Work and mental disorders in a German national representative sample

Most previous studies concerning the associations between work and mental ill-health have used dimensional self-report questionnaires for mental health problems (e.g., depressive symptoms). This study contributes to occupational health research by providing standardized clinical diagnoses based on DSM-IV criteria. A total of 2329 employees (age 18 65 years) took part in a structured, computer-assisted clinical interview (DIA-X/M-CIDI). Further, they specified whether their job was characterized by physical workload, overtime, or stress, and evaluated whether they feel impaired by each job characteristic. Results show that substance abuse/dependence (including nicotine dependence) was the highest prevalent mental disorder in German employees (12 month prevalence: 14.4%; only alcohol and illicit substance abuse/dependence: 4.9%) followed by anxiety (12.0%) somatoform (9.7%), and affective (9.3%) disorders. Sequential logistic regression analyses showed significant associations between the presence of stress at work and affective and somatoform disorders. Furthermore, feeling impaired by stress at work was strongly associated with anxiety, affective, somatoform disorders, and substance abuse/dependence. Beside work, personal characteristics, primarily gender, were associated with mental disorders in employees. However, except for affective disorders, gender did not modify the association between job characteristics and mental disorders. Taken together, results corroborate the necessity of considering mental disorders at work. Further studies to define the relation between work and mental disorders in employees are strongly recommended and should include objective analyses of job characteristics.