Externally assessed psychosocial work characteristics and diagnoses of anxiety and depression.

BACKGROUND: Interpretations of relationships between work characteristics and psychiatric disorders may be biased by over-reporting of unfavourable work characteristics among those with psychiatric disorders. This study attempts to account for this bias by using external assessments of work characteristics. METHODS: Psychiatric symptoms were assessed in an interview and psychiatric diagnoses were established according to DSM-IV. Current work characteristics and work characteristics three years ago were assessed in an interview with predetermined criteria and included cognitive requirements, possibility of influence, and required conformance to schedule, time pressure, and hindrances concerning goals, resources and instrumental support. Deterioration in work characteristics during the study period was also assessed. The sample consisted of 672 employed men and women in different occupations. RESULTS: Lack of instrumental support from colleagues and supervisors (OR 6.4, 95% CI 2.6 to 15.8) assessed as a hindrance to work performance, and deterioration in work characteristics during the study period (OR 2.8, 95% CI 1.3 to 6.1) were associated with increased odds ratios for depression after adjustment for confounding factors, including symptoms of mental illness at baseline. Findings for anxiety were similar but not statistically significant. CONCLUSION: Externally assessed lack of instrumental social support at work and deteriorating work characteristics were associated with an increased risk for depression.

Does psychological distress influence reporting of demands and control at work?

AIMS: To investigate whether self reporting of psychological demands and control at work is as valid for psychologically distressed subjects as for subjects with psychological wellbeing. METHOD: Self reported demands and control (according to the model of Karasek) were compared to expert assessments through direct observations of each subject's work conditions concerning time pressure, hindrances, qualification for work tasks, and possibility of having influence. The comparison was made between respondents reporting and not reporting psychological distress as measured by the general health questionnaire with 12 questions (GHQ-12). The sample consisted of 203 men and women in 85 occupations. RESULT: No systematic differences between self reported and externally assessed working conditions for respondents reporting different levels of psychological distress were found. CONCLUSION: Over-reporting of work demands or under-reporting of work control is unlikely at the levels of psychological distress studied.