Impact of work-related psychosocial factors on mental health: A cross-sectional study in the French working population
Résumé
BACKGROUND. According to Organization for Economic Cooperation and Development, mental health problems, such as depression and anxiety disorders, affect more than one in six people across the European Union in any given year. In the past few decades, mental health problems have increasingly contributed to sickness absence and long-term disability, and return to work is often complicated even if re-employment programs have a modest effect on the quality of life. Mental disorders lead to higher rates of absenteeism and constitute a leading cause of early retirement in Europe and have a direct impact on workplaces through reducing productivity, and increasing healthcare costs. A better understanding of work-related psychosocial factors (PSF) associated with employee’s mental health is important to help decision-makers and public authority to consider specific actions.
AIMS. The aim of this study at first, is to determine the exposure of the French work population to work-related PSF and second, to measure the impact of PSF on mental health.
DATA. The present work is based on a cross-sectional study conducted in march 2018 on a sample of 3200 workers, representative of the French working population. The sample has been randomly drawn from the French database “Ipsos Access Panel” and data were collected within a questionnaire administered during a computer assisted web interview (CAWI). To measure the level of mental health for each individual, the validated General Health Questionnaire (GHQ-28 items), constructed by Goldberg is used. GHQ-28 items, which is surely the most internationally used, is a self-administered screening questionnaire designed to detect probable psychiatric disorder in primary care settings. The questionnaire doesn’t give any information on the basic health status of the subject. It allows to know if the interviewee is better or worse than usual at the time of the questionnaire. The French version of the questionnaire, used in our study, has been validated. In order to measure psychosocial factors (PSF) at work, 44-item questionnaire is developed. These factors were inspired by major theoretical works from Karasek, Siegrist and Greenberg, and the French report by Michel Gollac. In addition, fifty individual covariates about socio-demographic situation, health and life hygiene conditions, job characteristics and work environment were measured. In our study, we focused only on some of them. Indeed, only nine variables were extracted in the database that could be important in the prediction of mental health. These variables are: gender, age, work duration per week, working on the week-end, working at night, work on staggered hours, commuting duration, previous experience of unemployment and chronic medical condition.
METHODS. A multiple logistic regression is used to estimate the impact of each work-related PSF on employee’s mental health, adjusted on the nine confounders.
RESULTS. This study analyzed French 2803 employees, among them 48.6% women, with a mean age of 41.4 (11.13). According to the literature and to the distribution of GHQ-28 score in the sample, we choose a threshold of 24 to identify potential psychiatric cases. This was 22.2%, IC95[20,6; 24.0]. Ten PSF remains significantly associated with mental health. “Having problems to handle professional and personal responsibilities” was reported by 15% of the population and has the strongest association with mental health (Odd Ratio OR=1.97, Confidence Interval 95% [1.52; 2.54]). Among people exposed, 45% were potential psychiatric cases whereas 18% among unexposed. 52% of the sample reported having an unsatisfactory job compensation (OR=1.42 [1.15, 1.77]). Job insecurity (OR=1.44 [1.15; 1.78], 42% exposed), lack of social support (OR=1.63 [1.29; 2.06], 27% exposed) were also identified, as well as the emotional burden of the job (OR=1.43 [1.13; 1.79], 43% exposed), and the absence of symbolic compensation of the job in terms of self- esteem (OR=1.32 [1.03;1.69], 22% exposed). The other PSF were unsatisfactory communication at work (OR=1.39 [1.11; 1.75], 43% exposed), feeling afraid when doing the job (OR=1.53, [1.21; 1.93], 28% exposed), doing repetitive tasks (OR=1.29 [1.04; 1.60], 38% exposed) and having a highly cognitive demanding job in term of concentration (OR=1.35 [1.08; 1.70], 32% exposed). In addition, four individual covariates were associated to mental health: having a bad medical condition, being woman, being over 45 years old and work more than 50 hours per week.
CONCLUSION. Our study identified 10 PSF associated with mental health with an important exposition rate among employees. The study provided an initial look at the mental health disorders for French employees and the urgency to address mental health at workplace. As correlation does not imply causality, a causal analysis should also be performed before generating recommendations for work conditions.