Occupational Medicine 2004;54:92-100
Occupational Medicine, Vol. 54 No. 2 © Society of Occupational Medicine 2004; all rights reserved
Farmers are at risk for anxiety and depression: the Hordaland Health Study
1 Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Norway
2 Faculty of Psychology, University of Bergen, Norway
3 Section for Occupational Medicine, Department of Public Health and Primary Health Care, University of Bergen, Norway
4 Department for Clinical Cancer Research, The Norwegian Radium Hospital, University of Oslo, Norway
Aims To examine whether, and why, farmers and non-farmers differ regarding levels of anxiety and depression.
Methods The study encompassed 17 295 workers age 40–49 years, including 917 farmers, from the population-based Hordaland Health Study 1997–99 (HUSK). Levels of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively). Self-reported information on various work-related factors, demographics, lifestyle and somatic health problems was included. The main analytical methods were univariate analysis of variance (ANOVA)/Kruskal–Wallis test, 
2/Fisher's exact test and logistic regression.
Results Compared with non-farmers, farmers had higher levels and prevalences of depression, particularly the male farmers, who also had higher anxiety levels. Among men, farmers reported longer work hours, lower income, higher psychological job demands and less decision latitude compared with non-farmers. Farmers had physically heavier work and a lower level of education than non-farmers. Generally, the differences were largest between full-time farmers and non-farmers. Differences in anxiety and depression levels between male full-time farmers and non-farmers could be explained by the farmers' longer work hours, physically harder work and lower income.
Conclusions Farming is associated with increased levels of anxiety and increased levels and prevalences of depression. As regards depression, preventative measures and screening for cases in need of treatment should be strongly considered.
Keywords Anxiety; depression; farmers; Hospital Anxiety and Depression Scale (HADS)
Received 20 January 2002
Revised 23 September 2003
Accepted 22 October 2003
Correspondence to: Bjarte Sanne, Section for Epidemiology and Medical Statistics, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, N- 5018 Bergen, Norway. Tel: +47 55 97 46 46; fax: +47 55 97 49 64; email: Bjarte.Sanne{at}isf.uib.no