{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:48:22Z","timestamp":1791870502996,"version":"4.3.4"},"reference-count":50,"publisher":"BMJ","issue":"11","funder":[{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","award":["ANR-11-INBS-0002"],"award-info":[{"award-number":["ANR-11-INBS-0002"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Interministerial Mission for Combating Drugs and Addictive Behaviors"},{"name":"MSD, AstraZeneca and Lundbeck managed by INSERM-Transfert"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2019,7,6]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To examine the association between effort\u2013reward imbalance and incident long-term benzodiazepine use (LTBU).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included 31\u2009077 employed participants enrolled in the French population-based CONSTANCES cohort between 2012 and 2014 who had not undergone LTBU in the 2 years before enrolment. LTBU was examined using drug reimbursement administrative databases. The effort\u2013reward imbalance was calculated in quartiles. We computed ORs (95% CIs) for LTBU according to effort\u2013reward imbalance over a 2-year follow-up period. We adjusted for age, gender, education, occupational grade, income, marital status, tobacco smoking, risk of alcohol use disorder, depressive symptoms and self-rated health.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Over the 2-year follow-up, 294 (0.9%) participants experienced incident LTBU. In the univariable analysis, effort\u2013reward imbalance was associated with subsequent LTBU with ORs of 1.79 (95% CI 1.23 to 2.62) and 2.73 (95% CI 1.89 to 3.95) for the third and fourth quartiles, respectively, compared with the first quartile. There was no interaction between effort\u2013reward imbalance and any of the considered variables other than tobacco smoking (p=0.033). The association remained significant in both smokers and non-smokers, with higher odds for smokers (p=0.031). In the fully adjusted model, the association remained significant for the third and fourth quartiles, with ORs of 1.74 (95% CI 1.17 to 2.57) and 2.18 (95% CI 1.50 to 3.16), respectively. These associations were dose dependent (p for trend &lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Effort\u2013reward imbalance was linked with incident LTBU over a 2-year follow-up period after adjustment for sociodemographic and health-related factors. Thus, screening and prevention of the risk of LTBU should be systematised among individuals experiencing effort\u2013reward imbalance, with special attention paid to smokers.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2019-212703","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T17:15:37Z","timestamp":1565630137000},"page":"993-1001","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Effort\u2013reward imbalance and long-term benzodiazepine use: longitudinal findings from the CONSTANCES cohort"],"prefix":"10.1136","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3494-5083","authenticated-orcid":false,"given":"Guillaume","family":"Airagnes","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Addictology, AP-HP, H\u00f4pitaux Universitaires Paris Ouest, Paris, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Paris Descartes, Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France"},{"name":"UMR 1168, VIMA, Inserm, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9dric","family":"Lemogne","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Addictology, AP-HP, H\u00f4pitaux Universitaires Paris Ouest, Paris, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Paris Descartes, Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"U1266, UMR-S 1266, Institut de Psychiatrie et Neurosciences de Paris, Inserm, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofiane","family":"Kab","sequence":"additional","affiliation":[{"name":"UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Hoertel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Addictology, AP-HP, H\u00f4pitaux Universitaires Paris Ouest, Paris, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Paris Descartes, Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"U1266, UMR-S 1266, Institut de Psychiatrie et Neurosciences de Paris, Inserm, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Goldberg","sequence":"additional","affiliation":[{"name":"UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Wahrendorf","sequence":"additional","affiliation":[{"name":"Centre for Health and Society,Institute of Medical Sociology, Medical Faculty, University of D\u00fcsseldorf,Universit\u00e4tsstrasse 1, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Siegrist","sequence":"additional","affiliation":[{"name":"Senior professorship on work stressresearch, Medical Faculty, University of D\u00fcsseldorf, Germany, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Roquelaure","sequence":"additional","affiliation":[{"name":"UMR 1085, Ester, Irest Inserm, Universit\u00e9 d\u2019Angers, Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Limosin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Addictology, AP-HP, H\u00f4pitaux Universitaires Paris Ouest, Paris, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Paris Descartes, Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"U1266, UMR-S 1266, Institut de Psychiatrie et Neurosciences de Paris, Inserm, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Zins","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Paris Descartes, Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France"},{"name":"UMR 1168, VIMA, Inserm, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,12]]},"reference":[{"key":"2025100304563142000_73.11.993.1","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1056\/NEJMra1611832","article-title":"Treatment of benzodiazepine dependence","volume":"376","author":"Soyka","year":"2017","journal-title":"N Engl J Med"},{"key":"2025100304563142000_73.11.993.2","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1016\/j.eurpsy.2015.09.003","article-title":"Long-term use of benzodiazepines: Definitions, prevalence and usage patterns - a systematic review of register-based studies","volume":"30","author":"Kurko","year":"2015","journal-title":"Eur Psychiatry"},{"key":"2025100304563142000_73.11.993.