Abstract
Entrepreneurial work can be challenging, including financial dependence on both the success of the venture and the continued work ability and well-being of the founder. Popular media suggests that entrepreneurs are at increased risk of depression and suicide; however, the research literature addressing this risk is unclear. Accordingly, this study aimed to explore what is known about depression among entrepreneurs. Scoping review and thematic synthesis of the findings. Thirty-four articles fit the criteria and corresponded to four overarching themes: Social relations, Personal factors, Work characteristics, and Mental health. Each theme contains sub-themes regarding the psychological impact of entrepreneurial work. These include personal factors such as gender, personality traits, and routine. Other factors include significant time demands, putting entrepreneurs at risk for social isolation and relationship strain. These may result in feelings of failure and shame, while stigma and a need to project a positive brand identity may prevent entrepreneurs from seeking the help that they need. This review demonstrates the variety of factors that impact entrepreneurs’ mental health. The themes that emerged from this work are congruent with a diathesis-stress model of depression. Together, these factors may contribute to a risk of depression and suicide among entrepreneurs that is, as yet, relatively unexplored in peer-reviewed research literature.
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References
Alt, S. (2019). Farmer suicides and the function of death in neoliberal biopolitics. International Political Sociology, 13(1), 37–52. https://doi.org/10.1093/ips/oly024.
American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Ed. (DSM-5). Arlington, VA: APA. https://doi.org/10.1176/appi.books.9780890425596
Arksey, H., & O'Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616.
Arnau-Soler, A., Adams, M. J., Clarke, T. K., MacIntyre, D. J., Milburn, K., Navrady, L., et al. (2019). A validation of the diathesis-stress model for depression in Generation Scotland. Translational Psychiatry, 9(1), 1–10. https://doi.org/10.1038/s41398-018-0356-7.
Arnold, J. (2016). Preventing startup suicide. Literally. Entrepreneur. Retrieved from https://www.entrepreneur.com/article/271435
Barstad, A., & Skrede, K. (2009). Levekår i landbruket 1995–2004. Livsform og rammebetingelse i endring. Oslo: Statistics Norway Retrieved from https://www.ssb.no/jord-skog-jakt-og-fiskeri/artikler-og-publikasjoner/levekaar-i-landbruket-1995-2004.
Beutell, N. J. (2007). Self-employment, work-family conflict and work-family synergy: antecedents and consequences. Journal of Small Business & Entrepreneurship, 20(4), 325–334. https://doi.org/10.1080/08276331.2007.10593403.
Bradley, D. E., & Roberts, J. A. (2004). Self-employment and job satisfaction: investigating the role of self-efficacy, depression, and seniority. Journal of Small Business Management, 42(1), 37–58. https://doi.org/10.1111/j.1540-627X.2004.00096.x.
Dahl, M. S., Nielsen, J., & Mojtabai, R. (2010). The effects of becoming an entrepreneur on the use of psychotropics among entrepreneurs and their spouses. Scandinavian Journal of Public Health, 38(8), 857–863. https://doi.org/10.1177/1403494810375490.
Darga, K. (2017). Impact Founder: inspirational stories of entrepreneurs who risk everything for what they believe in. Denver: Positively Powered ISBN: 0996169245.
DeJong, R., & Verhage, J. (1987). Quality of life and depression in entrepreneurs and managers. Journal of Human Behavior and Learning, 2(4), 46–53.
Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196, 129–136.
European Commission (n.d.). Promoting entrepreneurship. Retrieved from https://ec.europa.eu/growth/smes/promoting-entrepreneurship_en
Freeman, M. A., Staudenmaier, P. J., Zisser, M. R., & Andresen, L. A. (2019). The prevalence and co-occurrence of psychiatric conditions among entrepreneurs and their families. Small Business Economics, 53(2), 323–342. https://doi.org/10.1007/s11187-018-0059-8.
Gevaert, J., Moortel, D. D., Wilkens, M., & Vanroelen, C. (2018). What’s up with the self-employed? A cross-national perspective on the self-employed’s work-related mental well-being. SSM - Population Health, 4, 317–326. https://doi.org/10.1016/j.ssmph.2018.04.001.
