Does dissatisfaction with psychosocial work climate predict depressive, anxiety and substance abuse disorders? A prospective study of Danish public service employees

Background The aim of this study was to examine if dissatisfaction with psychosocial work climate predicts psychiatrically diagnosed depressive, anxiety and substance abuse disorders. Methods In Aarhus County, Denmark, 13 423 public service employees at 683 workplace units answered a questionnaire survey assessing psychosocial work environment. An average workplace unit score of overall satisfaction with psychosocial working conditions, rated on a scale from 0-10 with 10 being most satisfied, was computed and assigned to the individual employees at each work unit. Aggregated satisfaction scores were divided into three levels, according to the 25-75 percentiles. Data on hospitalisations and outpatient treatments for depressive, anxiety and substance abuse disorders was obtained from the Danish Central Psychiatric Research Register. HRs and 95% CIs were computed for first onset of studied disorders, starting from the baseline survey at 1 January 2002 through to 30 April 2008. Risk estimates were adjusted for sociodemographic variables. Results A low satisfaction with psychosocial working conditions was associated with an increased risk of any mental health disorder, HRadj 1.71, 95% CI 1.04 to 2.82. The lower the satisfaction level, the higher was the risk of mental health disorders. Moreover, substance abuse disorders were more frequent among men dissatisfied with work climate, HRadj 3.53, 95% CI 1.55 to 8.03. Conclusion Working in a dissatisfying psychosocial environment increases the risk of subsequent mental health disorders. Randomised, controlled intervention trials may help in resolving whether this association is causal.