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Occupational Mental Health and Burnout

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 43744

Special Issue Editors


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Guest Editor
Department of Occupational and Environmental Medicine, College of Medicine & Graduate School of Public Health, Hanyang University, Seoul, Korea
Interests: mental health; suicide; working condition; psychosocial factors; occupational disease; policy; occupational epidemiology

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Guest Editor
Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
Interests: long working hours; shift work; physical activity; sleep disorder; circadian rhythm; cardiovascular disease
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Guest Editor
Department of Occupational and Environmental Medicine, Institute of Environmental and Occupational Medicine, Pusan Paik Hospital, Inje University, Busan, Korea
Interests: work engagement; well-being; emotional labor; psychosocial factor at work; occupational mental health

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Guest Editor
Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
Interests: working condition; health; safety; occupational medicine; occupational health; occupational epidemiology; occupational exposure

Special Issue Information

Dear Colleagues,

Mental health is the single largest burden of non-fatal health problems, and is an important cause of presenteeism, absenteeism, unemployment, long-term disability, and lower productivity. Burnout is a representative occupational phenomenon included in the 11th revision of the International Classification of Disease. In particular, in the recent pandemic, it is known that the mental health of many essential service workers, including healthcare workers, is severely threatened.

Poor working conditions, work organization, job insecurity, workplace harassment, and other psychosocial factors are all related to mental health problems and burnout. However, the “future of work” poses various challenges, such as a multilevel approach in consideration of social context, definition of risk factors, interpretation in consideration of social context, and so on, even in the academic field that has dealt with mental health as part of occupational health.

Promoting mental wellbeing and a healthy workplace is not just a moral obligation but also a good investment for employers. In this context, evidence-based mental health promotion policy has become an important issue for healthy local communities and workplaces.

This Special Issue invites highly qualified papers, especially those combining academic challenges coupled with a practical focus on providing optimal mental health promotion or preventing burnout.

Prof. Dr. Inah Kim
Prof. Dr. Tae-Won Jang
Dr. Chunhui Suh
Dr. Wanhyung Lee
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Mental health
  • Burnout
  • Occupation
  • Working Condition
  • Psychosocial Factors

Published Papers (11 papers)

