@article{ref1,
title="Effort-reward imbalance, over-commitment and depressive episodes at work: evidence from the ELSA-Brasil Cohort Study",
journal="International journal of environmental research and public health",
year="2019",
author="de Araújo, Tânia Maria and Siegrist, Johannes and Moreno, Arlinda B. and de Jesus Mendes da Fonseca, Maria and Barreto, Sandhi M. and Chor, Dora and Griep, Rosane Härter",
volume="16",
number="17",
pages="e16173025-e16173025",
abstract="A growing burden of mental illness, and in particular depression, among workers is a concern of occupational public health. Scientific evidence has revealed consistent associations of work-related stress, as measured by theoretical models, with depression, but mostly so in developed countries. This contribution explores these associations in a developing Latin American country, Brazil, by applying an internationally established work stress model, the effort-reward imbalance (ERI). This model focuses on the work contract where unjust exchange between high efforts spent and low rewards received in turn contributes to stress-related disorders. The model's extrinsic ('effort', 'reward') and intrinsic components ('over-commitment'), as well as their combination, are hypothesized to be related to a higher risk of depressive episodes (DE). Using cross-sectional data from the ELSA-Brasil study, including 10,034 workers from the public sector, we observed increased prevalence ratio (PR) of DE according to ERI scales. The quartiles of highest 'effort' (PR = 1.85; 1.44-2.37), highest 'over-commitment' (PR = 3.62; 2.80-4.70) and lowest 'reward' (PR = 3.44; 2.55-4.64) were associated with DE, on adjusted models, as well was the E-R ratio (PR = 2.47; 1.92-3.17). An additive interaction was identified between the E-R ratio and 'over-commitment'. The results support the use of ERI as a screening tool for work stress in the Brazilian context and will offer guidance for worksite health promotion programs.<p /> <p>Language: en</p>",
language="en",
issn="1661-7827",
doi="10.3390/ijerph16173025",
url="http://dx.doi.org/10.3390/ijerph16173025"
}