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Exposure to work stress and use of psychotropic medications: a systematic review and meta-analysis
  1. Allison Milner1,
  2. Anna J Scovelle1,
  3. Tania L King1,
  4. Ida Madsen2
  1. 1 School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  2. 2 National Research Centre for the Working Environment, Copenhagen, Denmark
  1. Correspondence to Professor Allison Milner, Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia; allison.milner{at}


Background There is good evidence that job stressors are prospectively related to mental health problems, particularly depressive symptoms. This review aimed to examine whether job stressors were also related to use of psychotropic medications.

Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, we examined seven electronic databases that indexed literature from a wide range of disciplines. Inclusion criteria were (1) the study included a job stressor or psychosocial working condition as an exposure, and (2) psychotropic medication was an outcome. All effect-size estimates were considered but needed to present either a SE or 95% CIs to be included in meta-analyses. Data were pooled between studies using the relative risk (RR) or odds ratio (OR) and 95% CIs.

Results There were 18 unique studies with non-overlapping exposures eligible for inclusion in the quantitative meta-analysis. High job demands were associated with a statistically significant increased risk of psychotropic medication use (RR 1.16, 95% CI 1.02 to 1.31). There was also an elevated RR in relation to work–family conflict (RR 1.26, 95% CI 1.03 to 1.48). In studies reporting OR, high job demands were associated with an OR of 1.39 (95% CI 1.06 to 1.71).

Conclusions The findings of this review highlight the need for policy and programme attention to reduce harmful exposure to psychosocial job stressors. Health-service use measures should be considered as outcomes and may represent more severe mental health conditions.

  • epidemiology
  • mental health
  • systematic reviews
  • workplace
  • work stress

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  • Contributors AM and AJS completed the literature searches. Data extraction was completed and checked by AM, AJS and TLK. All authors contributed to the manuscript.

  • Funding AM was supported by a Victorian Health and Medical Research Fellowship. AJS and TK were supported by a partnership project grant from the National Health and Medicine Research Council (APP1134499).

  • Competing interests None declared.

  • Patient consent for publication Not required.

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