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Research

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14 pages, 755 KiB  
Article
High Emotional Demands at Work and Poor Mental Health in Client-Facing Workers
by Chunhui Suh and Laura Punnett
Int. J. Environ. Res. Public Health 2022, 19(12), 7530; https://doi.org/10.3390/ijerph19127530 - 20 Jun 2022
Cited by 2 | Viewed by 2569
Abstract
This study investigated the association between emotional demands and depression or anxiety in a wide range of jobs. We used data from the third Korean Working Conditions Survey (n = 50,032) for all occupational classifications, with no limitations placed on job title [...] Read more.
This study investigated the association between emotional demands and depression or anxiety in a wide range of jobs. We used data from the third Korean Working Conditions Survey (n = 50,032) for all occupational classifications, with no limitations placed on job title or employment type. Among the full set of regular paid workers in addition to self-employed, unpaid family workers, and informal employees such as independent contractors, 23,989 respondents worked with “customers, passengers, students, or patients” (i.e., clients). Emotional demands were evaluated using two questions: handling angry clients and needing to hide feelings for work performance. Any depression or anxiety over the last 12 months was taken to indicate poor mental health. Multivariable logistic regression modeling was performed to calculate adjusted ORs with 95% confidence intervals for the influence of emotional demands on mental health, adjusting for demographic factors (age, gender, education, income), occupational psychological demands, decision latitude, social support, weekly work hours and job insecurity. The prevalence of emotional demands was higher in self-employed and informal employees than in regular paid employees. The more frequent the exposure to the two emotional demands combined was, the higher the risk of depression or anxiety. High psychological demands, low social support, and low job security each further increased the risk of poor mental health. Emotional demands turned out to be widespread in the entire economy, were not limited to service or sales occupations, and were more evident in precarious work. The contribution of emotional demands and other preventable job stressors to the burden of depression or anxiety in society may be substantial. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
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11 pages, 489 KiB  
Article
Effect of Working from Home on the Association between Job Demands and Psychological Distress
by Hisashi Eguchi, Akiomi Inoue, Ayako Hino, Mayumi Tsuji, Seiichiro Tateishi, Kazunori Ikegami, Tomohisa Nagata, Ryutaro Matsugaki, Yoshihisa Fujino and on behalf of the CORoNaWork Project
Int. J. Environ. Res. Public Health 2022, 19(10), 6287; https://doi.org/10.3390/ijerph19106287 - 22 May 2022
Cited by 3 | Viewed by 2384
Abstract
Limited information is available regarding the association between workplace psychosocial factors and general mental health status among workers during the coronavirus disease 2019 pandemic. This study examined how working from home affected the association between job demands and psychological distress (PD). A cross-sectional [...] Read more.
Limited information is available regarding the association between workplace psychosocial factors and general mental health status among workers during the coronavirus disease 2019 pandemic. This study examined how working from home affected the association between job demands and psychological distress (PD). A cross-sectional online survey was conducted in December 2020 (N = 27,036). The dependent variable (PD) was assessed using the Kessler Psychological Distress Scale. Job demands were assessed using the Job Content Questionnaire. Working from home was determined by participants’ responses to the question, “Do you currently work from home?” We used a two-level regression analysis adjusted for prefecture. Each individual-level variable at Level 1 was nested into each prefecture at Level 2, stratified by working from home or not. Overall, 21.3% of participants worked from home. The interaction between working from home and job demands was significant. Job demands were positively associated with PD. The stratified analysis indicated that the associations were weaker among employees who worked from home compared with those among employees who did not. The association between job demands and PD may be weakened by working from home. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
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12 pages, 344 KiB  
Article
Comparison of Work-Related Stress in Cluster of Workers’ Suicides in Korea: Analysis of Industrial Accident Compensation Insurance, 2010–2017
by Jungwon Jang, Inah Kim, Yangwoo Kim and Jaechul Song
Int. J. Environ. Res. Public Health 2022, 19(5), 3013; https://doi.org/10.3390/ijerph19053013 - 4 Mar 2022
Cited by 3 | Viewed by 1693
Abstract
Background: There is limited research on the heterogeneity of worker suicides. We compared differences in workers’ suicides by clustering suicide deaths. Methods: From 2010 to 2017, 353 suicide deaths were claimed in the Industrial Accident Compensation Insurance; variables were coded using a standardized [...] Read more.
Background: There is limited research on the heterogeneity of worker suicides. We compared differences in workers’ suicides by clustering suicide deaths. Methods: From 2010 to 2017, 353 suicide deaths were claimed in the Industrial Accident Compensation Insurance; variables were coded using a standardized methodology. A two-step cluster analysis classified the clusters based on demographic and employment conditions. Details of the suicide, clinical variables, personal stresses, and work-related stresses were compared using the chi-square test and one-way analysis of variance. Results: We identified five clusters and they differed particularly in work-related stress. “Responsibility-burdened type” experienced excessive responsibility as managers; “role-changed type” experienced a sudden and unpredictable role change as clerks or sales workers; “risk-exposed type” experienced physical risk factors at work (working alone, outdoors, and in shifts) as machine operating and assembling workers, or craft and related trades workers; “job-insecurity type” experienced unstable employment (irregular, nonpermanent) as elementary or service workers; “workplace-violence type” was mainly unmarried women who lived alone, and experienced interpersonal conflict and violence as professionals and related workers. There were no differences between clusters in clinical variables (except problem drinking) and personal stresses. Conclusion: Interventions to alleviate work-related stress in worker clusters are needed to prevent suicide in workers. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
