Changes in psychosocial work environment and depressive symptoms: a prospective study in junior physicians.

ABSTRACT

BACKGROUND: We examined the impact of changes in the psychosocial work environment on depressive symptoms in a sample of junior physicians, a high risk group for stress and mental disorders. METHODS: This is a three-wave prospective study in 417 junior physicians during their residency in German hospitals. The psychosocial work environment was measured by the Effort-Reward Imbalance (ERI) Questionnaire at Waves 1 and 2, and the depressive symptoms were assessed with the State-Trait Depression Scales at all three waves. Multivariate linear regression was applied for prospective associations between ERI across Waves 1 and 2, and baseline-adjusted depressive symptoms at Wave 3. RESULTS: Compared with the ERI scores at Wave 1, at Wave 2, and mean scores between the two waves, the baseline-adjusted ERI change scores between the two waves showed slightly better statistical power, predicting depressive symptoms at Wave 3 (ß = 0.78, 95% CI = 0.38-1.18 for increased ERI per SD, ß = 0.64, 95% CI = 0.22-1.06 for increased effort per SD, ß = -0.65, 95% CI = -1.06 to -0.24 for increased reward per SD, and ß = 0.68, 95% CI = 0.27-1.09 for increased overcommitment per SD). CONCLUSIONS: Negative changes in the psychosocial work environment, specifically increased ERI, are associated with depressive symptoms in German junior physicians. Reducing the non-reciprocity of working life, particularly improving reward at work, may have beneficial effects on prevention of mental health problems in the hospital workplace.