Gourguechon, P. (2018). Entrepreneurs and suicide risk: a new perspective on entrapment provides hope. Forbes. Retrieved from https://www.forbes.com/sites/prudygourguechon/2018/08/23/entrepreneurs-and-suicide-a-new-perspective-on-entrapment-gives-hope/#463773025385
Government of Canada (2016). Canada: a nation of innovators. Retrieved from https://www.ic.gc.ca/eic/site/062.nsf/vwapj/InnovationNation_Report-EN.pdf/$file/InnovationNation_Report-EN.pdf
Gunia, B. C. (2018). The sleep trap: do sleep problems prompt entrepreneurial motives but undermine entrepreneurial means? Academy of Management Perspectives, 32(2), 228–242. https://doi.org/10.5465/amp.2016.0159.
Guptill, C. (2012). Injured professional musicians and the complex relationship between occupation and health. Journal of Occupational Science, 19(3), 258–270. https://doi.org/10.1080/14427591.2012.670901.
Hammell, K. W. (2009). Self-care, productivity, and leisure, or dimensions of occupational experience? Rethinking occupational “categories”. Canadian Journal of Occupational Therapy, 76(2), 107–114. https://doi.org/10.1177/000841740907600208.
Hessels, J., Rietveld, C. A., Thurik, A. R., & Van der Zwan, P. (2018). Depression and entrepreneurial exit. Academy of Management Perspectives, 32(3), 323–339. https://doi.org/10.5465/amp.2016.0183.
Hounsome, B., Edwards, R., Hounsome, N., & Edwards-Jones, G. (2012). Psychological morbidity of farmers and non-farming population: results from a UK survey. Community Mental Health Journal, 48(4), 503–510. https://doi.org/10.1007/s10597-011-9415-8.
Innovation and Science Australia (2017). Australia 2030: prosperity through Innovation. Canberra: Australian Government. Retrieved from https://www.industry.gov.au/data-and-publications/australia-2030-prosperity-through-innovation
Innovation, Science and Economic Development Canada (ISEDC) (2019). Key Small Business Statistics - January 2019. Retrieved from https://www.ic.gc.ca/eic/site/061.nsf/eng/h_03090.html
Kallioniemi, M. K., Simola, A. J. K., Kymalainen, H., Vesala, H. T., & Louhelainen, J. K. (2009). Mental symptoms among Finnish farm entrepreneurs. Annals of Agricultural and Environmental Medicine, 16(1), 159–168.
Kameyama, A., Matsumoto, T., Katsumata, Y., Akazawa, M., Kitani, M., Hirokawa, S., et al. (2011). Psychosocial and psychiatric aspects of suicide completers with unmanageable debt: a psychological autopsy study. Psychiatry and Clinical Neurosciences, 65(6), 592–595. https://doi.org/10.1111/j.1440-1819.2011.02266.x.
Kerr, B. (2015). Depression among entrepreneurs is an epidemic nobody is talking about. The hustle. Retrieved from https://thehustle.co/depression-among-entrepreneurs-is-an-epidemic-nobody-is-talking-about
Kolstrup, C. L., Kallioniemi, M., Lundqvist, P., Kymalainen, H., Stallones, L., & Brumby, S. (2013). International perspectives on psychosocial working conditions, mental health, and stress of dairy farm operators. Journal of Agromedicine, 18(3), 244–255. https://doi.org/10.1080/1059924X.2013.796903.
Leignel, S., Schuster, J.-P., Hoertel, N., Poulain, X., & Limosin, F. (2014). Mental health and substance use among self-employed lawyers and pharmacists. Occupational Medicine, 64(3), 166–171. https://doi.org/10.1093/occmed/kqt173.
Lepeley, M.-T. (2019). The multiplier effect of wellbeing of women entrepreneurs: a practical approach and a personal account (pp. 3-22). In M.-T. Lepeley, K. Kuschel, N. Beutell, N. Pouw, & E. L. Eijdenberg (Eds.), The wellbeing of women in entrepreneurship: a global perspective. New York: Routledge ISBN: 0367234386.
Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5(1), 69. https://doi.org/10.1186/1748-5908-5-69.
Lin, S.-K., Lee, C.-H., Pan, C.-H., & Hu, W.-H. (2003). Comparison of the prevalence of substance use and psychiatric disorders between government- and self-employed commercial drivers. Psychiatry and Clinical Neurosciences, 57(4), 425–431. https://doi.org/10.1046/j.1440-1819.2003.01142.x.
Logstein, B. (2016). Predictors of mental complaints among Norwegian male farmers. Occupational Medicine-Oxford, 66(4), 332–337. https://doi.org/10.1093/occmed/kqw019.
Loisel, P., Buchbinder, R., Hazard, R., Keller, R., Scheel, I., van Tulder, M., et al. (2005). Prevention of work disability due to musculoskeletal disorders: The challenge of implementing evidence. Journal of Occupational Rehabilitation, 15(4), 507–524. https://doi.org/10.1007/s10926-005-8031-2.
Mielniczuk, E., & Laguna, M. (2018). Positive affect mediates the relationship between self-efficacy and innovative behavior in entrepreneurs. Journal of Creative Behavior., 1–12. https://doi.org/10.1002/jocb.364.
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. British Medical Journal, 339(7716), 332–336. https://doi.org/10.1136/bmj.b2535.
Monroe, S. M., & Simons, A. D. (1991). Diathesis-stress theories in the context of life stress research: implications for the depressive disorders. Psychological Bulletin, 110(3), 406–425. https://doi.org/10.1037/0033-2909.110.3.406.
National Research Council. (2012). Rising to the challenge: U.S. innovation policy for the global economy. Washington, DC: The National Academies Press. https://doi.org/10.17226/13386.
Park, J., Han, B., & Kim, Y. (2019). Comparison of occupational health problems of employees and self-employed individuals who work in different fields. Archives of Environmental & Occupational Health, 1–14. https://doi.org/10.1080/19338244.2019.1577209.
Patzelt, H., & Shepherd, D. A. (2011). Negative emotions of an entrepreneurial career: self-employment and regulatory coping behaviors. Journal of Business Venturing, 26(2), 226–238. https://doi.org/10.1016/j.jbusvent.2009.08.002.
Piškur, B., Beurskens, A. J., Jongmans, M. J., Ketelaar, M., Norton, M., Frings, C. A., et al. (2012). Parents’ actions, challenges, and needs while enabling participation of children with a physical disability: a scoping review. BMC Pediatrics, 12(1), 177. https://doi.org/10.1186/1471-2431-12-177.
Pollack, J. M., Vanepps, E. M., & Hayes, A. F. (2012). The moderating role of social ties on entrepreneurs’ depressed affect and withdrawal intentions in response to economic stress. Journal of Organizational Behavior, 33(6), 789–810. https://doi.org/10.1002/job.1794.
Popay, J., Roberts, H., Snowden, A., Petticrew, M., Arai, L., Britten, N., & Duffy, S. (2006). Guidance on the conduct of narrative synthesis in systematic reviews: final report. Swindon: ESRC Research Methods Programme Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.178.3100&rep=rep1&type=pdf.
Rahim, A. (1996). Stress, strain, and their moderators: an empirical comparison of entrepreneurs and managers. Journal of Small Business Management, 34(1), 46–58.
Santin, G., Cohidon, C., Goldberg, M., & Lmbernon, E. (2009). Depressive symptoms and atypical jobs in France, from the 2003 decennial health survey. American Journal of Industrial Medicine, 52(10), 799–810. https://doi.org/10.1002/ajim.20744.
Slade, T., Gross, D., Niwa, L., McKillop, A. B., & Guptill, C. (2020). Improving the inclusivity, methodological quality, and ethical administration of sex and gender demographic questions. International Journal of Social Research Methodology. (in press)
Smith, R., & Mcelwee, G. (2011). After the fall: developing a conceptual script based model of shame in narratives of entrepreneurs in crisis! International Journal of Sociology and Social Policy, 31(1–2), 91–109. https://doi.org/10.1108/01443331111104823.
