Document resource
Objective While the longitudinal relationship between work stress and depression is well investigated with a single stress exposure measurement, there is a lack of studies that have investigated this relationship with repeated stress exposure measurements. This study aims to close this gap by analyzing the effect of repeated stress exposure on the development of depression in middle-aged employees.Material and Methods This analysis is based on representative data from 3104 socially insured employees born in 1959 and 1965 who were employed in Germany in the first (2011) and second wave (2014) of the lidA (leben in der Arbeit) cohort study. Work stress was measured by the three scales of the effort-reward imbalance (ERI) model (effort (E), reward (R), work overcommitment (WOC)), and the control component of the job strain model. Depression was assessed by Beck’s Depression Inventory. We used Generalized Estimation Equations (GEE) for longitudinal analysis, adjusting for socio-demographic and work-related characteristics and physical health. To reduce potential bias due to selection effects the analysis was weighted.Results During the three-year observation period, 7.9% of respondents developed clinically relevant depression. In the GEE model, repeated exposure measurement showed a comparably significant increased risk ratio for the ER-ratio (RR (high vs. low tertile): 2.49; 95%-CI: 1.67-3.71) and for WOC (RR (high vs. low): 2.49; 95%-CI: 1.88-3.30), but not for control in relation to the development of depression after adjustment for the control variables. In addition, significantly higher risks for depression were found for women compared to men, for poor compared to good health and for part-time compared to full-time employment.Conclusion This study found a comparable increased risk of depression associated with repeated exposure to ERI and WOC during mid-working age. These results may be useful for the development of sustainable workplace strategies for the prevention of work-related stress.