Depression among entrepreneurs: a scoping review

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

  1. 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.

    Article  Google Scholar 

  2. 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

  3. 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.

    Article  Google Scholar 

  4. 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.

    Article  Google Scholar 

  5. Arnold, J. (2016). Preventing startup suicide. Literally. Entrepreneur. Retrieved from https://www.entrepreneur.com/article/271435

  6. 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.

    Google Scholar 

  7. 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.

    Article  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. 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.

    Article  Google Scholar 

  10. Darga, K. (2017). Impact Founder: inspirational stories of entrepreneurs who risk everything for what they believe in. Denver: Positively Powered ISBN: 0996169245.

    Google Scholar 

  11. DeJong, R., & Verhage, J. (1987). Quality of life and depression in entrepreneurs and managers. Journal of Human Behavior and Learning, 2(4), 46–53.

    Google Scholar 

  12. Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196, 129–136.

    Article  Google Scholar 

  13. European Commission (n.d.). Promoting entrepreneurship. Retrieved from https://ec.europa.eu/growth/smes/promoting-entrepreneurship_en

  14. 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.

    Article  Google Scholar 

  15. 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.

    Article  Google Scholar 

  16. 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

  17. 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

  18. 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.

    Article  Google Scholar 

  19. 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.

    Article  Google Scholar 

  20. 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.

    Article  Google Scholar 

  21. 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.

    Article  Google Scholar 

  22. 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.

    Article  Google Scholar 

  23. 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

  24. 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

  25. 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.

    Google Scholar 

  26. 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.

    Article  Google Scholar 

  27. 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

  28. 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.

    Article  Google Scholar 

  29. 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.

    Article  Google Scholar 

  30. 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.

    Chapter  Google Scholar 

  31. 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.

    Article  Google Scholar 

  32. 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.

    Article  Google Scholar 

  33. 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.

    Article  Google Scholar 

  34. 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.

    Article  Google Scholar 

  35. 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.

  36. 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.

    Article  Google Scholar 

  37. 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.

    Article  Google Scholar 

  38. 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.

    Book  Google Scholar 

  39. 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.

  40. 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.

    Article  Google Scholar 

  41. 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.

    Article  Google Scholar 

  42. 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.

    Article  Google Scholar 

  43. 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.

    Google Scholar 

  44. Rahim, A. (1996). Stress, strain, and their moderators: an empirical comparison of entrepreneurs and managers. Journal of Small Business Management, 34(1), 46–58.

    Google Scholar 

  45. 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.

    Article  Google Scholar 

  46. 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)

  47. 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.

    Article  Google Scholar 

  48. 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.

    Article  Google Scholar 

  49. Taylor, R. R. (2017). Kielhofner’s model of human occupation: theory and application (5th ed.). Philadelphia: Wolters Kluwer ISBN: 1451190344.

    Google Scholar 

  50. 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.

    Article  Google Scholar 

  51. 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.

    Article  Google Scholar 

  52. 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.

    Article  Google Scholar 

  53. Townsend, E. & Polatajko, H. (2013). Enabling occupation II (2nd ed.) Ottawa: CAOT Publications ACE. ISBN: 189543789.

  54. 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.

    Article  Google Scholar 

  55. 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.

    Article  Google Scholar 

  56. 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.

    Article  Google Scholar 

  57. 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.

    Article  Google Scholar 

  58. World Health Organization (WHO). (2001). International classification of functioning, disability and health. Geneva: WHO ISBN: 9241545429.

    Google Scholar 

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Appendix. Search strategy

Appendix. Search strategy

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

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

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

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”))

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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Keywords

  • Entrepreneur
  • Mental health
  • Depression
  • Suicide

JEL classifications

  • L26
  • I10
  • J00
  • M13