To investigate whether chronic psychosocial work stressors (low job control, high job demands, job strain, low supervisor and coworker support, job insecurity, and long work hours) are longitudinally associated with suicidal ideation in a working population.
Five-hundred seventy-eight workers (aged 34–69) were chosen for this analysis from those who participated in both project 1 (2004–2006 at baseline) and project 4 (2004–2009 at follow-up) of the Midlife Development in the United States II study. The median time interval between the two projects was 26 months (range 2–62 months).
About 11% of the workers reported suicidal ideation at follow-up, while 3% of them reported moderate/severe suicidal ideation at follow-up. After controlling for age, marital status, race, family history of suicide, and suicidal ideation at baseline, low skill discretion and job strain (a combination of low job control and high job demands) were associated with total suicidal ideation. After excluding those with suicidal ideation at baseline from analysis and further controlling for other work stressors, job strain was strongly associated with moderate/severe suicidal ideation: ORs, 4.29 (1.30–14.15) for quartile-based job strain and 3.77 (1.21–11.70) for median-based job strain. Long work hours (> 40 h/week vs. ≤ 40 h/week) also increased the likelihood for moderate/severe suicidal ideation: OR 4.06 (1.08–15.19).
Job strain and long work hours were longitudinally associated with moderate/severe suicidal ideation. Increasing job control and ensuring optimal level of work demands, including 40 h or less of work per week may be an important strategy for the prevention of suicide in working populations.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Amagasa T, Nakayama T, Takahashi Y (2005) Karojisatsu in Japan: characteristics of 22 cases of work-related suicide. J Occup Health 47(2):157–164
Baumert J, Schneider B, Lukaschek K et al (2014) Adverse conditions at the workplace are associated with increased suicide risk. J Psychiatr Res 57:90–95
Bond FW, Bunce D (2001) Job control mediates change in a work reorganization intervention for stress reduction. J Occup Health Psychol 6(4):290–302
Centers for Disease Control and Prevention (CDC) (2013) Suicide among adults aged 35–64 years—United States, 1999–2010. Mortal Morb Wkly Rep 62(17):321–325
Choi B, Kawakami N, Chang S et al (2008) A cross-national study on the multidimensional characteristics of the five-item psychological demands scale of the job content questionnaire. Int J Behav Med 15(2):120–132
Choi B, Schnall PL, Yang H et al (2010a) Sedentary work, low physical job demand, and obesity in US workers. Am J Ind Med 53(11):1088–1101
Choi B, Schnall PL, Yang H et al (2010b) Psychosocial working conditions and active leisure-time physical activity in middle-aged us workers. Int J Occup Med Environ Health 23(3):239–253
Choi B, Kurowski A, Bond M et al (2012) Occupation-differential construct validity of the job content questionnaire (JCQ) psychological job demands scale with physical job demands items: a mixed methods research. Ergonomics 55(4):425–439
Choi B, Schnall P, Landsbergis P et al (2015) Recommendations for individual participant data meta-analyses on work stressors and health outcomes: comments on IPD-Work Consortium papers. Scand J Work Environ Health 41(3):299–311
Crandall M, Sridharan L, Schermer C (2010) Depression and thoughts of death among disadvantaged mothers: risk factors and impact on maternal and child health. Arch Suicide Res 14(3):248–260
Curtin SC, Warner M, Hedegaard H (2016) Increase in suicide in the United States, 1999–2014. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. https://www.cdc.gov/nchs/products/databriefs/db241.htm
Dienberg Love G, Seeman TE, Weinstein M et al (2010) Bioindicators in the MIDUS national study: protocol, measures, sample, and comparative context. J Aging Health 22(8):1059–1080
Evans GW, Johansson G, Rydstedt L (1999) Hassles on the job: a study of a job intervention with urban bus drivers. J Organ Behav 20(2):199–208
Garcia-Rojas IJ, Choi B, Krause N (2015) Psychosocial job factors and biological cardiovascular risk factors in Mexican workers. Am J Ind Med 58(3):331–351
Karasek RA (1979) Job demands, job decision latitude, and mental strain: implications for job redesign. Adm Sci Q 24(2):285–308
Karasek RA, Gordon G, Pietrokovsky C et al (1985) Job Content Questionnaire and User’s Guide. Los Angeles (CA). University of Southern California/University of Massachusetts, Lowell (MA)
Karasek R, Choi B, Ostergren PO et al (2007) Testing two methods to create comparable scale scores between the Job Content Questionnaire (JCQ) and JCQ-like questionnaires in the European JACE Study. Int J Behav Med 14(4):189–201
Kessler RC, Andrews G, Mroczek D et al (1998) The world health organization composite international diagnostic interview short form (CIDI-SF). Int J Meth Psych Res 7(4):171–185
Kim MS, Hong YC, Yook JH et al (2017) Effects of perceived job insecurity on depression, suicide ideation, and decline in self-rated health in Korea: a population-based panel study. Int Arch Occup Environ Health 90(7):663–671
Kivimäki M, Head J, Ferrie JE et al (2006) Why is evidence on job strain and coronary heart disease mixed? An illustration of measurement challenges in the Whitehall II study. Psychosom Med 68(3):398–401
Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16(9):606–613
Lee J, Kim I, Roh S (2016) Descriptive study of claims for occupational mental disorders or suicide. Ann Occup Environ Med 28:61
Loerbroks A, Cho SI, Dollard MF et al (2016) Associations between work stress and suicidal ideation: Individual-participant data from six cross-sectional studies. J Psychosom Res 90:62–69
Milner A, Page K, Spencer-Thomas S et al (2015) Workplace suicide prevention: a systematic review of published and unpublished activities. Health Promot Int 30(1):29–37
Milner A, Page K, Witt K et al (2016) Psychosocial working conditions and suicide ideation: evidence from a cross-sectional survey of working Australians. J Occup Environ Med 58(6):584–587
Milner A, Witt K, LaMontagne AD et al (2017) Psychosocial job stressors and suicidality: a meta-analysis and systematic review. Occup Environ Med. https://doi.org/10.1136/oemed-2017-104531. (Epub ahead of print)
Milos G, Spindler A, Hepp U et al (2004) Suicide attempts and suicidal ideation: links with psychiatric comorbidity in eating disorder subjects. Gen Hosp Psychiatry 26(2):129–135
Neeleman J, de Graaf R, Vollebergh W (2004) The suicidal process; prospective comparison between early and later stages. J Affect Disord 82(1):43–52
Nock MK, Borges G, Bromet EJ et al (2008) Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry 192(2):98–105
Olson LM, Wahab S (2006) American Indians and suicide: a neglected area of research. Trauma Violence Abuse 7(1):19–33
Orpen C (1979) The effects of job enrichment on employee satisfaction, motivation, involvement, and performance: a field experiment. Hum Relat 32(3):189–217
Ostry A, Maggi S, Tansey J et al (2007) The impact of psychosocial work conditions on attempted and completed suicide among western Canadian sawmill workers. Scand J Soc Med 35:265–271
Phillips JA, Nugent CN (2014) Suicide and the Great Recession of 2007–2009: the role of economic factors in the 50 US states. Soc Sci Med 116:22–31
Rockett IR, Regier MD, Kapusta ND et al (2012) Leading causes of unintentional and intentional injury mortality: United States, 2000–2009. Am J Public Health 102(11):e84–e92
Ryff C, Almeida DM, Ayanian JS et al (2007) Midlife Development in the United States (MIDUS II), 2004–2006 [computer file]. ICPSR04652-v1. Ann Arbor (MI): Inter-university Consortium for Political and Social Research [distributor], 2007-03-22. https://doi.org/10.3886/ICPSR04652
Ryff C, Seeman T, Weinstein M (2013) National Survey of Midlife Development in the United States (MIDUS II): Biomarker Bibliographic Citation. Project, ICPSR29282-v6. Ann Arbor. https://doi.org/10.3886/ICPSR29282.v6 (distributor, 2013-12–20)
Schiller H, Lekander M, Rajaleid K et al (2017) The impact of reduced work time on sleep and perceived stress—a group randomized intervention study using diary data. Scand J Work Environ Health 43(2):109–116
Schneider B, Grebner K, Schnabel A et al (2011) Impact of employment status and work-related factors on risk of completed suicide. A case-control psychological autopsy study. Psychiatry Res 190(2–3):265–270
Simon GE, Rutter CM, Peterson D et al (2013) Does response on the PHQ-9 Depression Questionnaire predict subsequent suicide attempt or suicide death? Psychiatr Serv 64(12):1195–1202
ten Have M, de Graaf R, van Dorsselaer S et al (2009) Incidence and course of suicidal ideation and suicide attempts in the general population. Can J Psychiatry 54(12):824–833
Tiesman HM, Konda S, Hartley D et al (2015) Suicide in U.S. Workplaces, 2003–2010: a comparison with non-workplace suicides. Am J Prev Med 48(6):674–682
Tsutsumi A, Kayaba K, Ojima T et al (2007) Low control at work and the risk of suicide in Japanese men: a prospective cohort study. Psychother Psychosom 76(3):177–185
Walker J, Hansen CH, Hodges L et al (2010) Screening for suicidality in cancer patients using Item 9 of the nine-item patient health questionnaire; does the item score predict who requires further assessment? Gen Hosp Psychiatry 32(2):218–220
Wang YG, Chen S, Xu ZM et al (2017) Family history of suicide and high motor impulsivity distinguish suicide attempters from suicide ideators among college students. J Psychiatr Res 90:21–25
Watson D, Clark LA, Weber K et al (1995) Testing a tripartite model: II. Exploring the symptom structure of anxiety and depression in student, adult, and patient samples. J Abnorm Psychol 104(1):15–25
World Health Organization (WHO) (2006) Preventing Suicide: a resource at work. World Health Organization. http://apps.who.int/iris/bitstream/10665/43502/1/9241594381_eng.pdf
World Health Organization (WHO) (2014) Preventing Suicide: a global imperative. WHO. http://apps.who.int/iris/bitstream/10665/131056/8/9789241564878_eng.pdf?ua=1&ua=1
World Health Organization (WHO) (2017) Suicide. http://www.who.int/mediacentre/factsheets/fs398/en
Conflict of interest
The author declares that he has no conflict of interest.
For this type of study formal consent is not required.
About this article
Cite this article
Choi, B. Job strain, long work hours, and suicidal ideation in US workers: a longitudinal study. Int Arch Occup Environ Health 91, 865–875 (2018). https://doi.org/10.1007/s00420-018-1330-7
- MIDUS II study
- Job strain
- Skill discretion
- Work demands
- Work hours