Shift Work remarkably increases the risk of anxiety and depression: JAMA.

China: Recent research from China revealed that there is an increased risk of anxiety and depression associated with shift work. Lifestyle changes associated with shift work are also one of the risk factors for anxiety and depression as per a study that was published in the journal JAMA Network Open. 

Advanced service culture development is causing shift work changes like working outside normal working hours or rotating these shift types. Such type of long-term shift work may lead to various diseases including physical and mental disorders. Despite much research that studied the association between shift work and diseases, there has been little research regarding the association and pathways of shift work with depression and anxiety. There is also uncertainty regarding the potential role of shift work type, frequency, and working years, and misses job-related confounding factors. Hence researchers conducted a study to comprehensively investigate the associations of shift work, its type, frequency, and working years with anxiety and depression. 

By using data from UK Biobank, a prospective population-based cohort study was carried out between 2006-2010, including 175 543 employed or self-employed workers. Baseline employment and shift work status information was obtained along with lifestyles including smoking, physical activity, alcohol consumption, dietary characteristics, sleep duration, sedentary time, and body mass index. Depression and anxiety were identified based on electronic health records. Cox proportional hazard regression models were used to calculate the association of shift work with anxiety and depression and cause mediation analyses we used to test the mediating role of lifestyle factors in this association.

Findings:

• Of the 1,75,543 included participants with a mean [SD] age of 52.6 [7.1] years; there were 88 290 men [50.3%] and there were 1,67,495 White participants [95.4%]).
• Nearly 27,637 participants (16.2%) reported shift work.
• During a median (IQR) follow-up of 9.06 (8.35-9.75) years, 3956 workers (2.3%) developed depression and 2838 (1.7%) developed anxiety.
• In the fully adjusted model, individuals who reported engaging in shift work, or shift workers, had a higher risk of depression and anxiety, and the risk was positively associated with shift frequency.
•  No significant difference was observed between night shifts and non-night shifts.
• In the dose-association analyses, years of shift work were negatively associated with the risk of depression and anxiety.
• Smoking, sedentary time, BMI, and sleep duration were the main potentially modifiable mediators.
• These mediators accounted for 31.3% of the relationship between shift work and depression and 21.2% of the relationship between shift work and anxiety. 

Thus, shift work was significantly associated with a higher risk of depression and anxiety, and the risk was positively associated with shift frequency. 

Further reading: Xu M, Yin X, Gong Y. Lifestyle Factors in the Association of Shift Work and Depression and Anxiety. JAMA Netw Open. 2023;6(8):e2328798. doi:10.1001/jamanetworkopen.2023.28798