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03563.x"},{"key":"2025100304563142000_73.11.993.4","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.4.654"},{"key":"2025100304563142000_73.11.993.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-019-6933-8","article-title":"Prevalence of prescribed benzodiazepine long-term use in the French general population according to sociodemographic and clinical factors: findings from the constances cohort","volume":"19","author":"Airagnes","year":"2019","journal-title":"BMC Public Health"},{"key":"2025100304563142000_73.11.993.6","doi-asserted-by":"publisher","DOI":"10.3109\/13651500903447810"},{"key":"2025100304563142000_73.11.993.7","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.1990.10472220"},{"key":"2025100304563142000_73.11.993.8","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1097\/ADM.0000000000000053","article-title":"Benzodiazepines and workplace safety: an examination of postaccident urine drug tests","volume":"8","author":"Price","year":"2014","journal-title":"J Addict Med"},{"key":"2025100304563142000_73.11.993.9","doi-asserted-by":"crossref","first-page":"119","DOI":"10.2105\/AJPH.2018.304734","article-title":"Work-related stressors and increased risk of benzodiazepine long-term use: findings from the CONSTANCES population-based cohort","volume":"109","author":"Airagnes","year":"2019","journal-title":"Am J Public Health"},{"key":"2025100304563142000_73.11.993.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2003.11.002"},{"key":"2025100304563142000_73.11.993.11","doi-asserted-by":"publisher","DOI":"10.1080\/02678379950019752"},{"key":"2025100304563142000_73.11.993.12","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jpsychires.2015.02.019","article-title":"Working conditions and psychotropic drug use: cross-sectional and prospective results from the French national SIP study","volume":"63","author":"Lassalle","year":"2015","journal-title":"J Psychiatr Res"},{"key":"2025100304563142000_73.11.993.13","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s00420-018-1374-8","article-title":"Is effort-reward imbalance at work associated with different domains of health functioning? baseline results from the French CONSTANCES study","volume":"92","author":"Siegrist","year":"2019","journal-title":"Int Arch Occup Environ Health"},{"key":"2025100304563142000_73.11.993.14","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph13040432","article-title":"Associations of extrinsic and intrinsic components of work stress with health: a systematic review of evidence on the Effort-Reward imbalance model","volume":"13","author":"Siegrist","year":"2016","journal-title":"Int J Environ Res Public Health"},{"key":"2025100304563142000_73.11.993.15","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.1052"},{"key":"2025100304563142000_73.11.993.16","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntw140"},{"key":"2025100304563142000_73.11.993.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-7358(99)00027-6"},{"key":"2025100304563142000_73.11.993.18","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000000483","article-title":"Is long-term use of benzodiazepine a risk for cancer?","volume":"94","author":"Iqbal","year":"2015","journal-title":"Medicine"},{"key":"2025100304563142000_73.11.993.19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2012.04418.x"},{"key":"2025100304563142000_73.11.993.20","doi-asserted-by":"crossref","first-page":"9","DOI":"10.3988\/jcn.2019.15.1.9","article-title":"Risk of dementia in long-term benzodiazepine users: evidence from a meta-analysis of observational studies","volume":"15","author":"He","year":"2019","journal-title":"J Clin Neurol"},{"key":"2025100304563142000_73.11.993.21","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1006"},{"key":"2025100304563142000_73.11.993.22","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1080\/02678373.2016.1252971","article-title":"Work stress and alcohol use: developing and testing a biphasic self-medication model","volume":"30","author":"Frone","year":"2016","journal-title":"Work Stress"},{"key":"2025100304563142000_73.11.993.23","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1002\/smi.2712","article-title":"Work stressors, sleep quality, and alcohol-related problems across deployment: a parallel process latent growth modeling approach among navy members","volume":"33","author":"Bravo","year":"2017","journal-title":"Stress Health"},{"key":"2025100304563142000_73.11.993.24","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.20492"},{"key":"2025100304563142000_73.11.993.25","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2004.019752"},{"key":"2025100304563142000_73.11.993.26","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1034\/j.1600-0447.2000.102006429.x","article-title":"A