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      Which work-related characteristics are most strongly associated with common mental disorders? A cross-sectional study

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          Abstract

          Objectives

          Studies exploring work-related risk factors of common mental disorders (CMDs), such as major depressive disorder (MDD), generalised anxiety disorder (GAD) or alcohol abuse, have generally focused on a limited set of work characteristics. For the first time in a primary care setting, we examine simultaneously multiple work-related risk factors in relation to CMDs.

          Method

          We use data from a study of working individuals recruited among 2027 patients of 121 general practitioners (GPs) representative of the Nord-Pas-de-Calais region in the North of France (April–August 2014). CMDs (MDD; GAD; alcohol abuse) were assessed using the Mini-International Neuropsychiatric Interview. Six worked-related factors were examined (work intensity, emotional demands, autonomy, social relations at work, conflict in values and job insecurity). Several covariates were considered (patient, GP and contextual characteristics). To study the association between workplace risk factors and CMDs, we used multilevel Poisson regression models adjusted for covariates.

          Results

          Among study participants, 389 (19.1%) met criteria for MDD, 522 (25.8%) for GAD and 196 (9.7%) for alcohol abuse. In multivariable analyses adjusted for covariates, MDD/GAD was significantly associated with work intensity (RR 1.16, 95% CI 1.06 to 1.27) (absolute risk=52.8%), emotional demands (RR 1.24, 95% CI 1.13 to 1.35) (absolute risk=54.9%) and social relations at work (RR 0.78, 95% CI 0.70 to 0.87) (absolute risk=15.0%); alcohol abuse was associated with social relations at work (RR 1.25, 95% CI 1.01 to 1.53) (absolute risk=7.6%) and autonomy (OR 0.82, 95% CI 0.67 to 0.99) (absolute risk=8.9%).

          Conclusions

          Several workplace factors are associated with CMDs among working individuals seen by a GP. These findings confirm the role of organisational characteristics of work as a correlate of psychological difficulties above and beyond other sources of risk.

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          Most cited references45

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          From alpha to omega: a practical solution to the pervasive problem of internal consistency estimation.

          Coefficient alpha is the most popular measure of reliability (and certainly of internal consistency reliability) reported in psychological research. This is noteworthy given the numerous deficiencies of coefficient alpha documented in the psychometric literature. This mismatch between theory and practice appears to arise partly because users of psychological scales are unfamiliar with the psychometric literature on coefficient alpha and partly because alternatives to alpha are not widely known. We present a brief review of the psychometric literature on coefficient alpha, followed by a practical alternative in the form of coefficient omega. To facilitate the shift from alpha to omega, we also present a brief guide to the calculation of point and interval estimates of omega using a free, open source software environment. © 2013 The British Psychological Society.
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            Adverse health effects of high-effort/low-reward conditions.

            J Siegrist (1996)
            In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.
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              The Copenhagen Psychosocial Questionnaire—a tool for the assessment and improvement of the psychosocial work environment

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2018
                5 August 2018
                : 8
                : 8
                : e020770
                Affiliations
                [1 ] Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013 , Paris, France
                [2 ] departmentDepartment of Infectious Diseases , Centre Hospitalier Régional , Orléans, France
                [3 ] University of Lille , France
                [4 ] Regional Federation of Research in Psychiatry and Mental Health Hauts-de-France , Lille, France
                [5 ] EA 40-47 University of Versailles Saint-Quentin , Versailles, France
                [6 ] Academic Unit of psychiatry for adults, Versailles Hospital , Versailles, France
                Author notes
                [Correspondence to ] Mr Mathieu Rivière; mathieu.riviere@ 123456iplesp.upmc.fr
                Article
                bmjopen-2017-020770
                10.1136/bmjopen-2017-020770
                6078252
                30082345
                e98ec0d4-8f20-4587-8d6a-8fa7e3b0183d
                © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 28 November 2017
                : 18 May 2018
                : 26 June 2018
                Funding
                Funded by: Ile-de-France region – DIM Gestes;
                Funded by: Nord – Pas-de-Calais regional health agency (ARS);
                Categories
                Occupational and Environmental Medicine
                Research
                1506
                1716
                Custom metadata
                unlocked

                Medicine
                primary care,psychiatry
                Medicine
                primary care, psychiatry

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