Abstract
Affective disorders encompass mental disorders related to excessively elated and depressed mood, referred in clinical diagnostic terms as manic episode, bipolar disorders, and depressive disorders. The etiology of affective disorders is complex and only partly understood. Regarding the role of working conditions in the etiology of affective disorders, research evidence is currently limited to depressive disorders. We present results from recent reviews and meta-analyses of prospective cohort studies showing that the combination of high job demands and low job control (denoted as job strain), low job control in itself, the imbalance between high efforts and low rewards at work, and high job insecurity are associated with a moderately increased risk of depressive disorders. Long working hours are associated with a weak, albeit statistically significantly increased risk; however the associations vary across different world regions. Exposure to workplace bullying is strongly associated with risk of depressive disorders; however, this result is based on only a few studies. We critically discuss the epidemiological evidence while considering various potential biases leading to both over- and underestimation of the reported associations. We conclude with pointing to future research needs for a better understanding of the role of working conditions in the etiology of depressive disorders, including strategies to address biases; a stronger focus on a work-life course perspective; the analyses of possible effect modification by other variables, including contextual factors; approaches for advancing theory and understanding mechanisms; and the development, implementation, and comprehensive evaluation of workplace intervention studies.
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Rugulies, R., Aust, B., Madsen, I.E.H. (2019). Occupational Determinants of Affective Disorders. In: Bültmann, U., Siegrist, J. (eds) Handbook of Disability, Work and Health. Handbook Series in Occupational Health Sciences, vol 1. Springer, Cham. https://doi.org/10.1007/978-3-319-75381-2_10-1
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