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Does dissatisfaction with psychosocial work climate predict depressive, anxiety and substance abuse disorders? A prospective study of Danish public service employees
  1. Helle Kold Jensen1,
  2. Joanna Wieclaw1,*,
  3. Torsten Munch-Hansen1,
  4. Ane Marie Thulstrup1,
  5. Jens Peter Bonde2
  1. 1 Department of Occupational Medicine and Danish Ramazzini Center, Aarhus University Hospital, Denmark;
  2. 2 Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Denmark
  1. Correspondence to: Joanna Wieclaw, Occupational Medicine, Aarhus University Hospital, Noerrebrogade 44, building 2C, Aarhus, DK-8000 C, Denmark; joanwiec{at}


Background: Several psychosocial work environment factors have been shown to be related to symptoms of mental health problems, but whether associations are causal remains disputable.

Methods: In Aarhus County, Denmark 13.423 public service employees at 683 work place units answered a questionnaire survey assessing psychosocial work environment. An average work place unit score of overall satisfaction with psychosocial working conditions, rated on a scale from 0-10 with 10 being most satisfied, was computed and assigned to the individual employees at each work unit. Aggregated satisfaction scores were divided into three levels, according to the 25-75 percentiles. Data on hospitalisations and outpatient treatments for depressive, anxiety and substance abuse disorders was obtained from the Danish Central Psychiatric Research Register. Hazard ratios and 95 % confidence intervals were computed for first onset of studied disorders, starting from the baseline survey at 1.1.2002 through 30.4.2008. Risk estimates were adjusted for sociodemographic variables.

Results: A low satisfaction with psychosocial working conditions was associated with an increased risk of any mental health disorder (HRadj 1.71, 95 % CI 1.04-2.82). The lower the satisfaction level, the higher was the risk of mental health disorders. Moreover, substance abuse disorders were more frequent among men dissatisfied with work climate, HRadj of 3.53, 95 % CI 1.55-8.03.

Conclusion: Working in a dissatisfying psychosocial environment increases the risk of subsequent mental health disorders. Randomised, controlled intervention trials may help in resolving whether this association is causal.

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