16 pages, 845 KiB  
Article
The Development of Teacher Burnout and the Effects of Resource Factors: A Latent Transition Perspective
by Min Xie, Shunsen Huang, Li Ke, Xia Wang and Yun Wang
Int. J. Environ. Res. Public Health 2022, 19(5), 2725; https://doi.org/10.3390/ijerph19052725 - 26 Feb 2022
Cited by 3 | Viewed by 3553
Abstract
To better understand burnout and its development, researchers have shown an increasing interest in recent years in identifying different profiles of burnout and its development process. However, there have been few longitudinal studies on the profile and development of teacher burnout. This study [...] Read more.
To better understand burnout and its development, researchers have shown an increasing interest in recent years in identifying different profiles of burnout and its development process. However, there have been few longitudinal studies on the profile and development of teacher burnout. This study used a person-centred approach to explore the profiles of teacher burnout, transition probabilities and the associations between these aspects and resource factors. Data were collected from 3743 primary school teachers in a two-wave longitudinal test over three years. The results showed that teacher burnout exhibited six relatively stable profiles across the whole study population and that the transition of individual profiles over time followed a certain probability. Psychological capital and professional identity were important resource factors in reducing the occurrence of teacher burnout and increasing transition probability toward burnout symptom alleviation over time, while positive coping played an important role in reducing the occurrence of teacher ineffectiveness. Therefore, the results indicated that the overall teacher burnout profile was stable, a discovery which has important implications for conducting group interventions to benefit more teachers, while the individual burnout profile exhibited a latent transition probability over time. Interventions employing different resource factors can be adopted to alleviate the symptoms of different burnout profiles. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
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18 pages, 700 KiB  
Article
Flourishing in Healthcare Trainees: Psychological Well-Being and the Conserved Transcriptional Response to Adversity
by Jennifer S. Mascaro, Amanda Wallace, Brooke Hyman, Carla Haack, Cherie C. Hill, Miranda A. Moore, Maha B. Lund, Eric J. Nehl, Sharon H. Bergquist and Steve W. Cole
Int. J. Environ. Res. Public Health 2022, 19(4), 2255; https://doi.org/10.3390/ijerph19042255 - 16 Feb 2022
Cited by 5 | Viewed by 2869
Abstract
While much attention has been paid to healthcare provider and trainee burnout, less is known about provider well-being (i.e., flourishing) or about the effects of well-being on immune function. This study examined the demographic and psycho-social correlates of well-being among healthcare trainees (resident [...] Read more.
While much attention has been paid to healthcare provider and trainee burnout, less is known about provider well-being (i.e., flourishing) or about the effects of well-being on immune function. This study examined the demographic and psycho-social correlates of well-being among healthcare trainees (resident physicians and physician assistant (PA) trainees) and evaluated the association of well-being with the “conserved transcriptional response to adversity” (CTRA) characterized by up-regulated expression of pro-inflammatory genes and down-regulated expression of innate antiviral genes. Participants (n = 58) completed self-reported assessments of sleep disturbance, loneliness, depressive symptoms, anxiety, stress, and well-being (flourishing). Blood sample RNA profiles were analyzed by RNA sequencing to assess the CTRA. Slightly over half (n = 32; 55.2%) of healthcare trainees were categorized as flourishing. Flourishing was less prevalent among primary caregivers, and more prevalent among trainees who exercised more frequently and those with fewest days sick. Loneliness (AOR = 0.75; 95% CI = 0.61, 0.91; p = 0.003) and stress (AOR = 0.65; 95% CI = 0.45, 0.94; p = 0.02) were associated with decreased odds of flourishing when controlling for other variables. Flourishing was associated with down-regulated CTRA gene expression, whereas loneliness was associated with up-regulated CTRA gene expression (both p < 0.05). Assessing these relationships in a larger, multi-site study is of critical importance to inform policy, curricula, and interventions to bolster sustainable trainee well-being. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
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11 pages, 616 KiB  
Article
Sensory Processing, Perceived Stress and Burnout Symptoms in a Working Population during the COVID-19 Crisis
by Frank van den Boogert, Pascalle Spaan, Bram Sizoo, Yvonne H. A. Bouman, Witte J. G. Hoogendijk and Sabine J. Roza
Int. J. Environ. Res. Public Health 2022, 19(4), 2043; https://doi.org/10.3390/ijerph19042043 - 11 Feb 2022
Cited by 4 | Viewed by 3355
Abstract
Although previous research suggests an association between sensory processing and perceived stress in a broad spectrum of mental health conditions, it remains unclear whether this phenomenon occurs independently from psychopathology. The present study investigated the association between sensory processing patterns, perceived stress and [...] Read more.
Although previous research suggests an association between sensory processing and perceived stress in a broad spectrum of mental health conditions, it remains unclear whether this phenomenon occurs independently from psychopathology. The present study investigated the association between sensory processing patterns, perceived stress and occupational burnout as a stress-related condition in a working population. We focused on different aspects of sensory processing and used the momentum of a particularly stressful period: during the first months of the global COVID-19 crisis. A total of 116 workers at a mental healthcare institution in The Netherlands completed the Adolescent/Adult Sensory Profile (AASP), the Perceived Stress Scale (PSS-10) and the Burnout Assessment Tool (BAT). Our results demonstrated that higher scores on sensory sensitivity and low registration were associated with higher scores on perceived stress and core burnout symptoms. Sensory hypersensitivity was also associated with more secondary burnout symptoms. Associations were not driven by underlying sensory-related disorders (e.g., ASD or ADHD). In conclusion, sensory processing difficulties are relevant predictors of stress and occupational burnout, also in healthy employees. This phenomenon warrants further attention, as relatively simple adjustments in working environment may possess important preventive effects. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