general population survey on patterns of benzodiazepine use and dependence in Lebanon","volume":"102","author":"Naja","year":"2000","journal-title":"Acta Psychiatr Scand"},{"key":"2025100304563142000_73.11.993.27","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1080\/14740338.2016.1221922","article-title":"Benzodiazepine dependence in subjects with alcohol use disorders: what prevalence?","volume":"15","author":"Morel","year":"2016","journal-title":"Expert Opin Drug Saf"},{"key":"2025100304563142000_73.11.993.28","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(03)00346-0"},{"key":"2025100304563142000_73.11.993.29","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3109\/08039488.2013.775342","article-title":"Socio-Demographic, lifestyle and psychological predictors of benzodiazepine and z-hypnotic use patterns","volume":"68","author":"Nordfj\u00e6rn","year":"2014","journal-title":"Nord J Psychiatry"},{"key":"2025100304563142000_73.11.993.30","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.drugalcdep.2014.06.020","article-title":"Quality of life in a cohort of high-dose benzodiazepine dependent patients","volume":"142","author":"Lugoboni","year":"2014","journal-title":"Drug Alcohol Depend"},{"key":"2025100304563142000_73.11.993.31","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2016-103678"},{"key":"2025100304563142000_73.11.993.32","doi-asserted-by":"publisher","DOI":"10.1037\/1076-8998.1.1.27"},{"key":"2025100304563142000_73.11.993.33","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1002\/pds.4233","article-title":"The National healthcare system claims databases in France, SNIIRAM and EGB: powerful tools for pharmacoepidemiology","volume":"26","author":"Bezin","year":"2017","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2025100304563142000_73.11.993.34","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(03)00351-4"},{"key":"2025100304563142000_73.11.993.35","unstructured":"Babor TF , Higgins-Biddle JC , Saunders JB , et al . AUDIT: The alcohol use disorders identification test: Guidelines for use in primary health care. World Health Organization, 2001."},{"key":"2025100304563142000_73.11.993.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.respe.2011.03.061"},{"key":"2025100304563142000_73.11.993.37","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.00291.x"},{"key":"2025100304563142000_73.11.993.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.05.013"},{"key":"2025100304563142000_73.11.993.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2010.03.008"},{"key":"2025100304563142000_73.11.993.40","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2006.11.038"},{"key":"2025100304563142000_73.11.993.41","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1441.030"},{"key":"2025100304563142000_73.11.993.42","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwj064"},{"key":"2025100304563142000_73.11.993.43","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.149252"},{"key":"2025100304563142000_73.11.993.44","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.pnpbp.2012.09.001","article-title":"Psychosocial characteristics of benzodiazepine addicts compared to not addicted benzodiazepine users","volume":"40","author":"Konopka","year":"2013","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"2025100304563142000_73.11.993.45","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1007\/s00420-014-0982-1","article-title":"Is musculoskeletal pain a consequence or a cause of occupational stress? A longitudinal study","volume":"88","author":"Bonzini","year":"2015","journal-title":"Int Arch Occup Environ Health"},{"key":"2025100304563142000_73.11.993.46","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.129.2.270"},{"key":"2025100304563142000_73.11.993.47","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckv036"},{"key":"2025100304563142000_73.11.993.48","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0035463","article-title":"Job strain and tobacco smoking: an individual-participant data meta-analysis of 166 130 adults in 15 European studies","volume":"7","author":"Heikkil\u00e4","year":"2012","journal-title":"PLoS One"},{"key":"2025100304563142000_73.11.993.49","doi-asserted-by":"crossref","first-page":"252","DOI":"10.3109\/02813432.2015.1117282","article-title":"Risk factors for excessive benzodiazepine use in a working age population: a nationwide 5-year survey in Norway","volume":"33","author":"Fride Tvete","year":"2015","journal-title":"Scand J Prim Health Care"},{"key":"2025100304563142000_73.11.993.50","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/S0010-440X(99)90129-3","article-title":"Scalability, reliability, and validity of the benzodiazepine dependence self-report questionnaire in outpatient benzodiazepine users","volume":"40","author":"Kan","year":"1999","journal-title":"Compr Psychiatry"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech-2019-212703","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T11:56:43Z","timestamp":1759492603000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech-2019-212703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,12]]},"references-count":50,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,10,11]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/jech-2019-212703"],"URL":"https:\/\/doi.org\/10.1136\/jech-2019-212703","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,12]]}}}