Consequences of work addiction
There are four main aspects of potential consequnces of work addiction:
- individual (e.g., death, including suicide, mental and physical health problems, including burnout, lower quality of life, lower happiness)
- social (e.g., family problems, behavioral and emotional problems of children of parents addicted to work, conflicts with coworkers, ineffective managament at work by managers addicted to work, consequences of death of a person addicted to work)
- recipients of work (e.g., poor quality of work, mistakes at work, such as medical errors by doctors who are addicted to work and burnout)
- economic (e.g., health care costs, decreased productivity)
Most of the available data is of correlational nature and shows associations between work addiction and potential negative consequences. However, few prospective or longitudinal studies suggest a casual role of work addiction in functional impairments. These are supported by case studies and clinical literature on therapeutic interventions among individuals addicted to work, including reports from clinical occupational medicine settings. Nevertheless, more large scale prospective epidemiological studies are necessary to establish the extent to which work addiction contributes to negative consequences. Also, systematic studies on the economic costs of work addiction are lacking. Most data is indirect and comes from the estimates of the costs of high workload, as well as work-related stress, depression or burnout or estimates of health care costs of obsessive compulsive personality disorder.
RECIPIENTS OF WORK
Most data on the potential economic costs of work addiction is indirect and comes from the estimates of the costs of high workload, as well as work-related stress, depression or burnout or estimates of health care costs of obsessive compulsive personality disorder (OCPD). The reasonable gross estimates can be made on the basis of the established facts:
- high workload and occupational stress are risk factors for physical and mental health problems
- burnout is associated with worse health
- work addiction is strictly related to high workload, occupational stress and burnout
- OCPD is associated with occupational stress, burnout, and depression
- OCPD is closely associated with work addiction
Therefore, a following general association between work addiction and global burden of disease together with its socio-economic costs can be expected:
work addiction => high workload and occupational stress => health consequences/socio-economic costs
When the role of OCDP as a risk factor for work addiction and the role of burnout as a consequence of ill-managed stress at work are included, the causal chain may be:
OCPD => work addiction => high workload and occupational stress => burnout => health consequences/socio-economic costs
Currently, the relationship between OCPD and work addiction, and their contributions to negative consequences require more studies. Also, the link between burnout and ill-health needs more clarification.
Nevetheless, based on these assumptions and the available data it can be expected that work addiction is a major source of socioeconomic costs in the industrialized countries due to:
- health-related absence at work,
- health care costs,
- decreased productivity.
Depression attributed to occupational stress
Depression is among the most common causes of working disability in industrialized countries.
The current estimated cost of depression related to stress at work in the European Union is €617 billion annually, which is more than the gross domestic product (GDP) of most European countries.
Obsessive compulsive personality disorder
Obsessive-compulsive personality disorder (OCPD; DSM classification) or anankastic personality disorder (APD; ICD classification) is the most prevalent personality disorder among the general population (3%–8%) and outpatient groups. OCPD/APD has been identified as producing the highest economic burden among personality disorders in terms of direct medical costs and productivity losses, even exceeding the costs of borderline personality disorder (BPD). Furthermore, patients with personality disorders have more extensive histories of psychiatric outpatient, inpatient, and psychopharmacologic treatment than do comparison patients with a major depressive disorder.
A Finnish study showed that 50% of men and 28% of women with first-episode depression among employed individuals recruited from occupational health care units were diagnosed with OCPD/APD. This is consistent with the effect sizes reported for the relationship between OCPD/APD and burn-out.
Cardiovascular disease and other health problems
Neuropsychiatric disorders and non-communicable diseases such as cardiovascular disease (CVD) and diabetes are among the leading causes of the global burden of disease. Their total costs related to work stress are more than alarming, with the second most-costly category being CVD.
World Health Organization (WHO) and International Labour Organization (ILO) estimate exposure to long working hours (≥55 hours/week) is common and causes large attributable burdens of ischemic heart disease and stroke. In 2016, 488 million people, or 8.9% of the global population, were exposed to working long hours (≥55 hours/week). An estimated 745,194 deaths and 23.3 million disability-adjusted life years from ischemic heart disease and stroke combined were attributable to this exposure.