Psychological Medicine

Original Articles

Occupations, work characteristics and common mental disorder

S. A. Stansfelda1 c1, C. Pikea1, S. McManusa2, J. Harrisa2, P. Bebbingtona3, T. Brughaa4, A. Hassiotisa3, R. Jenkinsa5, H. Meltzera4, P. Morana6 and C. Clarka1

a1 Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK

a2 National Centre for Social Research, London, UK

a3 UCL Department of Mental Health Sciences, London, UK

a4 Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK

a5 WHO Collaborating Centre for Research and Training in Mental Health and Section of Mental Health Policy, Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK

a6 Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK

Background The present study aimed to assess the prevalence of common mental disorders (CMDs) by occupation in a representative sample of the English adult population. Another aim was to examine whether the increased risk of CMD in some occupations could be explained by adverse work characteristics.

Method We derived a sample of 3425 working-age respondents from the Adult Psychiatric Morbidity Survey 2007. Occupations were classified by Standard Occupational Classification group, and CMD measured by the Revised Clinical Interview Schedule. Job characteristics were measured by questionnaire, and tested as explanatory factors in associations of occupation and CMD.

Results After adjusting for age, gender, housing tenure and marital status, caring personal service occupations had the greatest risk of CMD compared with all occupations (odds ratio 1.73, 95% confidence interval 1.16–2.58). The prevalence of adverse psychosocial work characteristics did not follow the pattern of CMD by occupation. Work characteristics did not explain the increased risk of CMDs associated with working in personal service occupations. Contrary to our hypotheses, adding work characteristics individually to the association of occupation and CMD tended to increase rather than decrease the odds for CMD.

Conclusions As has been found by others, psychosocial work characteristics were associated with CMD. However, we found that in our English national dataset they could not explain the high rates of CMD in particular occupations. We suggest that selection into occupations may partly explain high CMD rates in certain occupations. Also, we did not measure emotional demands, and these may be important mediators of the relationship between occupation type and CMDs.

(Received January 03 2012)

(Revised July 06 2012)

(Accepted July 12 2012)

(Online publication August 21 2012)

Key words

  • Depression;
  • epidemiology;
  • mental disorder;
  • occupation;
  • work


c1 Address for correspondence: S. A. Stansfeld, Ph.D., Centre for Psychiatry, Old Anatomy Building, Barts and the London School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK. (Email: