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Working conditions predict incidence of long-term spells of sickness absence due to depression: results from the belstress I prospective study
  1. Nicolas Clumeck1,
  2. Chantal Kempenaers1,
  3. Isabelle Godin2,
  4. Michèle Dramaix2,
  5. Marcel Kornitzer2,
  6. Paul Linkowski1,
  7. France Kittel2
  1. 1 Laboratoire de Psychiatrie, Université Libre de Bruxelles (ULB), Belgium;
  2. 2 Ecole de santé Publique, Université Libre de Bruxelles (ULB), Belgium
  1. E-mail: nicolasclumeck{at}


Background: During the last few years, a high incidence of sick leave due to depression has been reported, resulting in important economic and social impacts. Only a limited number of studies investigating the influence of psychosocial working conditions on sick leave have been prospective and have utilized a valid methodology, while none have studied sick leave due to depression. In this paper, we analyze the impact of adverse psychosocial working conditions on the risk for long-term sick leave due to depression.

Method: This study resulted from the large scale Belstress I study on the relationship between perceived job stress and health problems. Subjects were Belgian employees selected from 11 large companies (n=9396). Using a longitudinal design, we explored the association between the three Karasek stress dimensions (job control, psychological demand, and social support), separatelely and combined them according to the demand-control and demand-control-support models and the incidence of long-term sick leave for depression as diagnosed by the family physician.

Results: After adjusting for age, occupational categories, living situation, and baseline depression score, “passive jobs” (OR=2.67; 95% CI: 1.15, 6.19) and “high strain” jobs (OR= 3.23; 95% CI: 1.40, 7.43) predicted sick leave due to depression at follow-up in men.

Job control predicted sick leave due to depression in both men (OR:2.43; 95%CI:1.27, 4.66) and women (OR:2.21; 95%CI:1.05, 4.68).

Conclusions: This study provides evidence that the psychosocial working environment influences long-term sick leave due to depression. Efforts to improve skill discretion and decision authority at work could help prevent depression.

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