Stephan, U., & Roesler, U. (2010). Health of entrepreneurs versus employees in a national representative sample. Journal of Occupational and Organizational Psychology, 83, 717–738. https://doi.org/10.1348/096317909X472067.
Taylor, R. R. (2017). Kielhofner’s model of human occupation: theory and application (5th ed.). Philadelphia: Wolters Kluwer ISBN: 1451190344.
Toivanen, S., Mellner, C., & Vinberg, S. (2015). Self-employed persons in Sweden - mortality differentials by industrial sector and enterprise legal form: a five-year follow-up study. American Journal of Industrial Medicine, 58(1), 21–32. https://doi.org/10.1002/ajim.22387.
Toivanen, S., Griep, R. H., Mellner, C., Vinberg, S., & Eloranta, S. (2016). Mortality differences between self-employed and paid employees: a 5-year follow-up study of the working population in Sweden. Occupational and Environmental Medicine, 73(9), 627–636. https://doi.org/10.1136/oemed-2015-103472.
Torske, M. O., Bjorngaard, J. H., Hilt, B., Glasscoc, K. D., & Krokstad, S. (2016). Farmers’ mental health: a longitudinal sibling comparison - the HUNT study, Norway. Scandinavian Journal of Work, Environment and Health, Supplement, 42(6), 547–556. https://doi.org/10.5271/sjweh.3595.
Townsend, E. & Polatajko, H. (2013). Enabling occupation II (2nd ed.) Ottawa: CAOT Publications ACE. ISBN: 189543789.
Uy, M. A., Foo, M. D., & Song, Z. (2013). Joint effects of prior start-up experience and coping strategies on entrepreneurs’ psychological well-being. Journal of Business Venturing, 28(5), 583–597. https://doi.org/10.1016/j.jbusvent.2012.04.003.
Van Praag, C. M., & Versloot, P. H. (2007). What is the value of entrepreneurship? A review of recent research. Small Business Economics, 29(4), 351–382. https://doi.org/10.1007/s11187-007-9074-x.
Wijnvoord, L. E. C., Brouwer, S., Buitenhuis, J., van der Klink, J. J. L., & de Boer, M. R. (2016). Indications of a scarring effect of sickness absence periods in a cohort of higher educated self-employed. PLoS One, 11(5), 1–9. https://doi.org/10.1371/journal.pone.0156025.
Wiklund, J., Hatak, I., Patzelt, H., & Shepherd, D. A. (2018). Mental disorders in the entrepreneurship context: when being different can be an advantage. Academy of Management Perspectives, 32(2), 182–206. https://doi.org/10.5465/amp.2017.0063.
World Health Organization (WHO). (2001). International classification of functioning, disability and health. Geneva: WHO ISBN: 9241545429.
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Appendix. Search strategy
Appendix. Search strategy
1.1 Ovid MEDLINE(R) and Epub ahead of print, in-process and other non-indexed citations and daily 1946 to July 05, 2019
Date searched: July 8, 2019
Results: 256
1. Entrepreneurship/
2. (entrepreneur* or self-employ*).mp.
3. ((founding or founded or founder* or owner*) adj5 (startup* or start-up* or company or companies or business* or president or CEO or COO)).mp.
4. or/1–3
5. (((depression or depressed) not econ* depress*) or dysthymi* or antidepress* or anti-depress* or ((depress* or mood or affective or bipolar or bi-polar) adj5 (disorder* or symptom*)) or suicid* or self-harm* or selfharm* or mental-health or (mental adj5 (wellbeing or well-being)) or mental*-ill* or mental-disorder* or psychiatric-disorder*).mp.
6. exp. mood disorders/
7. 5 or 6
8. 4 and 7
9. limit 8 to animals
10. 8 not 9
11. limit 10 to (address or autobiography or bibliography or biography or clinical trial, veterinary or clinical trials, veterinary as topic or dictionary or directory or editorial or historical article or news or newspaper article or portrait or video-audio media or webcasts).
12. 10 not 11
1.2 Embase 1974 to 2019 July 05
Date searched: July 8, 2019
Results: 296
1. entrepreneurship/
2. (entrepreneur* or self-employ*).mp.
