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Daniel E.
High-stress jobs 'double chances of depression'

By Jeremy Laurance, Health Editor
The Independent
August 2, 2007

It is the curse of the modern world. Too much to do and too little time to do it. And now researchers have demonstrated its harmful effect on health.

A survey of young people in their early thirties has found those in high-stress jobs run twice the risk of suffering serious depression or anxiety as those in lower-stress occupations.

Top of the stress league are men who are head chefs in big restaurants and construction workers under pressure to complete a building on time. They are six times more likely to buckle under stress, researchers report.

Theirs are the most stressful jobs because, in addition to working to deadlines in an environment where failure is publicly visible, they face hard physical labour every day in extremes of heat or cold and frequently without encouragement or support.

Least stressful were those jobs which involved looking after children at home, where there are no deadlines to meet, greater flexibility and no fear of public failure.

Time pressure is the single most important cause of stress and of the illness to which it leads, the researchers from the Institute of Psychiatry at King's College London say. Physical conditions at work, boredom and relations with bosses and colleagues mattered less.

Overall, more than one in 20 cases of depression or anxiety annually is attributable to high stress at work, causing individual suffering and imposing a substantial burden on the health service and the economy, they say.

The survey, conducted for one year among 1,000 people aged 32 in a wide range of occupations, found 15 per cent of those in high-stress jobs suffered a first episode of clinical depression or anxiety during that year, compared with 8 per cent in low-stress jobs. Women were generally worse affected than men. People who had previously suffered depression or anxiety and those with "negative" personalities who were more likely to complain were eliminated from the study.

Maria Melchior, an epidemiologist at the Medical Research Council's Social, Genetic and Developmental Psychiatry Research Centre at King's, said: "Even at the beginning of their careers, we can see the effects of stress. It appears to bring on diagnosable forms of depression and anxiety in previously healthy young workers. It is very important these detrimental effects should be prevented."

She added: "There are ways of reducing stress through the organisation of the workplace and through interventions with individuals who can be taught how to cope with demanding jobs."

The findings run counter to previous research by Professor Sir Michael Marmot and colleagues, who followed a cohort of Whitehall civil servants for more than two decades. The Whitehall studies concluded that the most important factor in raising stress levels at work was lack of control, chiefly affecting those with low-status jobs.

But Dr Melchior said: "We found it was not so much lack of control as the high demands associated with the job that caused work stress. The demands tended to be higher in the high-status jobs, but were not restricted to them."

Professor Terrie Moffitt, also of King's and co-author of the study, published in Psychological Medicine, said it was the first to cover a variety of workers including actors, teachers, doctors, farmers, stockbrokers, pilots and police. Previous research had focused on single professions.

The research was carried out in Dunedin, New Zealand, on a group of people who have been followed since birth in 1972 as part of a separate study. Their jobs and lifestyles were comparable to those in other industrialised countries. "The results we have got here apply beyond New Zealand, including to the UK," Professor Moffitt said.

Job-related stress has been rising worldwide, according to the World Health Organisation, with one third of workers in industrialised countries affected.

Women tend to be worst affected, suffering higher levels of depression and anxiety during childbearing years. Before puberty and after the menopause their levels are lower and match men's. The reasons are thought to be hormonal, the burden of motherhood, and the tendency of bright women to hide their talents and accept lower-level work so as not to outshine male partners - or a combination of all three.

The authors said that despite the high incidence of stress, its effects were under-treated. Professor Moffitt said: "People are not flooding to their GPs. Only a third of those affected in New Zealand went to a psychiatrist or took medication. In Britain, 20 per cent of those who suffer depression get medication."

Pressure has a positive side

Time is what most people have too little of. Jobs, homes and families impose demands that are difficult to manage for anyone - and if the job is demanding, ordinary stress may tip into clinical illness. But before condemning high-stress modern lifestyles, consider the alternative. Deadlines can bring excitement as well as fear. Unpredictablity means variety and wards off boredom. Having too much to do is better than having too little. Unemployment is a scourge whose victims suffer far more than those in work - and are prey to drug-taking and crime. The loss of work, through redundancy or retirement, may trigger a worse reaction than the stress of doing it. In this context, a job, even a high-stress one, can be healing.
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