Effort-reward imbalance and common mental disorders among public sector employees of Iran: a cross-sectional analysis.

ABSTRACT

BACKGROUND: The effort-reward imbalance (ERI) model is a widely used theoretical model to measure stress in the workplace. The objective of this study was to investigate the relationship between ERI and three common mental disorders major depressive disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). METHODS: In this cross-sectional analysis, the study sample consisted of 4453 baseline participants of the Employees' Health Cohort Study of Iran (EHCSIR). Trained psychologists utilized the Persian version of the Composite International Diagnostic Interview (CIDI-2.1) during the baseline assessment to identify common mental disorders. Additionally, the validated Persian version of the 23-item ERI questionnaire was employed to assess effort, reward, overcommitment, and effort-reward ratio. To examine the association of ERI components with three common mental disorders (MDD, GAD, and OCD) over the past twelve months, multiple logistic regression analyses were conducted. RESULTS: The prevalence of effort-reward imbalance in the study sample was 47.1%. Higher ERI score was significantly associated with MDD (OR 3.43, 95% CI 2.30-5.13), GAD (OR 2.42, 95% CI 1.27-4.63), and OCD (OR 2.23, 95% CI1.19-4.19). The study participants who reported higher scores on work overcommitment had a higher likelihood of having MDD (OR 1.16, 95% CI1.10-1.23), GAD (OR 1.07, 95% CI 1.01-1.14), and OCD (OR 1.19, 95% CI 1.09-1.29). CONCLUSIONS: According to the study's findings, work-related stress, as determined by the ERI model, is a significant factor in the development of common mental disorders among employees in the public sector.