Psychologically and biochemically assessed stress in a follow-up study of long-term unemployed

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Abstract
It has been suggested that psychological stress is one of the reasons for the high morbidity among unemployed people in Western countries. The same may apply to the well-documented high mortality. It would be expected that increased levels of biological stress would be found in these people. In the present study a sample of 310 long-term unemployed people from Norway was followed for 2 years. Psychologcal stress was assessed by medical examination and by the psychometric tests GHQ-28 and HSCL-30, the latter compared with a reference population of employed people. Serum levels of cortisol, prolactin and testosterone, together with immunoglobulins IgA, IgG and IgM, were compared with working controls. The unemployed had a high level of psychological distress at the first examination, the sanie for men and women. At the 2-year follow up distress was reduced by re-employment. This fits the ‘causation hypothesis' which explains the high distress level as caused by unemployment. The other direction of causation, ‘the selection hypothesis', assuming that distressed persons have an increased chance of continuous unemployment, was also confirmed in the present study. As for biological stress, significant differences were not found between the unemployment, the re-employed and the working controls.