1. Emotional demands at work and the risk of
clinical depression
– a longitudinal study in the Danish public sector
Marianne A Vammen1, Sigurd Mikkelsen1, Åse Marie Hansen, Jens Peter Bonde1, Matias B Grynderup,
Anette Kærgaard, Linda Kærlev, Ole Mors, Reiner Rugulies and Jane F Thomsen1.
1Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
Contact: marianne.agergaard.vammen@regionh.dk, +45 25 56 57 93.
Methods
A total of 4,389 non-depressed public employees were enrolled in 2007. At follow-up two years later, 3,224 (72%) from 474 work-units
participated. Participants with high levels of mental health symptoms went through a psychiatric interview (Schedule for Clinical
Assessment in Neuropsychiatry, SCAN). Sixty-two cases of clinical depression were diagnosed. Emotional demands were examined as
measures of perceived emotional demands and of content-related emotional demands (generic and patient-related), individually
reported (individual-based) and aggregated by work-units (work-unit-based). Odds ratios (OR) of depression were estimated by
logistic regression taking sociodemographic factors, lifestyle and history of depression into account. Positive work environment
factors; meaningful work, enrichment, supervisor, and colleague support, were considered as potential modifiers.
Results
Individually reported perceived emotional demands was related to depression. The analysis based on work-unit data was in the same
direction though not statistically significant. Content-related emotional demands did not predict depression. Meaningful work and
supervisor support but not enrichment were independent predictors of a reduced risk of depression. We observed no modifying effects
of the positive work environment factors.
Conclusion
• Individually reported
perceived emotional
demands predict clinical
depression two-years later,
whereas content-related
emotional demands do not.
• The results are not
statistically significant when
aggregated by work-units
• Positive work environment
factors do not modify the
effect.
Acknowledgments. This PRISME study was supported through grants from The Danish Working Environment Fund and Lundbeck a/s.
Background
High emotional demands at work may
cause an increased risk of depression.
However, the use of self-reported exposure
measures and proxies for disease have
made interpretation of associations difficult.
Objective
I. Investigate if different
dimensions of emotional
demands are associated
with clinical depression.
II. Examine if positive work
environment factors modify
the effect.
Dimensions of emotional demands at
work: The figure above illustrates the
interaction between the employee, the
employee's work and emotions. Perceived
emotional demands concerns the personal
perception of work (left) and content-
related emotional demands (generic and
patient-related) concerns the emotional
content in work (right) e.g. dealing with
others grieves or suffering.
Risk of clinical depression
Emotional demands
dimensions
Participants Individual-based Work-unit-based
n ORa 95% CI ORa 95% CI
Perceived 3116 1.40 1.02-1.92 1.24 0.75-2.07
Content-related 3124 0.93 0.70-1.24 0.92 0.62-1.35
Patient-related 1341 1.14 0.62-2.09 1.01 0.39-2.68
a adjusted for: personal income, previous episode(s) of depression, traumatic life events, loneliness
and smoking.