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17 pages, 1085 KiB  
Article
Exploring the Associations between Perceived Organizational Support and Job Burnout among Chinese Academic Journal Editors: A Moderated Mediation Model
by Xiaoyan Yu, Shiyong Wu, Wei Chen, Wen Zheng, Mingxi Huang, Lei Yang and Shuyi Zhou
Int. J. Environ. Res. Public Health 2021, 18(22), 12167; https://doi.org/10.3390/ijerph182212167 - 19 Nov 2021
Cited by 6 | Viewed by 3776
Abstract
Background: Job burnout (JB) has become a prevalent emotional and psychological syndrome across diverse contexts, especially in the face of the COVID-19 pandemic. This study aimed to examine the relationship between perceived organizational support (POS), job satisfaction (JS), self-efficacy (SE), and JB, alongside [...] Read more.
Background: Job burnout (JB) has become a prevalent emotional and psychological syndrome across diverse contexts, especially in the face of the COVID-19 pandemic. This study aimed to examine the relationship between perceived organizational support (POS), job satisfaction (JS), self-efficacy (SE), and JB, alongside their mechanism of interplay. Methods: We took 210 Chinese academic journal editors as the research participants and designed a moderated mediation model to examine the posited construct. All the data were gathered online and analyzed with the statistical software SPSS and SmartPLS. Results: The participants comprised 117 women (55.71%) and 93 men (44.29%). There were significant differences among observed variables in age, experience, and title. POS had a significant negative predictive effect on JB (95% CI = −0.43; −0.06). JS mediated the relationship between POS and JB (95% CI = −0.48; −0.11). SE moderated the association between JS and JB (95% CI = 0.04; 0.75) but did not function as a moderator in the relationship between POS and JS (95% CI = −0.01; 0.24). Conclusions: POS, JS, and SE were crucial determinants of JB among Chinese academic journal editors. Targeted interventions should be initiated to diminish editors’ feelings of being unappreciated, inefficient, dissatisfied, and unaccomplished at work. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
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10 pages, 546 KiB  
Article
Emotional Demand and Mental Health in Korean Employees
by Soon-Chan Kwon, Inah Kim and Yu-Mi Kim
Int. J. Environ. Res. Public Health 2021, 18(14), 7312; https://doi.org/10.3390/ijerph18147312 - 8 Jul 2021
Cited by 2 | Viewed by 2598
Abstract
Background: Emotional demand (ED) at work is related to mental health in the general workforce, not just emotional workers. We investigated the relationships between ED and mental health outcomes, including distress, depressive symptoms (DS), experience of depression (DE), and suicidal ideation (SI) on [...] Read more.
Background: Emotional demand (ED) at work is related to mental health in the general workforce, not just emotional workers. We investigated the relationships between ED and mental health outcomes, including distress, depressive symptoms (DS), experience of depression (DE), and suicidal ideation (SI) on the entire general workforce using nationally representative data. Methods: 5787 full-time employees were analyzed using cross-sectional design with the fourth Korean National Health and Nutrition Examination Survey (K-NHANES IV). Work-related psychosocial factors and mental health status were measured through face-to-face interviews. Multi-stage and stratified survey designs were considered in the analysis, and the mental health effects of ED were analyzed using multivariable logistic analysis. The Cochran–Armitage trend test was conducted to investigate increases in the relationship between the severity of ED and mental health outcomes. Results: The subjects comprised 3089 men and 2698 women. ED was reported by 36.7% of men and 39.3% of women. The estimated prevalence of distress was 27.5% in men and 34.6% in women. Adjusted odds ratios (ORs) of ED for distress were 2.62 (95% confidence interval (CI) = 2.10–3.28) for men and 2.57 (95% CI = 1.92–3.45) for women. DS was significantly related to ED (men: OR = 1.72, 95% CI = 1.18–2.50; women: OR = 1.91, 95% CI = 1.33–2.74). ED was also significant psychosocial risk factor for DE (men: OR = 1.88, 95% CI = 1.07–3.29; women: OR = 1.77, 95% CI = 1.15–2.75) and SI (men: OR = 1.64, 95% CI = 1.11–2.41; women: OR = 2.31, 95% CI = 1.63–3.28). Conclusions: ED was a risk factor for distress, DS, DE, and SI in the general workforce. Legal and social safety networks should be constructed for workers whose emotions may be hidden at work, as well as workers in emotion-related fields. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
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9 pages, 532 KiB  
Article
Is There Utility in Specifying Professional Efficacy as an Outcome of Burnout in the Employee Health Impairment Process
by Leon T. de Beer
Int. J. Environ. Res. Public Health 2021, 18(12), 6255; https://doi.org/10.3390/ijerph18126255 - 9 Jun 2021
Cited by 6 | Viewed by 2736
Abstract
The aim of this study was to investigate the utility of specifying professional efficacy as an outcome of burnout in the employee health impairment process of the job demands–resources model. The sample comprised a general, but purposive, sample of employees (n = [...] Read more.
The aim of this study was to investigate the utility of specifying professional efficacy as an outcome of burnout in the employee health impairment process of the job demands–resources model. The sample comprised a general, but purposive, sample of employees (n = 660). Specifically, participants needed to be at least 18 years of age and be employed in the formal sector. Structural equation modeling methods were applied to analyze the data with a mean- and variance-adjusted weighted least squares estimation. The results showed that the research model was a good fit to the data. Furthermore, the results showed that burnout had a statistically significant negative structural path to professional efficacy, but that professional efficacy in turn did not statistically significantly explain variance in either psychological distress or turnover intention beyond burnout. There were also no meaningful indirect effects, from emotional load to either psychological distress or turnover intention, of professional efficacy. All in all, the results showed that there was no practical utility in specifying professional efficacy as an outcome of burnout in the employee health impairment process of the job demands–resources model, except if professional efficacy is being investigated as an outcome for its own sake. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
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Review

