Occupation and mental health in a national UK survey

To measure the prevalence of common mental disorder (CMD) by occupation in a representative sample of Great Britain and to identify occupations with increased and decreased risk of CMD. A cross-sectional interview-based survey was carried out including 5,497 working male and female respondents, 16-64 years from a stratified random survey of private households in Britain. Occupations were classified by the Standard Occupational Classification (SOC) into four groups: major, sub-major, minor and constituent unit groups. Common Mental Disorder was measured by the Revised Clinical Interview Schedule. Major SOC groups with higher prevalence of common mental disorder included clerical and secretarial, sales, and personal and protective services whereas craft and related, 'other' professional occupations and plant and machine operatives had lower prevalence compared to 13% overall prevalence in all adults. In sub-major SOC groups managers and administrators, teaching professionals, clerical and secretarial, 'other' sales and personal service occupations had higher prevalence whereas many professional and skilled occupations had lower prevalence. Specific SOC unit groups with higher prevalence included primary and secondary teachers, welfare community, youth workers, security staff, waiters, bar staff, nurse auxiliaries and care assistants. General managers in government and large organizations (OR = 2.79, 95% CI 1.41-5.54), managers in transport and storing (OR = 2.44, 95% CI 1.18-5.03), buyers and mobile sales persons (OR = 2.48, 95% CI 1.09-5.60), sales occupations (NES) (OR = 2.78, 95% CI 1.25-6.19) and clerks (NES) (OR = 2.71, 95% CI 1.59-4.61) had increased risk of common mental disorder relative to specialist managers adjusting for social and financial factors and physical ill-health. Occupations with higher risk of common mental disorder may be typified by high levels of job demands, especially emotional demands and lack of job security. The reasons why occupations have low rates of common mental disorder are varied and may include high levels of job discretion, good job training and clearly defined job tasks.