| Literature DB >> 32091111 |
Julia K Åhlin1, Paraskevi Peristera, Hugo Westerlund, Linda L Magnusson Hanson.
Abstract
Objectives Retirement is a major life transition. However, previous evidence on its mental health effects has been inconclusive. Whether retirement is desirable or not may depend on pre-retirement work characteristics. We investigated trajectories of depressive symptoms across retirement and how a number of psychosocial working characteristics influenced these trajectories. Methods We included 1735 respondents from the Swedish Longitudinal Occupational Survey of Health (SLOSH), retiring during 2008-2016 (mean retirement age 66 years). They had completed biennial questionnaires reporting job demands, decision authority, workplace social support, efforts, rewards, procedural justice and depressive symptoms. We applied group-based trajectory modelling to model trajectories of depressive symptoms across retirement. Multinomial logistic regression analyses estimated the associations between -psychosocial working characteristics and depressive symptom trajectories. Results We identified five depression trajectories. In four of them, depressive symptoms decreased slightly around retirement. In one, the symptom level was initially high, then decreased markedly across retirement. Perceptions of job demands, job strain, workplace social support, rewards, effort-reward imbalance and procedural justice were associated with the trajectories, while perceptions of decision authority and work efforts were only partly related to the trajectories. Conclusions We observed a rather positive development of depressive symptoms across retirement in a sample of Swedish retirees. For a small group with poor psychosocial working characteristics, symptoms clearly decreased, which may indicate that a relief from poor working characteristics is associated with an improvement for some retirees. However, for other retirees poor working characteristics were associated with persistent symptoms, suggesting a long-term effect of these work stressors.Entities:
Mesh:
Year: 2020 PMID: 32091111 PMCID: PMC7737805 DOI: 10.5271/sjweh.3889
Source DB: PubMed Journal: Scand J Work Environ Health ISSN: 0355-3140 Impact factor: 5.024
Figure 1Flowchart illustrating the sample selection from SLOSH 2006–2018. a Among the 26 347 participants who were excluded, some individuals did not respond in ≥2 waves, some individuals remained working, and some made transitions from or to work/non-work other than retirement.
Figure 2Mean depressive symptoms across retirement measured by the Symptom Checklist-core depression (SCL-CD6) among 1735 SLOSH participants between 2006 and 2018.
Figure 3Trajectories of depressive symptom scores (0–24) across retirement in the SLOSH study (N=1735) and the proportion of retirees in each group. Trajectory group labels: 1=no depression, stable (very low), 2=no depression, stable (low), 3=moderate depression, considerably decreasing, 4=mild depression, decreasing, 5=moderate depression, stable.
Characteristics of the sample and of the depression trajectory groups in the SLOSH study, 2006–2018. Missing information: depressive symptoms change (N=74; 4.3%), civil status (N=10; 0.6%), occupational position (N=22; 1.3%). [SD=standard deviation.]
| Total | Trajectory groups | P-value [ | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| N=1735 | Group 1 | Group 2 | Group 3 | Group 4 | Group 5 | ||||||||
| No depression, stable (very low) | No depression, stable (low) | Moderate depression, considerably decreasing | Mild depression, decreasing | Moderate depression, stable | |||||||||
| N | % | N | % | N | % | N | % | N | % | N | % | ||
| Sex | |||||||||||||
| Men | 805 | 46.6 | 269 | 57.1 | 361 | 43.1 | 14 | 36.8 | 134 | 41.1 | 27 | 43.6 | <0.001 |
