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Psychosocial job stressors and suicidality: a meta-analysis and systematic review
  1. Allison Milner1,2,
  2. Katrina Witt3,
  3. Anthony D LaMontagne1,2,
  4. Isabelle Niedhammer4,5
  1. 1Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  2. 2Work, Health and Wellbeing Unit, Centre for Population Health Research, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
  3. 3Turning Point, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
  4. 4INSERM, U1085, Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France
  5. 5Epidemiology in Occupational Health and Ergonomics (ESTER) Team, University of Angers, Angers, France
  1. Correspondence to Dr Allison Milner, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, 3010, USA; allison.milner{at}


Objectives Job stressors are known determinants of common mental disorders. Over the past 10 years, there has been evidence that job stressors may also be risk factors for suicidality. The current paper sought to examine this topic through the first comprehensive systematic review and meta-analysis of the literature to date.

Methods We used a three-tier search strategy of seven electronic databases. Studies were included if they reported on a job stressor or job-related stress as an exposure and suicide ideation, self-harm, suicide attempt or suicide as an outcome. Two researchers independently screened articles. All extracted effect estimates were converted to log-transformed ORs.

Results There were 22 studies that were included in meta-analysis. Overall, exposure to job stressors was associated with elevated risk of suicide ideation and behaviours. The OR for suicide ideation (14 studies) ranged from 1.29 (95% CI 1.15 to 1.44) for poor supervisor and colleague support to 1.96 (95% CI 1.33 to 2.90) for job insecurity. For suicide (six studies), exposure to lower supervisor and collegial support produced an OR of 1.19 (95% CI 1.00 to 1.42), while low job control resulted in an OR of 1.30 (95% CI 1.10 to 1.53). There were only two studies that examined suicide attempt, both of which suggested an adverse effect of exposure to job stressors.

Conclusions This study provides some evidence that job stressors may be related to suicidal outcomes. However, as most studies in the area were cross-sectional and observational in design, there is a need for longitudinal research to assess the robustness of observed associations.

  • job stress
  • suicide
  • self-harm
  • work
  • employment
  • job control
  • job demands

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  • Contributors AM conceived the study. AM and KW developed the methodology, conducted the searches, screened the articles and conducted data extraction. IN checked the data extracted. ADL commented on the draft of the paper, along with other coauthors. All authors contributed to the final manuscript.

  • Funding The American Foundation for Suicide Prevention (SRG-1-091-13); Society for Mental Health Research and Deakin University provided financial support for this study.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Correction notice This article has been corrected since it published Online First. The conclusions paragraph in the abstract has been corrected.

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