Skip to main content
Log in

Occupational characteristics and the occurrence of psychotic disorders

  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Summary

This study was undertaken to investigate whether individuals working under various occupational stressors are at increased risk of three forms of psychotic conditions. This paper presents prospective analyses of antecedent occupational stressors in psychotic conditions with interview data from a community sample in five US metropolitan areas — the NIMH Epidemiologic Catchment Area Program. Three non-overlapping conditions were defined using DSM-III definitions as assessed by the Diagnostic Interview Schedule (DIS): (1) DSM-III schizophrenia criterion A; (2) full schizophrenia; and (3) criterion A and affective episode. Artistic (RR=3.32, 95% CI 1.08–10.14) and construction trades occupations (RR=2.58, 95% CI 1.15–5.77), “noisome working conditions” occupations (RR=1.20, 95% CI 0.99–1.47) and physically demanding occupations (RR=1.39, 95% CI 1.05–1.72) were associated with increased risk of developing DIS/DSM-III schizophrenia criterion A, even after adjustment for sociodemographic and psychopathology factors including alcohol and marijuana use. Psychologically demanding occupations (RR=0.85, 95% CI 0.75–0.95) were associated with decreased risk of developing DIS/DSM-III schizophrenia. This finding is supported by results from experimental studies on the arousability of pre-schizophrenics. Finally, teachers (RR=11.35, 95% CI 2.56–50.38), sales occupations (RR=4.16, 95% CI 1.00–21.30) and occupations characterized by low control over work were associated with increased risk of developing DIS criterion A and affective episode, resembling previous findings on occupational stressors and depression. Overall, our results replicate and extend previous work on occupational stressors and psychotic conditions through use of prospective data, several psychotic conditions, multiple assessment of occupational stressors and adjustment for potential confounders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Andreasen NC (1987) Creativity and mental illness: prevalence rates in writers and their first-degree relatives. Am J Psychiatry 144: 1288–1292

    Google Scholar 

  • Andreasen NC, Powers PS (1974) Creativity and psychosis: a comparison of cognitive style. Arch Gen Psychiatry 32: 70–73

    Google Scholar 

  • Anthony JC, Folstein M, Romanoski AR et al. (1985) Comparison of the lay diagnostic interview schedule and a standardized psychiatric diagnosis: experience in East Baltimore. Arch Gen Psychiatry 42: 667–675

    Google Scholar 

  • American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. American Psychiatric Association, Washington

    Google Scholar 

  • American Psychiatric Association (1987) Diagnostic and satistical manual of mental disorders, 3rd ed. rev. American Psychiatric Association Washington

    Google Scholar 

  • Berkson J (1946) Limitations of the application of fourfold table analysis to hospital data. Biometrics Bull 2: 47–53

    Google Scholar 

  • Brenner HM (1973) Mental illness and the Economy. Harvard University Press Cambridge, Massachusetts

    Google Scholar 

  • Breslow NE, Lubin JH, Marek P, Langholz B (1983) Multiplicative models and cohort analysis. J Am Stat Association 78: 1–12

    Google Scholar 

  • Cain PS, Treiman DJ (1981) The dictionary of occupational titles as a source of occupational data. Am Sociol Review 46: 253–278

    Google Scholar 

  • Claridge G (1985) The origins of mental illness. Basel Blackwell New York

    Google Scholar 

  • Day R (1981) Life events and schizophrenia: the “triggering” hypothesis. Acta Psychiat Scand 64: 97–122

    Google Scholar 

  • Dohrenwend BP (1990) Socioenconomic status (SES) and psychiatric disorders. Are the issues still compelling? Soc Psychiatry Psychiatr Epidemiol 25: 41–47

    Google Scholar 

  • Dykes M, McGhie A (1976) A comparative study of attentional strategies of schizophrenic and highly creative normal subjects. Brit J Psychiatry 128: 50–56

    Google Scholar 

  • Eaton WW, Kessler LG (1985) Epidemiologic field methods in psychiatry: the NIMH Epidemiological Catchment Area Program. Academic Press New York

    Google Scholar 

  • Eaton WW, Day R, Kramer M (1988) The used of epidemiology for risk factor research in schizophrenia: an overview and methodological critique. In: Tsuang M, Simpson J (eds) Handbook of schizophrenia, vol 3: Nosology, epidemiology and genetics. Elsevier Amsterdam

    Google Scholar 

  • Eaton WW, Anthony JC, Mandell W, Garrison R (1990) Occupations and the prevalence of DIS/DSM-III major depressive disorder. J Occup Med 32: 1079–1087

