Spitzer RL (2002) The PHQ-9: a new depression diagnostic and severity measure. Psychiat Ann 32(9):509–515

    Article  Google Scholar 

  41. Kroenke K, Spitzer RL, Williams JBW (2001) The PHQ-9—validity of a brief depression severity measure. J Gen Intern Med 16(9):606–613

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Kiely KM, Butterworth P (2015) Validation of four measures of mental health against depression and generalized anxiety in a community based sample. Psychiatry Res 225(3):291–298

  43. Bosma H, Marmot MG, Hemingway H, Nicholson AC, Brunner E, Stansfeld SA (1997) Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. BMJ 314(7080):558–565

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. D’Souza RM, Strazdins L, Clements MS, Broom DH, Parslow R, Rodgers B (2005) The health effects of jobs: status, working conditions, or both? Aust N Z J Public Health 29(3):222–228

    Article  PubMed  Google Scholar 

  45. D’Souza RM, Strazdins L, Lim LL, Broom DH, Rodgers B et al (2003) Work and health in a contemporary society: demands, control, and insecurity. J Epidemiol Community Health 57(11):849–854

  46. Lerner DJ, Levine S, Malspeis S, Dagostino RB (1994) Job strain and health-related quality-of-life in a national sample. Am J Public Health 84(10):1580–1585

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Eysenck HJ, Eysenck SBG (1975) Manual of the Eysenck Personality Questionnaire. Hodder and Stoughton, London

    Google Scholar 

  48. Parslow RA, Jorm AF, Christensen H, Rodgers B, Strazdins L, D’Souza RM et al (2004) The associations between work stress and mental health: a comparison of organizationally employed and self-employed workers. Work Stress 18(3):231–244

Download references


We thank Helen Christensen, Andrew MacKinnon, Simon Easteal, Anthony Jorm, Patricia Jacomb, Karen Maxwell, Kristine Koh, and the PATH interviewers. PATH has been supported by the Australian National Health and Medical Research Council (NHMRC Grant No. 973302, 179805, 350833, 157125). This manuscript was supported by the Australian Research Council Centre of Excellence in Population Ageing Research (Project #: CE110001029); ARC Future Fellowship (FT130101444 to PB); and an NHMRC Fellowship (#1002560 to KJA). The findings and views reported in this paper are those of the author(s) and not those of the original studies or their respective funding agencies.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Richard A. Burns.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Burns, R.A., Butterworth, P. & Anstey, K.J. An examination of the long-term impact of job strain on mental health and wellbeing over a 12-year period. Soc Psychiatry Psychiatr Epidemiol 51, 725–733 (2016).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: