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= Paid-up subscribersWork stress trebles odds of common mental disorders
20 Oct 2011
A cross-sectional study using data from the 2007 household survey in England has founda strong association between work stress and common mental health disorders, which is independent of the effects of non-work stressors. Adjustment for non-work stressors had very little effect on the results, indicating that work stressors have an independent effect on common mental health disorders. It would be of interest to investigate the link between work stress and specific psychiatric conditions, but this would have required a much larger sample size. More than half of those with a common mental health disorder (55%) had mixed anxiety and depression (MADD) i.e. subthreshold depressive and anxiety symptoms. The status of ICD-10 MADD is questionable: it is poorly defined and usually self-limiting, but is associated with significantly impaired quality of life and high levels of work absence.Dr Philip Bland comments in the editorial: 'A cross-sectional study cannot demonstrate that work stress causes mental ill health. Alternative explanations for the association could be that individuals who are at increased risk of developing common mental health disorders are more likely to choose stressful jobs, or that depressed patients are more likely to perceive their work in a negative way. The Dunedin longitudinal study attempted to control for both of these possibilities and found that excessive job demands were associated with a doubling of the risk of major depression or GAD.Doctors have the highest incidence of work-related mental ill health of any profession. This may be the consequence of high demands (e.g. increasing complexity of consultations) and diminishing autonomy (guidelines and performance measures). Doctors who have an excessive need for approval and esteem from work (overcommitment) are particularly vulnerable. Conversely, doctors who work within supportive partnerships will have a reduced risk. In my experience, 360° appraisal can facilitate positive feedback and help colleagues and staff to feel both valued and supported.'
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