    Google Scholar 

  • England P, Kilbourne B (1988) Occupational measures from the dictionary of occupational titles for 1980 census detailed occupations. Inter-University Consortium for Political and Social Research Ann Arbor

    Google Scholar 

  • Falloon IRH, Boyd JL, McGill CW (1984) Family Care of Schizophrenia. Guilford Press, New York

    Google Scholar 

  • Gust SW, Walsh JM (1989) Drugs in the workplace: research and evaluation data. National Institute on Drug Abuse Research Monograph 91. National Institute on Drug Abuse Rockville

    Google Scholar 

  • Johnsson JV (1990) Work organization, stress and occupational health: a social epidemiological perspective. In: Abrahamsson B et al. (eds) Perspectives on work and welfare. Sage London

    Google Scholar 

  • Keefe JA, Magaro PA (1980) Creativity and schizophrenia: an equivalence of cognitive processing. J Abnor Psychology 89: 390–398

    Google Scholar 

  • Karasek RA, Pieper C, Schwartz J, Fry L, Schier D (1985) Job content instrument questonnaire and user's guide. Columbia University Job/Heart Project New York

    Google Scholar 

  • Karasek RA, Schwartz JE, Pieper C (1982) A job characteristics scoring system for occupational analysis, Part I. Center for the Social Sciences, Columbia University New York

    Google Scholar 

  • Karasek RA, Theorell T (1990) Healthy work. Stress, productivity and the reconstruction of working life. Basic Books New York

    Google Scholar 

  • Korff M von, Nestadt G, Romanoski A et al. (1985) Prevalence of treated and untreated DSM-III schizophrenia. Results of a twostage community survey. J Nerv Ment Dis 173: 577–581

    Google Scholar 

  • Lennerlof L (1988) Learned helplessness at work. Int J Health Services 18: 207–222

    Google Scholar 

  • Liberatos P, Link BG, Kelsex JL (1988) The measurement of social class in epidemiology. Epidemiol Rev 10: 87–121

    Google Scholar 

  • Link BG, Dohrenwend BP, Skodol AE (1986) Socio-economic status and schizophrenia: noisome occupational characteristics as a risk factor. Am J Sociol 51: 242–258

    Google Scholar 

  • Muntaner C, Torrubia R, Perez G (1987) Predisposition towards schizotypal and borderline personality disorders in university students. Rev Dept Psiquiat 14: 187–192

    Google Scholar 

  • Muntaner C, Eaton WW, Garrison R (submitted for publication) Dimensions of the psychosocial work environment

  • National Institute on Alcohol Abuse and Alcoholism (1982) Occupational alcoholism: a review of research issues. Research Monograph No 8. Superintendent of Documents, US Government Printing Office Washington

    Google Scholar 

  • Navarro V (1990) Race or class versus race and class: mortality differentials in the U.S.. Lancet 336: 1238–1240

    Google Scholar 

  • Neugebauer R, Dohrenwend B, Dohrenwend B (1980) Formulations of hypotheses about the true prevalence of functional psychiatric disorders among adults in the United States. In: Dohrenwend B, Dohrenwend B, Gould M, Link B, Neugebauer R, Wunsch-Hitzig R (eds) Mental illness in the United States: epidemiological estimates. Praeger, New York

    Google Scholar 

  • Robins LN, Helzer JE, Croughan J, Ratcliff KA (1981) National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Arch Gen Psychiatry 38: 381–389

    Google Scholar 

  • Schlesselman JJ (1982) Case-control studies: design, conduct and analysis. Oxford University Press, New York

    Google Scholar 

  • Schwartz JE, Pieper CF, Karasek RA (1988) A procedure for linking psychosocial data to health surveys. Am J Public Health 78: 904–909

    Google Scholar 

  • Sundstrom E (1986) Work places: the psychology of the physical environment in offices and factories. Cambridge University Press New York

    Google Scholar 

  • Tien AY, Eaton WW (in press) Sociodemographic risk factors and psychopathologic precursors for the schizophrenia syndrome. Arch Gen Psychiatry

  • US Burea of the Census (1980) Classifield index of industries and occupations. US Department of Commerce Washington

    Google Scholar 

  • US Department of Labor (1977) Dictionary of occupational titles 4th edn. US Government Printing Office Washington

    Google Scholar 

  • Wright EO, Hachen D, Costello C, Sprague J (1982) The American class structure. Am Sociol Rev 47: 709–726

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Muntaner, C., Tien, A.Y., Eaton, W.W. et al. Occupational characteristics and the occurrence of psychotic disorders. Soc Psychiatry Psychiatr Epidemiol 26, 273–280 (1991). https://doi.org/10.1007/BF00789219

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00789219

Keywords

Navigation