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Demands, skill discretion, decision authority and social climate at work as determinants of major depression in a 3-year follow-up study

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Abstract

Purpose

The psychosocial work environment may be a determinant of the development and course of depressive disorders, but the literature shows inconsistent findings. Thus, the aim of this study is to determine longitudinal effects of the job demands–control–support model (JDCSM) variables on the occurrence of major depression among working men and women from the general population.

Methods

The sample comprised 4,710 working women and men living in Stockholm, who answered the same questionnaire twice, 3 years apart, who were not depressed during the first wave and had the same job in both waves. The questionnaire included JDCSM variables (demands, skill discretion, decision authority and social climate) and other co-variables (income, education, occupational group, social support, help and small children at home, living with an adult and depressive symptoms at time 1; and negative life events at time 2). Multiple logistic regressions were run to calculate odds ratios of having major depression at time 2, after adjustment for other JDCSM variables and co-variables.

Results

Among women, inadequate work social climate was the only significant risk indicator for major depression. Surprisingly, among men, high job demands and low skill discretion appeared as protective factors against major depression.

Conclusions

The results showed a strong relationship between inadequate social climate and major depression among women, while there were no certain effects for the remaining exposure variables. Among men, few cases of major depression hampered well-founded conclusions regarding our findings of low job demands and high skill discretion as related to major depression.

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Acknowledgments

The authors thank the PART project grant providers: the Swedish Medical Research Council, the Swedish Council for Working Life and Social Research and the Stockholm County Council (Grant number VR K2007-61X-20381-01-3). The PhD student support was provided by the COLFUTURO Foundation (Colombia), the ERACOL academic exchange programme (Erasmus Mundus External Cooperation—Europe) and Universidad del Valle (Colombia). We also wish to thank Professor Töres Theorell for valuable suggestions during the development of the study, Peeter Fredlund and Michael Lundberg for statistical advice and the Reviewers for suggestions for improving the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Norrbacka, Plan 7, Karolinska Hospital, 171 73, Stockholm, Sweden

    Andrés Fandiño-Losada & Yvonne Forsell

  2. School of Public Health/CISALVA Institute, Universidad del Valle, Cali, Colombia

    Andrés Fandiño-Losada

  3. Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala Universitet, Uppsala, Sweden

    Ingvar Lundberg

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  1. Andrés Fandiño-Losada
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  2. Yvonne Forsell
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  3. Ingvar Lundberg
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Correspondence to Andrés Fandiño-Losada.

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Fandiño-Losada, A., Forsell, Y. & Lundberg, I. Demands, skill discretion, decision authority and social climate at work as determinants of major depression in a 3-year follow-up study. Int Arch Occup Environ Health 86, 591–605 (2013). https://doi.org/10.1007/s00420-012-0791-3

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