Abstract

The objective of this study was to highlight the relationships between deterioration of a wide variety of psychosocial factors (PSF) and increase of mental health symptoms.

About 5,500 workers from of the French cohort “Health and Career paths” were considered in this study. Mental health symptoms were assessed in 2006 and 2010 by the Mini International Neuropsychiatric Interview leading to diagnosis of Major Depressive Disorder (MDD) or Generalised Anxiety Disorder (GAD). The outcome considered here was the diagnosis of MDD/GAD in 2010. Seventeen self-reported PSF, evaluated in 2006 and 2010, explored six domains: labour intensity and working time (7 items), emotional demand (3), autonomy (2), social relationships at work (2), conflict of values (2), and job insecurity (1). For each PSF, four exposure groups were considered: exposed both in 2006 and 2010 (A), exposed in 2006 and not in 2010 (B), exposed in 2010 and not in 2006 (C), and never exposed (as reference).

Changes in PSF exposure between 2006 and 2010, although small, were rather towards deterioration, in particular for the pressure at work and the lack of reward. In men without MDD/GAD in 2006, job insecurity and high volume of work were related to MDD/GAD diagnosis in 2010, whatever the exposure groups. MDD/GAD diagnosis in 2010 was associated with high complexity of work in group A, emotional discordance in group B and long working hours in group C. In women, job insecurity was highly associated to MDD/GAD diagnosis in 2010. Exposure to fear at work, work-family imbalance or lack of reward affected women, but not men.

These results underlined, in the context of a 4-year follow-up, the relationships between several PSF, in addition to those of „Karasek and Siegrist models, and MDD/GAD diagnosis. Job insecurity and emotional discordance impaired mental health in both genders.