3. ((founding or founded or founder* or owner*) adj5 (startup* or start-up* or company or companies or business* or president or CEO or COO)).mp.
4. or/1–3
5. exp. mood disorder/
6. (((depression or depressed) not econ* depress*) or dysthymi* or antidepress* or anti-depress* or ((depress* or mood or affective or bipolar or bi-polar) adj5 (disorder* or symptom*)) or suicid* or self-harm* or selfharm* or mental-health or (mental adj5 (wellbeing or well-being)) or mental*-ill* or mental-disorder* or psychiatric-disorder*).mp.
7. 5 or 6
8. 4 and 7
9. (exp animal/ or animal.hw. or nonhuman/) not (exp human/ or human cell/ or human experiment/ or normal human/ or (human or humans).ti.)
10. 8 not 9.
11. limit 10 to (conference abstract or note or short survey or tombstone).
12. 10 not 11
1.3 PsycINFO 1806 to July week 1 2019
Date searched: July 8, 2019
Results: 360
1. self-employment/
2. entrepreneurship/
3. (entrepreneur* or self-employ*).mp.
4. ((founding or founded or founder* or owner*) adj5 (startup* or start-up* or company or companies or business* or president or CEO or COO)).mp.
5. or/1-4
6. exp. affective disorders/
7. (((depression or depressed) not econ* depress*) or dysthymi* or antidepress* or anti-depress* or ((depress* or mood or affective or bipolar or bi-polar) adj5 (disorder* or symptom*)) or suicid* or self-harm* or selfharm* or mental-health or (mental adj5 (wellbeing or well-being)) or mental*-ill* or mental-disorder* or psychiatric-disorder*).mp.
8. 6 or 7
9. 5 and 8
10. limit 9 to animal
11. 9 not 10
1.4 SCOPUS
Date searched: July 8, 2019
Results: 664
(TITLE-ABS-KEY (entrepreneur* OR self-employ* OR ((founding OR founded OR founder* OR owner*) W/5 (startup* OR start-up* OR company OR companies OR business* OR president OR ceo OR coo))) AND TITLE-ABS-KEY (depression OR depressed OR dysthymi* OR antidepress* OR anti-depress* OR ((depress* OR mood OR affective OR bipolar OR bi-polar) W/5 (disorder* OR symptom*)) OR suicid* OR self-harm* OR selfharm* OR mental-health OR (mental W/5 (wellbeing OR well-being)) OR mental*-ill* OR mental-disorder* OR psychiatric-disorder*)) AND (EXCLUDE (DOCTYPE, “cp”) OR EXCLUDE (DOCTYPE, “ed”) OR EXCLUDE (DOCTYPE, “no”) OR EXCLUDE (DOCTYPE, “sh”)) AND (EXCLUDE (SRCTYPE, “p”) OR EXCLUDE (SRCTYPE, “d”))
1.5 Web of Science
Indexes = SCI-EXPANDED, SSCI, A&HCI, ESCI, CCR-EXPANDED, IC Timespan = All years
Date searched: July 8, 2019
Results: 499
TS = (entrepreneur* OR self-employ* OR ((founding OR founded OR founder* OR owner*) NEAR/5 (startup* OR start-up* OR company OR companies OR business* OR president OR ceo OR coo))) AND TS = (depression OR depressed OR dysthymi* OR antidepress* OR anti-depress* OR ((depress* OR mood OR affective OR bipolar OR bi-polar) NEAR/5 (disorder* OR symptom*)) OR suicid* OR self-harm* OR selfharm* OR mental-health OR (mental NEAR/5 (wellbeing OR well-being)) OR mental*-ill* OR mental-disorder* OR psychiatric-disorder*)
Refined by: [excluding] DOCUMENT TYPES: (EDITORIAL MATERIAL OR BIOGRAPHICAL ITEM OR MEETING ABSTRACT OR NOTE)
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Cubbon, L., Darga, K., Wisnesky, U.D. et al. Depression among entrepreneurs: a scoping review. Small Bus Econ 57, 781–805 (2021). https://doi.org/10.1007/s11187-020-00382-4
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DOI: https://doi.org/10.1007/s11187-020-00382-4