Job strain, burnout, and depressive symptoms: a prospective study among dentists

J Affect Disord. 2007 Dec;104(1-3):103-10. doi: 10.1016/j.jad.2007.03.004. Epub 2007 Apr 19.


Background: Burnout has been presented as an antecedent of depression, but longitudinal data are lacking. We investigated whether burnout mediates the association between job strain and depressive symptoms.

Methods: Two surveys were conducted. In 2003, 71% of Finnish dentists were reached, and the response rate of the 3-year follow-up was 84% (n=2555). Burnout was measured with the Maslach Burnout Inventory and depressive symptoms with the Beck Depression Inventory. The sequences 'job strain-burnout-depressive symptoms' and 'job strain-depressive symptoms-burnout' were investigated with logistic regression analyses.

Results: Of the burnout sufferers without depressive symptoms at baseline, 23% reported depressive symptoms at follow-up. The adjusted odds ratio of burnout for depressive symptoms was 2.6 (95% CI 2.0-3.5). The effect of job strain on depressive symptoms had an OR of 3.4 (95% CI 2.0-5.7), but it disappeared when adjusted for burnout. Of those who had depressive symptoms without burnout at baseline, 63% had burnout at follow-up. The adjusted odds ratio of depressive symptoms for burnout was 2.2 (95% CI 1.4-3.4). The effect of job strain on burnout had an OR of 27.9 (95% CI 6.5-120.2) for the men and 4.9 (95% CI 2.5-9.6) for the women. These effects remained significant after adjustment for depressive symptoms.

Limitations: The study was conducted among one occupational group.

Conclusions: There is a reciprocal relationship between burnout and depressive symptoms. Job strain predisposes to depression through burnout. In comparison, job strain predisposes to burnout directly and via depression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Burnout, Professional*
  • Dentists / statistics & numerical data*
  • Depression / diagnosis
  • Depression / epidemiology*
  • Depression / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Occupational Diseases / diagnosis
  • Occupational Diseases / epidemiology*
  • Prevalence
  • Prospective Studies
  • Psychology
  • Quality of Life / psychology
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires
  • Workplace / psychology*