Psychosocial factors and depressive and anxiety disorders in a longitudinal survey

Objectives
This study aimed highlighting the relationship between change in exposure to a wide variety of psychosocial factors (PSF) and the increase of mental health symptoms among 5,500 workers out of the French cohort “Health and Career paths”.
Methods
Mental health symptoms were assessed in 2006 & 2010 by the Mini International Neuropsychiatric Interview leading to diagnosis of Major Depressive Disorder (MDD) or Generalized Anxiety Disorder (GAD). The outcome considered here was the diagnosis of MDD and/or GAD (MDD/GAD) in 2010. Seventeen self-reported PSF were evaluated in 2006 & 2010. They explored six domains: labor 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 & 2010 (A), exposed in 2006 and not in 2010 (B), exposed in 2010 and not in 2006 (C), and never exposed (as reference). Multiple logistic models were performed separately in men and women.
Results
Considering the 3 exposure groups (A, B, C), prevalence of high complexity of work, emotional discordance and lack of reward was the highest (from 10 to 30%) in men and women. On the opposite, prevalence of job insecurity, ethical conflicts and atypical working hours was the lowest (around 5%) in both genders. 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 (exposed in 2006 and 2010), emotional discordance in group B (exposed in 2010) and long working hours in group C (exposed in 2006). As in men, job insecurity was highly predictive of MDD/GAD diagnosis in 2010 in women. Exposure to fear at work, work-family imbalance or lack of reward affected women, but not men.
Conclusion
These results underlined, in the context of a 4-year follow-up, the relationships between several PSF, additional to those of Karasek and Siegrist models, and MDD/GAD diagnosis. In particular, job insecurity and emotional discordance impaired mental health in both genders.