Working conditions and psychotropic medication: a prospective cohort study

Purpose To examine whether work arrangements, physical working conditions and psychosocial working conditions are associated with subsequent mental health problems, measured by prescribed psychotropic drugs. Methods Data on working conditions collected among 40–60-year-old employees of the City of Helsinki, Finland (N = 6,498) were linked with the register of prescribed medication. Purchases of antidepressants (ATC class N06A), sleeping pills and sedatives (N05B and N05C), and any psychotropic drugs during a 5-year follow-up were examined. Current users and those with regular use of psychotropic drugs during the past 3 years were excluded, leaving 5,786 respondents for analysis. Results Working overtime was associated with purchases of sleeping pills among men but otherwise the associations between work arrangements and psychotropic medication were negligible. Desktop work was associated with purchases of sleeping pills among women. Among psychosocial working conditions, high self-assessed mental strenuousness and job dissatisfaction were consistently associated with purchases of antidepressants, sleeping pills and any psychotropic drugs. The strongest association was found for job dissatisfaction, which increased the risk of antidepressant purchases by 24% per one standard deviation increase in job dissatisfaction. The results for men were largely similar, with high mental strenuousness and job dissatisfaction, and poor workplace climate showing the strongest associations, particularly with antidepressant purchases. Conclusions Adjustment of work environments by reducing mental strenuousness and improving job satisfaction might help in prevention of mental health problems that account for a major part of the disease burden among employees.