Adverse psychosocial work exposures and 2-year incident prescription of psychotropic medications: a prospective French study using the national healthcare reimbursement database

Objective: Despite the abundant literature on the associations between psychosocial work exposures and mental health outcomes, prospective studies using medico-administrative data are lacking. The objective was to study the associations between various psychosocial work exposures and incident prescription of psychotropic medications. Methods: The study relied on three waves (2010, 2012, 2014) of the French ESPS survey (Health, Health Care and Insurance Survey) (baseline data), linked to the national database of healthcare reimbursements (follow-up data). Each survey wave was conducted among a randomly selected national sample of people aged 18+. The study included a total of 8689 observations among 7695 workers without psychotropic medication prescription within the 6 months preceding survey wave. Ten psychosocial work exposures (quantitative demands, tensions with the public, freedom, possibilities for learning new things, colleague support, recognition, salary satisfaction, job insecurity, temporary contract, and redundancy plan) were assessed at each survey wave. Covariates included gender, age, marital status, employee/self-employed worker, private/public sector, occupation, and full/part-time work. The outcome was psychotropic medication prescription within the 2 years following survey wave. Mixed effects Cox regression modelling was used. Results: Seven of the ten psychosocial work exposures were associated with incident psychotropic medication prescription. Associations were observed more with incident prescription of antidepressants and anxiolytics than with hypnotics/sedatives. The number of psychosocial work exposures increased the risk linearly, except for hypnotics/sedatives. No gender interaction was found for any of these associations. Conclusion: The findings may support that poor psychosocial working conditions increase the risk of subsequent psychotropic medication prescription.