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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. H K Jensen1,
  2. J Wieclaw1,
  3. T Munch-Hansen1,
  4. A M Thulstrup1,
  5. J P Bonde1,2
  1. 1Department of Occupational Medicine and Danish Ramazzini Center, Aarhus University Hospital, Aarhus, Denmark
  2. 2Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
  1. Correspondence to Joanna Wieclaw, Department of Occupational Medicine, Aarhus University Hospital, Noerrebrogade 44, Bygn. 2C, DK–8000 Aarhus C, Denmark; joanna.wieclaw{at}


Background The aim of this study was to examine if dissatisfaction with psychosocial work climate predicts psychiatrically diagnosed depressive, anxiety and substance abuse disorders.

Methods In Aarhus County, Denmark, 13 423 public service employees at 683 workplace units answered a questionnaire survey assessing psychosocial work environment. An average workplace 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. HRs and 95% CIs were computed for first onset of studied disorders, starting from the baseline survey at 1 January 2002 through to 30 April 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 to 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 3.53, 95% CI 1.55 to 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.

  • Psychosocial
  • workplace
  • longitudinal studies
  • mental health disorders
  • depression
  • mental health DI

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  • Funding The study was supported by a grant from the Danish Work Environment Research Fund (54-2003-08) and the Danish Research Council (2136-07-0049).

  • Competing interests None.

  • Ethical approval The data used in the study are register data and the use was approved by the Danish Data Protection Agency. There was no direct contact with human subjects and therefore no approval from an ethics committee was required.

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