Factors Associated with Depression, Anxiety, and Stress Among Food Industry Workers: A Systematic Review


  • Mohd Zafrullan Zamberi Department of Community Health, Faculty of Medicine and Health Sciences, 43400 Universiti Putra Malaysia Serdang, Selangor, Malaysia.
  • Muhammad Izmanuddin Fitri Abdul Razak Department of Community Health, Faculty of Medicine and Health Sciences, 43400 Universiti Putra Malaysia Serdang, Selangor, Malaysia.
  • Amirul Asraf Sapawi Department of Community Health, Faculty of Medicine and Health Sciences, 43400 Universiti Putra Malaysia Serdang, Selangor, Malaysia
  • Khadijahtul Qubra Amizah Hamzah Department of Community Health, Faculty of Medicine and Health Sciences, 43400 Universiti Putra Malaysia Serdang, Selangor, Malaysia.
  • Dr Rahmat Dapari Faculty of Medicine and Health Sciences, UPM
  • Nazri Che Dom Faculty of Health Sciences, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia.
  • Mohd Rohaizat Hassan Department of Community Health, Faculty of Medicine, National University of Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia.
  • Syed Sharizman Syed Abdul Rahim Public Health Medicine Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah, Malaysia.




food industry; food service; mental health; depression; anxiety; stress


In 2021, food industry workers represented approximately one-tenth of the total labour force in Malaysia. There was an estimated 15% of working-age adults who experienced a mental disorder worldwide in 2019. To make the situation worse, service workers in food retail and food services face tremendous stress and mental health consequences during the COVID-19 pandemic. Various study found that worsening mental health and psychological distress have been accelerated substantially by the pandemic. An unsafe or unhealthy working environment can undermine mental health, as poor mental health can interfere with a person’s ability to work if left unsupported. This systematic review aimed to evaluate findings related to factors associated with depression, anxiety, and stress among food industry workers. Articles related to these factors were collected electronically from two different databases (EBSCOHOST and Scopus). An independent reviewers screened the titles and abstracts of the collected articles from each database, and then stored them in Google Sheet based on the inclusion and exclusion criteria. Next, the included articles were critically appraised to assess the quality of the studies using the Mixed Methods Appraisal Tool (MMAT). Out of the 292 articles identified, four were included in the final review. Sociodemographic characteristics, as well as biological, psychological, and occupational factors were found to be associated with common mental issues among food industry workers. By identifying the risk factors, specific interventions can be implemented by the employers and other relevant parties to prevent, promote, protect, and support the mental health well-being of food industry workers. These findings may be utilised to improve the implementation of key interventions directed to prevent, promote, protect, and support the mental health of food industry workers. Consequently, an enabling environment can be created to address mental health at work, as outlined by the World Health Organization (WHO). Employers may adapt or revamp their work environment to minimise exposure to psychological risks among their workers, which could prevent workers from experiencing adverse mental health conditions. Workers should also be equipped with awareness and skills, as well as opportunities to recognise and act early on mental health issues in order to promote and protect their mental health. Moreover, workers with pre-existing or ongoing mental health conditions should receive support to access job opportunities, or continue working, and thrive at work, since good mental health status at work can improve an individual’s performance and productivity.


Department of Statistics Malaysia. Malaysia Standard Industrial Classification (MSIC) 2008 [Internet]. Department of Statistics Malaysia, editor. Malaysia Standard Industrial Classification (MSIC) 2008. Department of Statistics Malaysia; 2008. 1–588 p. Available from: https://www.dosm.gov.my/v1/uploads/files/4_Portal Content/3_Methods %26 Classifications/2_List of References/MSIC_2008.pdf

Department of Statistics Malaysia. Labour Force Statistics Report, Malaysia October 2022. Department of Statistics Malaysia. 2022.

Lewis S, Freeman M, Ommeren V, Chisholm D, Siegl OG, Kestel D. World Health Organization. World mental health report: Transforming mental health for all. 2022. 1–296 p. Available from: https://apps.who.int/iris/rest/bitstreams/1433523/retrieve

Chisholm D, Sweeny K, Sheehan P, Rasmussen B, Smit F, Cuijpers P, et al. Scaling-up treatment of depression and anxiety: A global return on investment analysis. Lancet Psychiatry. 2016;3(5):415–24. Available from: http://dx.doi.org/10.1016/S2215-0366(16)30024-4

Rosemberg MS, Adams M, Polick C, Li WV, Dang J, Tsai JH. COVID-19 and mental health of food retail, food service, and hospitality workers. J Occup Environ Hyg. 2021 Apr-May;18(4-5):169-179. doi: 10.1080/15459624.2021.1901905. Epub 2021 Apr 16. PMID: 33861938; PMCID: PMC8720174.

