Changes in psychosocial and physical working conditions and subsequent psychotropic medication

Abstract

Background: We set out this study to examine the associations between changes in psychosocial and physical working conditions and subsequent psychotropic medication in ageing employees. Methods: Data (N=3587; 80% women) were derived from the Helsinki Health Study, which is a cohort study of Finnish employees aged 40-60 years at Phase 1 (2000-2002). Changes in working conditions were assessed between Phase 1 and Phase 2 (2007). Survey data were linked to data on prescribed psychotropic medication (ATC) obtained from the register of the Social Insurance Institution of Finland between Phase 2 and the end of 2013. Outcomes were any psychotropic medication; antidepressants (N06A); anxiolytics (N05B); and sedatives and hypnotics (N05C). Cox regression analyses were performed adjusting for age and sex. Findings: The results showed that repeated exposures to low job control, high job demands and high physical work load were associated with an increased risk of subsequent antidepressant and anxiolytic medication. Increased and repeated exposure to high physical work load, increased job control and repeated high job demands were associated with subsequent sedative and hypnotic medication. Hazard ratios varied from 1.18 to 1.66. Improvement in job control was associated with a lower risk of anxiolytic, but with a higher risk of sedative and hypnotic medication. Decreased physical work load was associated with a lower risk of antidepressant and anxiolytic medication. Discussion: Improvement both in psychosocial and physical working conditions may decrease the risk of mental ill-health indicated by psychotropic medication.