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Job stressors and long-term sick leave due to depressive disorders among Japanese male employees: findings from the Japan Work Stress and Health Cohort Study
  1. Akiomi Inoue1,
  2. Norito Kawakami1,
  3. Takashi Haratani2,
  4. Fumio Kobayashi3,
  5. Masao Ishizaki4,
  6. Takeshi Hayashi5,
  7. Osamu Fujita6,
  8. Yoshiharu Aizawa7,
  9. Shogo Miyazaki8,
  10. Hisanori Hiro9,
  11. Takeshi Masumoto10,
  12. Shuji Hashimoto11,
  13. Shunichi Araki12
  1. 1 Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Japan;
  2. 2 National Institute of Occupational Safety and Health, Japan;
  3. 3 Aichi Medical University, Japan;
  4. 4 Kanazawa Medical University, Japan;
  5. 5 Hitachi Health Care Center, Hitachi, Ltd., Japan;
  6. 6 Kariya Toyota General Hospital, Japan;
  7. 7 Kitasato University School of Medicine, Japan;
  8. 8 Meiji University Law School, Japan;
  9. 9 University of Occupational and Environmental Health, Japan;
  10. 10 Occupational Health Service Division, Kimitsu Health Service Center, Japan;
  11. 11 Fujita Health University School of Medicine, Japan;
  12. 12 Saitama Occupational Health Promotion Center, Japan Labour Health and Welfare Organization, Japan
  1. * Corresponding author; email: akiomi-tky{at}


Background: Research on the association between job strain or other job stressors and depressive disorders is still limited. The purpose of the present study is to investigate the prospective association of job strain, role stressors, and job insecurity with long-term sick leave due to depressive disorders.

Methods: A prospective study was conducted of a total of 15,256 men aged 18 to 67 with no previous history of mental disorders employed in six manufacturing factories located in several regions of Japan. At baseline, they were surveyed using a self-administered questionnaire, including self-reported measures of job strain, as well as its components (job overload and job control), role stressors (role ambiguity and role conflict), social support at work, job insecurity, and other demographic and psychological covariates. During the follow-up, a long-term sick leave of 30 days or more due to depressive disorders was recorded.

Results: During 5.14 years of follow-up on average, 47 incident cases of sick leave of 30 days or more due to depressive disorders were observed. High job control at baseline was associated with a lower risk of long-term sick leave due to depressive disorders, after adjusting for demographic variables, depressive symptoms, and neuroticism at baseline (hazard ratio, 0.28 [95% confidence interval, 0.11-0.71]); high role ambiguity was associated with the higher risk (hazard ratio, 3.49 [95% confidence interval, 1.43-8.49]).

Conclusion: Job control and role ambiguity may be important predictors of long-term sick leave due to depressive disorders among male employees, independent of depressive symptoms and neuroticism.

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