Association between Work-Related Stress and Major Depression: 15-Year Follow-up Results from the Prospective Quebec Cohort

Ana Paula Gralle , Université Laval
Denis Talbot, ULaval
Xavier Trudel, ULaval
Alain Milot, ULaval
Mahee Gilbert-Ouimet, ULaval
Danielle Laurin, Université Laval
Clermont Dionne, Université Laval
Sophie Lauzier, Université Laval
Benoît Mâsse, Université de Montreal
Ruth Ndjaboué, Université Laval
Michel Vézina, Université Laval
Alain Lesage, Centre de recherche Fernand-Séguin de l’Hôpital Louis H.-Lafontaine
Renée Bourbonnais, Université Laval
Neil Pearce, London School of Hygiene & Tropical Medicine
Chantal Brisson, CRCHUQ-ULaval

Background: Depression is a challenge to public health because of its high lifetime prevalence, high morbidity and high associated economic cost. It is also associated with a worse outcome for other chronic diseases. There is consistent empirical evidence linking work-related stress to mental health problems. However, few prospective studies have analyzed the long-term effect of psychosocial stress at work, defined using the Effort-Reward Imbalance (ERI) model, on depression as measured by validated instruments. Methods: We have used longitudinal data from the PROspective Quebec cohort. Our study population contains 4738 participants (2371 women) who were working in 1999-2001 and who responded to the CIDI-SF questionnaire on depression 15 years later. We used marginal structural models with inverse probability of exposure weighting and multiple imputation to estimate the association between psychosocial stress at work and depression. Results: The overall prevalence of depression was 4.0%. Among women, it was 2.3 times higher than among men (5.5% and 2.4%, respectively). After adjustment for possible confounding factors, the overall odds ratio for depression among participants exposed to ERI, compared with unexposed participants, was 1.9 (95% confidence interval:1.4-2.6). Conclusion: These preliminary results suggest that the combination of high effort with low perceived rewards at work is a strong predictor of depression.

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 Presented in Session 89. Employment, Occupational Characteristics, and Health