Shift Work and Poor Mental Health: A Meta-Analysis of Longitudinal Studies.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational longitudinal studies
PubMed 31536404 · doi:10.2105/AJPH.2019.305278
What was done
Authors searched PubMed, Scopus, and Web of Science up to August 2018 for longitudinal or case-control studies examining shift work (working outside 7:00 am to 6:00 pm) and adverse mental health outcomes (anxiety, depression, or general poor mental health). Following MOOSE guidelines, adjusted risk estimates from included longitudinal studies were pooled using random-effects meta-analysis, and meta-regression was used to explore heterogeneity by gender.
What was found
Across 7 longitudinal studies with 28,431 unique participants, shift work was associated with an increased risk of overall adverse mental health outcomes combined (ES = 1.28; 95% CI, 1.02 to 1.62; I² = 70.6%) and depressive symptoms specifically (ES = 1.33; 95% CI, 1.02 to 1.74; I² = 31.5%). Gender differences explained >90% of heterogeneity, with female shift workers having significantly higher odds of depressive symptoms than female non-shift workers (OR = 1.73; 95% CI, 1.39 to 2.14).
Why it matters
This review synthesizes longitudinal data linking non-standard work hours to adverse mental health and identifies female shift workers as a particularly vulnerable subgroup.
Limits
The total number of included studies is small (n = 7). Overall mental health analyses exhibited substantial heterogeneity (I² = 70.6%). The abstract does not report numerical findings for anxiety symptoms, specific shift schedules (e.g., rotating vs. fixed night), or details on baseline confounding adjustments.
Cited by
- supports Shift work is associated with worse overall health outcomes, including increased rates of digestive and mood issues.