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12 pages, 1464 KiB  
Review
Prevalence, Risk Factors and Burnout Levels in Intensive Care Unit Nurses: A Systematic Review and Meta-Analysis
by Santiago Ramírez-Elvira, José L. Romero-Béjar, Nora Suleiman-Martos, José L. Gómez-Urquiza, Carolina Monsalve-Reyes, Guillermo A. Cañadas-De la Fuente and Luis Albendín-García
Int. J. Environ. Res. Public Health 2021, 18(21), 11432; https://doi.org/10.3390/ijerph182111432 - 30 Oct 2021
Cited by 56 | Viewed by 12877
Abstract
Nursing is considered to be an at-risk profession of burnout due to daily exposure to difficult situations such as death and pain care. In addition, some units such as the intensive care unit (ICU), can be stressful due to high levels of morbidity [...] Read more.
Nursing is considered to be an at-risk profession of burnout due to daily exposure to difficult situations such as death and pain care. In addition, some units such as the intensive care unit (ICU), can be stressful due to high levels of morbidity and mortality and ethical dilemmas. Burnout causes a deterioration in quality of care, increasing the risk of mortality in patients due to poor performance and errors in the healthcare environment. The aim of this study was to analyse the levels, prevalence and related factors of burnout in ICU nurses. A systematic review and meta-analysis were carried out in the Medline, Scopus and CINAHL databases. Fifteen articles were found for the systematic review and four for the meta-analysis. With a sample of n = 1986 nurses, the meta-analytic estimate prevalence for high emotional exhaustion was 31% (95% CI, 8–59%), for high depersonalization was 18% (95% CI, 8–30%), and for low personal accomplishment was 46% (95% CI, 20–74%). Within the dimensions of burnout, emotional exhaustion had a significant relationship with depression and personality factors. Both sociodemographic factors (being younger, single marital status, and having less professional experience in ICU) and working conditions (workload and working longer hours) influence the risk of burnout syndrome. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
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Other

