Objectives Psychological distress is a strong predictor of major depression. Accumulating evidences show that psychosocial work factors (i.e. work stressors) of the demand-control and effort-reward imbalance models may contribute to the development of mental health problems. Women are more likely to be exposed to these psychosocial work factors than men. Moreover, women spend twice as much time per week performing family responsibilities than men. This study evaluated for the first time the prospective adverse effect of the double exposure to psychosocial work factors and high family responsibilities on women psychological distress.

Methods Women were assessed at baseline (N=1,135) and 3- and 5-year follow-ups. Psychosocial work factors of the demand-control and effort-reward imbalance models were measured using validated questionnaires. Family responsibilities were self-assessed and referred to “the number of children and their age” and “housework and children care”. Psychological distress was measured with the validated Psychiatric Symptoms Index questionnaire. Prevalence ratios of psychological distress were modelled with log-binomial regression.

Results Compared to unexposed women, women having a double exposure to job strain and high family responsibilities had a higher prevalence of psychological distress at baseline (1.53 (95% CI: 1.22–1.93) and at the 5-year follow-up (1.43 (95% CI: 1.07–1.91). Women having a double exposure to effort-reward imbalance and high family responsibilities had also a significantly higher prevalence of psychological distress at baseline (2.04 (95% CI: 1.68–2.49)), 3-year (1.90 (95% CI: 1.52–2.38), and 5-year follow-up (1.56 (95% CI: 1.16–2.10).

Conclusion In this study, a double exposure to job strain or effort-reward imbalance and high family responsibilities increased the prevalence of high psychological distress over a 5-year follow-up. Primary prevention aimed at reducing psychosocial work factors and implementing family friendly organisational practices may contribute to lower mental health problems.