| Women | 930 | 53.6 | 202 | 42.9 | 477 | 56.9 | 24 | 63.2 | 192 | 58.9 | 35 | 56.5 | |
| Civil status | |||||||||||||
| Single | 348 | 20.2 | 72 | 15.4 | 166 | 19.9 | 12 | 32.4 | 80 | 24.8 | 18 | 29.5 | <0.01 |
| Married/cohabiting | 1377 | 79.8 | 396 | 84.6 | 670 | 80.1 | 25 | 67.6 | 243 | 75.2 | 43 | 70.5 | |
| Occupational position | |||||||||||||
| Unskilled workers | 257 | 15.0 | 69 | 14.9 | 111 | 13.4 | 7 | 18.4 | 56 | 17.3 | 14 | 23.0 | 0.630 |
| Skilled workers | 268 | 15.7 | 74 | 16.0 | 136 | 16.4 | 3 | 7.9 | 47 | 14.6 | 8 | 13.1 | |
| Assistant non-manual employees | 272 | 15.9 | 67 | 14.5 | 126 | 15.2 | 5 | 13.2 | 62 | 19.2 | 12 | 19.7 | |
| Intermediate non-manual employees | 536 | 31.3 | 147 | 31.8 | 268 | 32.4 | 14 | 36.8 | 91 | 28.2 | 16 | 26.3 | |
| Professionals/upper-level executives | 336 | 19.6 | 93 | 20.1 | 167 | 20.2 | 7 | 18.4 | 58 | 18.0 | 11 | 18.0 | |
| Self-employed | 44 | 2.6 | 13 | 2.8 | 20 | 2.4 | 2 | 5.3 | 9 | 2.8 | 0 | 0.0 | |
| Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | ||
| Depressive symptom change [ | -1.5 | 4.3 | -0.6 | 1.9 | -1.4 | 3.9 | -7.5 | 9.2 | -2.6 | 5.5 | -1.3 | 6.4 | <0.001 |
| Age at retirement (range 55–74 years) | 65.9 | 1.9 | 65.9 | 2.0 | 66.0 | 1.8 | 65.3 | 2.8 | 65.7 | 2.0 | 66.0 | 2.0 | <0.05 |
Chi2 test for categorical variables and ANOVA for continuous variables.
Change in the mean score of depressive symptoms between the wave prior to retirement (-1 year) and the wave in which retirement had taken place (+1 year).
Health characteristics and psychosocial working characteristics of the sample and of the depression trajectory groups in the SLOSH study, 2006–2018. Missing information: physical inactivity (N=9; 0.5%), excessive drinking (N=49; 2.8%), smoking daily (N=9; 0.5%), cardiovascular disease (N=19; 1.1%), diabetes (N=23; 1.3%), job demands (N=23; 1.3%), decision authority (N=7; 0.4%), job strain (N=30; 1.7%), social support (N=47; 2.7%), efforts (N=215; 12.4%), rewards (N=255; 14.7%), effort–rewards imbalance (ERI) (N=265; 15.3%, efforts and rewards were not measured in SLOSH wave 2), procedural justice (N=124; 7.1%).
| Total | Trajectory groups | P-value [ | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| N=1735 | Group 1 | Group 2 | Group 3 | Group 4 | Group 5 | ||||||||
| No depression, stable (very low) | No depression, stable (low) | Moderate depression, considerably decreasing | Mild depression, decreasing | Moderate depression, stable | |||||||||
| N | % | N | % | N | % | N | % | N | % | N | % | ||
| Physical inactivity | 310 | 18.0 | 66 | 14.1 | 146 | 17.5 | 8 | 21.6 | 72 | 22.3 | 18 | 29.0 | <0.01 |
| Excessive drinking | 95 | 5.6 | 14 | 3.0 | 50 | 6.1 | 2 | 5.3 | 20 | 6.5 | 9 | 15.0 | <0.01 |
| Smoking (daily) | 180 | 10.4 | 47 | 10.0 | 76 | 9.1 | 3 | 7.9 | 42 | 13.1 | 12 | 19.4 | <0.05 |
| Cardiovascular disease | 170 | 9.9 | 24 | 5.1 | 81 | 9.8 | 1 | 2.6 | 50 | 15.7 | 14 | 23.0 | <0.001 |
| Diabetes | 131 | 7.7 | 29 | 6.2 | 58 | 7.0 | 5 | 13.2 | 31 | 9.8 | 8 | 13.3 | 0.08 |
| High job demands | 668 | 39.0 | 125 | 26.8 | 327 | 39.5 | 22 | 57.9 | 163 | 51.1 | 31 | 50.8 | <0.001 |
| Low decision authority | 717 | 41.5 | 169 | 36.0 | 350 | 41.9 | 21 | 55.3 | 152 | 46.9 | 31 | 51.7 | <0.05 |
| Job strain | 262 | 15.4 | 40 | 8.6 | 121 | 14.7 | 14 | 36.8 | 71 | 22.3 | 16 | 26.7 | <0.001 |
| Low social support | 674 | 39.9 | 135 | 29.2 | 319 | 38.9 | 25 | 65.8 | 163 | 52.9 | 32 | 53.3 | <0.001 |
| High efforts | 538 | 35.4 | 129 | 30.9 | 251 | 34.3 | 18 | 52.9 | 117 | 41.6 | 23 | 41.8 | <0.01 |
| Low rewards | 605 | 40.9 | 113 | 27.8 | 279 | 39.2 | 21 | 65.6 | 155 | 56.4 | 37 | 67.3 | <0.001 |
| ERI | 722 | 49.1 | 160 | 39.5 | 340 | 48.1 | 24 | 75.0 | 164 | 60.5 | 34 | 61.8 | <0.001 |
| Low procedural justice | 808 | 50.2 | 178 | 40.8 | 399 | 50.8 | 24 | 64.9 | 170 | 57.4 | 37 | 66.1 | <0.001 |
Chi2 test for categorical variables.
