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

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract

• Effect Size: Seven of ten psychosocial work exposures associated with incident prescription (specific measures not reported)

• Primary Outcome: Incident prescription of psychotropic medications within 2 years

• Nnt Or Sensitivity: Linear dose-response relationship observed for cumulative psychosocial work exposures

• Confidence Interval: Not reported in abstract

Clinical Application

Workplace interventions targeting psychosocial factors are feasible and may reduce subsequent mental health service utilisation Relevant to Australian workplace mental health initiatives, Safe Work Australia guidelines, and PBS prescribing patterns for psychotropic medications Working adults in developed healthcare systems with accessible mental health services

Abstract

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.

References

1. 1.Bertrais, S., Quatrevaux, M., & Niedhammer, I. (2026). Adverse psychosocial work exposures and 2-year incident prescription of psychotropic medications: a prospective French study using the national healthcare reimbursement database. Journal of Affective Disorders, 121078. https://doi.org/10.1016/j.jad.2025.121078