ABSTRACT
Objectives To investigate if exposure to adverse
psychological job characteristics predicts incident use of
antidepressants, taking into account differential
misclassification and residual confounding.
Methods A prospective cohort study with a 3.5-year
follow-up of 4661 Danish employees, aged 40 and
50 years, drawn from a 10% random sample of the
Danish population was carried out. Job characteristics
were the predictor variables and use of antidepressants
was the outcome variable. Survey data on psychosocial
work environment were linked with register data on
dispensing of antidepressant medicine between June
2000 and December 2003. Respondents with major
depression at baseline, with antidepressant use in the
5 years preceding baseline, or not employed at baseline
were excluded.
Results Among men, the OR for antidepressant use was
significantly increased for high quantitative demands (OR
2.12, 95% CI 1.29 to 3.48) and low social support from
colleagues (OR 2.28, 95% 1.36 to 3.82) after adjustment
for lifestyle factors, socio-demographic factors,
co-morbidity, other work factors and depressive
symptoms at baseline. Both effects were dose
dependent. An interaction effect with high demands was
found for high anticipated private social support and
living with children. Among women, no effect of job
characteristics on antidepressant use was found.
Conclusion Among men, but not among women, high
quantitative demands and low social support from
colleagues were predictive of incident use of
antidepressants, indicating incident depressive episodes,
even after taking into account differential
misclassification and residual confounding. The effects
were buffered for those with high anticipated private
social support and for those having children.