Logo of oenvmedOccupational and Environmental MedicineVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Occup Environ Med. Jan 2003; 60(1): 3–9.
PMCID: PMC1740370

Reducing work related psychological ill health and sickness absence: a systematic literature review


A literature review revealed the following: key work factors associated with psychological ill health and sickness absence in staff were long hours worked, work overload and pressure, and the effects of these on personal lives; lack of control over work; lack of participation in decision making; poor social support; and unclear management and work role. There was some evidence that sickness absence was associated with poor management style. Successful interventions that improved psychological health and levels of sickness absence used training and organisational approaches to increase participation in decision making and problem solving, increase support and feedback, and improve communication. It is concluded that many of the work related variables associated with high levels of psychological ill health are potentially amenable to change. This is shown in intervention studies that have successfully improved psychological health and reduced sickness absence.

Full Text

The Full Text of this article is available as a PDF (142K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Whitley TW, Allison EJ, Jr, Gallery ME, Cockington RA, Gaudry P, Heyworth J, Revicki DA. Work-related stress and depression among practicing emergency physicians: an international study. Ann Emerg Med. 1994 May;23(5):1068–1071. [PubMed]
  • Wall TD, Bolden RI, Borrill CS, Carter AJ, Golya DA, Hardy GE, Haynes CE, Rick JE, Shapiro DA, West MA. Minor psychiatric disorder in NHS trust staff: occupational and gender differences. Br J Psychiatry. 1997 Dec;171:519–523. [PubMed]
  • Agius RM, Blenkin H, Deary IJ, Zealley HE, Wood RA. Survey of perceived stress and work demands of consultant doctors. Occup Environ Med. 1996 Apr;53(4):217–224. [PMC free article] [PubMed]
  • Baldwin PJ, Dodd M, Wrate RW. Young doctors' health--I. How do working conditions affect attitudes, health and performance? Soc Sci Med. 1997 Jul;45(1):35–40. [PubMed]
  • Deary IJ, Blenkin H, Agius RM, Endler NS, Zealley H, Wood R. Models of job-related stress and personal achievement among consultant doctors. Br J Psychol. 1996 Feb;87(Pt 1):3–29. [PubMed]
  • Heyworth J, Whitley TW, Allison EJ, Jr, Revicki DA. Predictors of work satisfaction among SHOs during accident and emergency medicine training. Arch Emerg Med. 1993 Dec;10(4):279–288. [PMC free article] [PubMed]
  • Parkes KR. Occupational stress among student nurses: a natural experiment. J Appl Psychol. 1982 Dec;67(6):784–796. [PubMed]
  • Quine L. Workplace bullying in NHS community trust: staff questionnaire survey. BMJ. 1999 Jan 23;318(7178):228–232. [PMC free article] [PubMed]
  • Sutherland VJ, Cooper CL. Identifying distress among general practitioners: predictors of psychological ill-health and job dissatisfaction. Soc Sci Med. 1993 Sep;37(5):575–581. [PubMed]
  • Estryn-Behar M, Kaminski M, Peigne E, Bonnet N, Vaichere E, Gozlan C, Azoulay S, Giorgi M. Stress at work and mental health status among female hospital workers. Br J Ind Med. 1990 Jan;47(1):20–28. [PMC free article] [PubMed]
  • Gray-Toft PA, Anderson JG. Organizational stress in the hospital: development of a model for diagnosis and prediction. Health Serv Res. 1985 Feb;19(6 Pt 1):753–774. [PMC free article] [PubMed]
  • Johnson JV, Hall EM, Ford DE, Mead LA, Levine DM, Wang NY, Klag MJ. The psychosocial work environment of physicians. The impact of demands and resources on job dissatisfaction and psychiatric distress in a longitudinal study of Johns Hopkins Medical School graduates. J Occup Environ Med. 1995 Sep;37(9):1151–1159. [PubMed]
  • Petterson IL, Arnetz BB, Arnetz JE. Predictors of job satisfaction and job influence--results from a national sample of Swedish nurses. Psychother Psychosom. 1995;64(1):9–19. [PubMed]
  • Pisarski A, Bohle P, Callan VJ. Effects of coping strategies, social support and work-nonwork conflict on shift worker's health. Scand J Work Environ Health. 1998;24 (Suppl 3):141–145. [PubMed]
  • Revicki DA, May HJ. Organizational characteristics, occupational stress, and mental health in nurses. Behav Med. 1989 Spring;15(1):30–36. [PubMed]
  • Ferrie JE, Shipley MJ, Marmot MG, Stansfeld SA, Smith GD. An uncertain future: the health effects of threats to employment security in white-collar men and women. Am J Public Health. 1998 Jul;88(7):1030–1036. [PMC free article] [PubMed]
  • Frese M. Social support as a moderator of the relationship between work stressors and psychological dysfunctioning: a longitudinal study with objective measures. J Occup Health Psychol. 1999 Jul;4(3):179–192. [PubMed]
  • LaRocco JM, House JS, French JR., Jr Social support, occupational stress, and health. J Health Soc Behav. 1980 Sep;21(3):202–218. [PubMed]
  • Niedhammer I, Goldberg M, Leclerc A, Bugel I, David S. Psychosocial factors at work and subsequent depressive symptoms in the Gazel cohort. Scand J Work Environ Health. 1998 Jun;24(3):197–205. [PubMed]
  • Romanov K, Appelberg K, Honkasalo ML, Koskenvuo M. Recent interpersonal conflict at work and psychiatric morbidity: a prospective study of 15,530 employees aged 24-64. J Psychosom Res. 1996 Feb;40(2):169–176. [PubMed]
  • Shields M. Long working hours and health. Health Rep. 1999 Autumn;11(2):33–55(Fre). [PubMed]
  • Stansfeld SA, North FM, White I, Marmot MG. Work characteristics and psychiatric disorder in civil servants in London. J Epidemiol Community Health. 1995 Feb;49(1):48–53. [PMC free article] [PubMed]
  • Stansfeld SA, Bosma H, Hemingway H, Marmot MG. Psychosocial work characteristics and social support as predictors of SF-36 health functioning: the Whitehall II study. Psychosom Med. 1998 May-Jun;60(3):247–255. [PubMed]
  • Lökk J, Arnetz B. Psychophysiological concomitants of organizational change in health care personnel: effects of a controlled intervention study. Psychother Psychosom. 1997;66(2):74–77. [PubMed]
  • Malcolm RM, Harrison J, Forster H. Effects of changing the pattern of sickness absence referrals in a local authority. Occup Med (Lond) 1993 Nov;43(4):211–215. [PubMed]
  • Smoot SL, Gonzales JL. Cost-effective communication skills training for state hospital employees. Psychiatr Serv. 1995 Aug;46(8):819–822. [PubMed]
  • Frese M. Stress at work and psychosomatic complaints: a causal interpretation. J Appl Psychol. 1985 May;70(2):314–328. [PubMed]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...