Table 3

Quality of the evidence for the relationship between risk factors and stress related disorders according to the GRADE framework

Number of participantsNumber of studies/
cohorts		Study phase*Study limitations
Study quality majority of studies
<11/16: ↓		Inconsistency
I2 ≥50%: ↓		Indirectness
Yes: ↓		Imprecision
CI effect size (<1 and>2)
Yes: ↓		Publication Bias
Yes: ↓		Effect size
OR (95% CI)
Lower Limit OR >2.0 : ↑		Exposure-response gradient
(dose-effect)
majority of studies: ↑		Overall quality of evidence
Effort-reward imbalance76 7606/61No48%NoNoNo1.91
(1.70 to 2.15)		2/6Moderate
Low procedural justice64 6765/51No0%NoNoNo1.74
(1.62 to 1.86)		2/5Moderate
Low relational justice64 6765/51No0%NoNoNo1.55
(1.44 to 1.67)		2/5Moderate
High job demands41 3978/81No49%NoNoNo1.56
(1.41 to 1.72)		0/8Moderate
Low coworker support22 9204/41No10%NoNoNo1.29
(1.17 to 1.43)		0/4Moderate
Low supervisor support23 3825/51No0%NoNoNo1.27
(1.16 to 1.38)		0/5Moderate
Low coworker and supervisor support72622/21No0%NoNoNo1.41
(1.18 to 1.69)		0/2Moderate
High emotional demands13 6412/21No0%NoNoUndetected1.58
(1.35 to 1.84)		0/2Moderate
Low decision authority13 3122/21No0%NoNoUndetected1.34
(1.20 to 1.49)		0/2Moderate
Job insecurity88331/11No–NoYes: ↓UndetectedMen 1.63
(1.18 to 2.27)
Women 0.94
(0.56 to 1.59)		0/1Low
Decision latitude11 2872/21No0%NoNoUndetected1.07
(0.92 to 1.25)		0/2Moderate
Low skill discretion31232/21No0%NoNoUndetected1.11
(0.94 to 1.32)		0/2Moderate
Bullying and violence96944/41NoHeterogeneity in definitionsNoYes: ↓No1.42–3.64
(0.42 to 15.92)		0/4Low

  • *All included studies are phase one explanatory prospective cohort studies with ‘moderate’ as starting point for the quality of the evidence.