TY - JOUR

T1 - Work-unit social capital and incident purchase of psychotropic medications

T2 - A longitudinal cohort-study of healthcare workers

AU - Jensen, Johan Hoy

AU - Flachs, Esben Meulengracht

AU - Torok, Eszter

AU - Rod, Naja Hulvej

AU - Madsen, Ida E. H.

AU - Rugulies, Reiner

AU - Kawachi, Ichiro

PY - 2020

Y1 - 2020

N2 - Background: Whether workplace social capital affects employees' mental health is debated. We examined the association between work-unit aggregated social capital and incident purchase of psychotropic medications among employees.Methods: We used data from the WHALE (Well-being in Hospital Employees) cohort study. The study population comprised 21,711 employees without recent psychotropic purchase-history nested within 2283 work units in the Capital Region of Denmark. Employees were invited to participate in a survey in March 2014 (86% response). We assessed workplace social capital by eight items (covering trust/justice and collaboration) and aggregated the mean of responses up to each work unit and categorized the scores into quartiles. Data on psychotropic purchases (antidepressants and anxiolytics/hypnotics/sedatives) were extracted via linkage to national registers. Using two-level mixed-effects survival models, we analyzed the association between work-unit social capital and psychotropic purchases during a one-year follow-up period adjusting for individual-level workplace social capital.Results: Low work-unit social capital was associated with higher purchases of overall psychotropic medications in a dose-response manner (low-versus-high: HR=1.32, 95% CI=1.05-1.65), but this effect attenuated after adjusting for individual-level workplace social capital (HR=1.14, 95% CI=0.88-1.46). Low work-unit social capital was associated with higher purchases of antidepressants (HR=1.78, 95% CI=1.16-2.73) even after adjusting for individual-level workplace social capital (HR=1.69, 95% CI=1.05-2.73).Limitations: Medical doctors/dentists were underrepresented in the data on workplace social capital.Conclusions: Low work-unit social capital may be associated with higher use of antidepressants among health-care employees. Interventions to improve social capital could potentially promote mental health at work in the healthcare setting.

AB - Background: Whether workplace social capital affects employees' mental health is debated. We examined the association between work-unit aggregated social capital and incident purchase of psychotropic medications among employees.Methods: We used data from the WHALE (Well-being in Hospital Employees) cohort study. The study population comprised 21,711 employees without recent psychotropic purchase-history nested within 2283 work units in the Capital Region of Denmark. Employees were invited to participate in a survey in March 2014 (86% response). We assessed workplace social capital by eight items (covering trust/justice and collaboration) and aggregated the mean of responses up to each work unit and categorized the scores into quartiles. Data on psychotropic purchases (antidepressants and anxiolytics/hypnotics/sedatives) were extracted via linkage to national registers. Using two-level mixed-effects survival models, we analyzed the association between work-unit social capital and psychotropic purchases during a one-year follow-up period adjusting for individual-level workplace social capital.Results: Low work-unit social capital was associated with higher purchases of overall psychotropic medications in a dose-response manner (low-versus-high: HR=1.32, 95% CI=1.05-1.65), but this effect attenuated after adjusting for individual-level workplace social capital (HR=1.14, 95% CI=0.88-1.46). Low work-unit social capital was associated with higher purchases of antidepressants (HR=1.78, 95% CI=1.16-2.73) even after adjusting for individual-level workplace social capital (HR=1.69, 95% CI=1.05-2.73).Limitations: Medical doctors/dentists were underrepresented in the data on workplace social capital.Conclusions: Low work-unit social capital may be associated with higher use of antidepressants among health-care employees. Interventions to improve social capital could potentially promote mental health at work in the healthcare setting.

KW - Antidepressants

KW - Hospital workers

KW - Psychosocial work environment

KW - Stress

KW - COMMON MENTAL-DISORDERS

KW - SICKNESS ABSENCE

KW - GENERAL-PRACTICE

KW - DEPRESSION

KW - ASSOCIATION

KW - PREVALENCE

KW - ENVIRONMENT

KW - DISABILITY

KW - PREDICTOR

KW - EMPLOYEES

U2 - 10.1016/j.jad.2020.07.004

DO - 10.1016/j.jad.2020.07.004

M3 - Journal article

C2 - 32697716

VL - 276

SP - 53

EP - 61

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -