Effort-reward imbalance and depressive disorders

This contribution provides a short summary of current evidence on the influence of chronic stress at work, as measured by the effort-reward imbalance model, on the risk of developing depressive disorders. Findings from prospective epidemiological studies demonstrating overall a two-fold increase in relative risks of depression among exposed people are supplemented by evidence from experimental research exploring potential psychobiological pathways. Finally, practical implications of this new knowledge for worksite health promotion are discussed. In this regard, the theoretical model offers three approaches at the personal, interpersonal and structural levels. In addition to strengthening measures of primary prevention companies and professional groups have to meet challenges of improved reintegration of depressed people into work.