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25 pages, 2614 KiB  
Systematic Review
Occurrence of Mental Illness and Mental Health Risks among the Self-Employed: A Systematic Review
by Kristina Willeke, Patrick Janson, Katharina Zink, Carolin Stupp, Sarah Kittel-Schneider, Anne Berghöfer, Thomas Ewert, Ryan King, Peter U. Heuschmann, Andreas Zapf, Manfred Wildner and Thomas Keil
Int. J. Environ. Res. Public Health 2021, 18(16), 8617; https://doi.org/10.3390/ijerph18168617 - 15 Aug 2021
Cited by 8 | Viewed by 3445
Abstract
We aimed to systematically identify and evaluate all studies of good quality that compared the occurrence of mental disorders in the self-employed versus employees. Adhering to the Cochrane guidelines, we conducted a systematic review and searched three major medical databases (MEDLINE, Web of [...] Read more.
We aimed to systematically identify and evaluate all studies of good quality that compared the occurrence of mental disorders in the self-employed versus employees. Adhering to the Cochrane guidelines, we conducted a systematic review and searched three major medical databases (MEDLINE, Web of Science, Embase), complemented by hand search. We included 26 (three longitudinal and 23 cross-sectional) population-based studies of good quality (using a validated quality assessment tool), with data from 3,128,877 participants in total. The longest of these studies, a Swedish national register evaluation with 25 years follow-up, showed a higher incidence of mental illness among the self-employed compared to white-collar workers, but a lower incidence compared to blue-collar workers. In the second longitudinal study from Sweden the self-employed had a lower incidence of mental illness compared to both blue- and white-collar workers over 15 years, whereas the third longitudinal study (South Korea) did not find a difference regarding the incidence of depressive symptoms over 6 years. Results from the cross-sectional studies showed associations between self-employment and poor general mental health and stress, but were inconsistent regarding other mental outcomes. Most studies from South Korea found a higher prevalence of mental disorders among the self-employed compared to employees, whereas the results of cross-sectional studies from outside Asia were less consistent. In conclusion, we found evidence from population-based studies for a link between self-employment and increased risk of mental illness. Further longitudinal studies are needed examining the potential risk for the development of mental disorders in specific subtypes of the self-employed. Full article
(This article belongs to the Special Issue Occupational Mental Health and Burnout)
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