Associations between psychosocial working characteristics, and the depression trajectories, presented as relative risk ratios (RR) and 95% confidence intervals (CI). [Bold indicates statistically significant].
| Trajectories of depressive symptoms across retirement | Crude Model | Model 1 [ | Model 2 [ | N [ | |||
|---|---|---|---|---|---|---|---|
| RR | 95% CI | RR | 95% CI | RR | 95% CI | ||
| Group 1: no depression, stable (very low) | 1.00 | (reference) | 1.00 | (reference) | 1.00 | (reference) | |
| High job demands | |||||||
| Group 2: No depression, stable (low) | 1622 | ||||||
| Group 3: Moderate depression, considerably decreasing | |||||||
| Group 4: Mild depression, decreasing | |||||||
| Group 5: Moderate depression, stable | |||||||
| Low decision authority | |||||||
| Group 2: No depression, stable (low) | 1.26 | 0.98–1.62 | 1.26 | 0.98–1.62 | 1633 | ||
| Group 3: Moderate depression, considerably decreasing | 1.50 | 0.77–2.95 | 1.43 | 0.71–2.89 | 1.43 | 0.70–2.90 | |
| Group 4: Mild depression, decreasing | |||||||
| Group 5: Moderate depression, stable | 1.57 | 0.88–2.81 | 1.64 | 0.91–2.96 | |||
| Job strain | |||||||
| Group 2: No depression, stable (low) | 1616 | ||||||
| Group 3: Moderate depression, considerably decreasing | |||||||
| Group 4: Mild depression, decreasing | |||||||
| Group 5: Moderate depression, stable | |||||||
| Low social support | |||||||
| Group 2: No depression, stable (low) | 1600 | ||||||
| Group 3: Moderate depression, considerably decreasing | |||||||
| Group 4: Mild depression, decreasing | |||||||
| Group 5: Moderate depression, stable | |||||||
| High efforts | |||||||
| Group 2: No depression, stable (low) | 1.16 | 0.90–1.51 | 1.09 | 0.83–1.42 | 1.08 | 0.83–1.42 | 1463 |
| Group 3: Moderate depression, considerably decreasing | |||||||
| Group 4: Mild depression, decreasing | |||||||
| Group 5: Moderate depression, stable | 1.56 | 0.86–2.84 | 1.48 | 0.80–2.71 | 1.38 | 0.74–2.57 | |
| Low rewards | |||||||
| Group 2: No depression, stable (low) | 1429 | ||||||
| Group 3: Moderate depression, considerably decreasing | |||||||
| Group 4: Mild depression, decreasing | |||||||
| Group 5: Moderate depression, stable | |||||||
| Effort–reward imbalance | |||||||
| Group 2: No depression, stable (low) | 1419 | ||||||
| Group 3: Moderate depression, considerably decreasing | |||||||
| Group 4: Mild depression, decreasing | |||||||
| Group 5: Moderate depression, stable | |||||||
| Low procedural justice | |||||||
| Group 2: No depression, stable (low) | 1535 | ||||||
| Group 3: Moderate depression, considerably decreasing | |||||||
| Group 4: Mild depression, decreasing | |||||||
| Group 5: Moderate depression, stable | |||||||
Adjusted for sex, age, occupational position, civil status.
Model 1 + physical inactivity, excessive drinking, smoking, cardiovascular disease, diabetes.
Number of individuals in the crude model, Model 1 and Model 2, for each exposure variable.