Which work-related characteristics are most strongly associated with common mental disorders? A cross-sectional study

Mathieu Rivière (1) , Ariane Leroyer (2) , Lionel Ferreira Carreira (2) , Thierry Blanchon (1) , Laurent Plancke (3) , Maria Melchior (1) , Nadia Younes (4)

1 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
2 Faculté de Médecine Henri Warembourg - Université de Lille
3 F2RSM Psy - Fédération régionale de la recherche en psychiatrie et santé mentale Hauts-de-France [Lille]
4 HANDIReSP - Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur

Objectives Studies exploring work-related risk factors of common mental disorders (CMDs), such as major depressive disorder (MDD), generalised anxiety disorder (GAD) or alcohol abuse, have generally focused on a limited set of work characteristics. For the first time in a primary care setting, we examine simultaneously multiple work-related risk factors in relation to CMDs. Method We use data from a study of working individuals recruited among 2027 patients of 121 general practitioners (GPs) representative of the Nord-Pas-de-Calais region in the North of France (April–August 2014). CMDs (MDD; GAD; alcohol abuse) were assessed using the Mini-International Neuropsychiatric Interview. Six worked-related factors were examined (work intensity, emotional demands, autonomy, social relations at work, conflict in values and job insecurity). Several covariates were considered (patient, GP and contextual characteristics). To study the association between workplace risk factors and CMDs, we used multilevel Poisson regression models adjusted for covariates. Results Among study participants, 389 (19.1%) met criteria for MDD, 522 (25.8%) for GAD and 196 (9.7%) for alcohol abuse. In multivariable analyses adjusted for covariates, MDD/GAD was significantly associated with work intensity (RR 1.16, 95% CI 1.06 to 1.27) (absolute risk=52.8%), emotional demands (RR 1.24, 95% CI 1.13 to 1.35) (absolute risk=54.9%) and social relations at work (RR 0.78, 95% CI 0.70 to 0.87) (absolute risk=15.0%); alcohol abuse was associated with social relations at work (RR 1.25, 95% CI 1.01 to 1.53) (absolute risk=7.6%) and autonomy (OR 0.82, 95% CI 0.67 to 0.99) (absolute risk=8.9%). Conclusions Several workplace factors are associated with CMDs among working individuals seen by a GP. These findings confirm the role of organisational characteristics of work as a correlate of psychological difficulties above and beyond other sources of risk.

Domaines: Médecine humaine et pathologie; Santé publique et épidémiologie; Psychiatrie et santé mentale

Mathieu Rivière, Ariane Leroyer, Lionel Ferreira Carreira, Thierry Blanchon, Laurent Plancke, et al.. Which work-related characteristics are most strongly associated with common mental disorders? A cross-sectional study. BMJ Open, 2018, 8 (8), pp.e020770. ⟨10.1136/bmjopen-2017-020770⟩. ⟨hal-01901872⟩