Work-unit social capital and incident purchase of psychotropic medications: A longitudinal cohort-study of healthcare workers

Tidsskriftartikel - 2020

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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 healthcare employees. Interventions to improve social capital could potentially promote mental health at work in the healthcare setting.

Reference

Jensen JH, Flachs EM, Török E, Rod NH, Madsen IEH, Rugulies R, Kawachi I. Work-unit social capital and incident purchase of psychotropic medications: A longitudinal cohort-study of healthcare workers. Journal of Affective Disorders 2020;276:53-61.
doi: 10.1016/j.jad.2020.07.004

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