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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. 1Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  2. 2National Institute of Occupational Safety and Health, Kawasaki, Japan
  3. 3Aichi Medical University, Nagakute, Aichi, Japan
  4. 4Kanazawa Medical University, Uchinada, Ishikawa, Japan
  5. 5Hitachi Health Care Center, Hitachi, Ltd., Hitachi, Ibaraki, Japan
  6. 6Kariya Toyota General Hospital, Kariya, Aichi, Japan
  7. 7Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
  8. 8Meiji University Law School, Tokyo, Japan
  9. 9University of Occupational and Environmental Health, Kitakyushu, Japan
  10. 10Kimitsu Health Service Center, Kimitsu, Chiba, Japan
  11. 11Fujita Health University School of Medicine, Toyoake, Aichi, Japan
  12. 12Saitama Occupational Health Promotion Center, Japan Labour Health and Welfare Organization, Saitama, Japan
  1. Correspondence to Mr Akiomi Inoue, Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; 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 was 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 18–67 years 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% CI 0.11 to 0.71); high role ambiguity was associated with the higher risk (hazard ratio 3.49, 95% CI 1.43 to 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.

  • depressive disorder
  • job strain
  • occupational
  • psychosocial
  • prospective study
  • role stressor
  • sick leave
  • sickness absence
  • workplace

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  • Funding A special research grant for the prevention of work-related diseases in 1995–9 from the Ministry of Health, Labour and Welfare, Japan, supported our baseline data collection. The analysis and preparation of the manuscript were partly supported by a Grant-in-Aid for Scientific Research (B) 2004 (no 16390170) and a Grant-in-Aid for Scientific Research (A) 2008 (no 20240062) from the Ministry of Education, Culture, Sports, Science and Technology, Japan.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Research Committee for Human Subjects, Gifu University School of Medicine.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.