Peters, Susan E et al. Work and worker health in the post-pandemic world: a public health perspective. The Lancet Public Health, Volume 7, Issue 2, e188 - e194

World Health Organization. WHO Guidelines on mental health at work. World Health Organization, editor. World Health Organization; 2022. 134 p. Available from: https://www.who.int/publications/i/item/ 9789240053052

Sornsenee P, Kongtragulsub K, Watcharajiranich K, Chantanuwat R, Aungchayakul A, Mangkhalathat K, et al. Factors associated with anxiety and depression among micro, small, and medium enterprise restaurant entrepreneurs due to Thailand’s COVID-19-related restrictions: a cross-sectional study. Risk Manag Healthc Policy. 2022;15(May):1157–65. Available from: https://doi.org/10.2147/RMHP.S359507

Machado ICK, Bernardes JW, Monteiro JK, Marin AH. Stress, anxiety and depression among gastronomes: association with workplace mobbing and work–family interaction. Int Arch Occup Environ Health. 2021;94(8):1797–807. Available from: https://doi.org/10.1007/s00420-021-01745-4

Saah FI, Amu H, Kissah-Korsah K. Prevalence and predictors of work-related depression, anxiety, and stress among waiters: a cross-sectional study in upscale restaurants. PLoS One. 2021;16(4 April):1–18. Available from: http://dx.doi.org/10.1371/journal.pone.0249597

Kamal MFM, Mohd Zahari MS, Hanafiah MH, Ariffin NWM. The Influence of Japanese Work Cultures on Malaysian Foodservice Employees’ Work Stress and Their Turnover Intention. The South East Asian Journal of Management. 2020;14(2):194–214. Available from: https://scholarhub.ui.ac.id/seam/vol14/iss2/4

Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, Gagnon MP, Griffiths F, Nicolau B, O’Cathain A, Rousseau MC, Vedel I, & Pluye P. (2018). The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Education for Information, 34, 1-7. https://doi.org/10.3233/EFI-180221

Jackson L. Why looking after workers’ mental health makes sound business sense. The Guardian. 2019;1–9. Available from: https://www.theguardian.com/mental-health-supplement-2019/2019/may/16/why-looking-after-workers-mental-health-makes-sound-business-sense

Niemeyer H, Bieda A, Michalak J, Schneider S, Margraf J. Education and mental health: do psychosocial resources matter? SSM Popul Health. 2019;7(March):100392. Available from: https://doi.org/10.1016/j.ssmph.2019.100392

Plana-Ripoll O, Pedersen CB, Holtz Y, Benros ME, Dalsgaard S, de Jonge P, et al. Exploring comorbidity within mental disorders among a Danish national population. JAMA Psychiatry. 2019;76(3):259–70. Available from: https://doi.org/10.1001/jamapsychiatry.2018.3658

Gamse C. Mental health comorbidity: one thing leads to another. Medpage Today. 2019 [cited 2022 Dec 29]. Available from: https://www.medpagetoday.com/resource-centers/mental-health-focus/mental-health-comorbidity-one-thing-leads-another/2408

McGrath JJ, Wray NR, Pedersen CB, Mortensen PB, Greve AN, Petersen L. The association between family history of mental disorders and general cognitive ability. Transl Psychiatry. 2014;4(May):1–6. Available from: https://doi.org/10.1038/tp.2014.60

Dalal S. Alshaya. Genetic and epigenetic factors associated with depression: An updated overview. Saudi Journal of Biological Sciences. 2022; 29 (8). https://doi.org/10.1016/j.sjbs.2022.103311.

Kedzior KK, Laeber LT. A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population: a meta-analysis of 31 studies. BMC Psychiatry. 2014;14(1). Available from: https://doi.org/10.1186/1471-244X-14-136

DeLisi LE. The effect of cannabis on the brain: can it cause brain anomalies that lead to increased risk for schizophrenia? Curr Opin Psychiatry. 2008 Mar;21(2):140-50. doi: 10.1097/YCO.0b013e3282f51266

Ujike H, Morita Y. New perspectives in the studies on endocannabinoid and cannabis: cannabinoid receptors and schizophrenia. Journal of Pharmacological Sciences. 2004;96(4):376–381

Duffy M, Yamada DC. The psychosocial impact of workplace bullying and mobbing on targets. In: Duffy M, Yamada DC, editors. Workplace bullying and mobbing in the United States. Santa Barbara: ABC-CLIO, LLC; 2018. p. 1–669.

Malik NA, Björkqvist K. Workplace bullying and occupational stress among university teachers: mediating and moderating factors. Eur J Psychol. 2019;15(2):240–59. Available from: https://doi.org/10.5964/ejop.v15i2.1611

Sarwar A, Bashir S, Karim Khan A. Spillover of workplace bullying into family incivility: testing a mediated moderation model in a time-lagged study. J Interpers Violence. 2021;36(17–18):8092–117. Available from: https://doi.org/10.1177/0886260519847778

Bakhtiar MFS, Zamri MT, Hashim NI, Othman Z, Ismail MNI. Workplace stress, organizational commitment and turnover intention: a case of Japanese restaurant in Malaysia. Heritage, Culture and Society. 2016;197–202. Available from: http://dx.doi.org/10.1201/9781315386980-35

Blackmore ER, Stansfeld SA, Weller I, Munce S, Zagorski BM, Stewart DE. Major depressive episodes and work stress: results from a national population survey. Am J Public Health [Internet]. 2007;97(11):2088–93. Available from: https://doi.org/10.2105/AJPH.2006.104406

Amit N, Ismail R, Zumrah AR, Mohd Nizah MA, Tengku Muda TEA, Tat Meng EC, et al. Relationship between debt and depression, anxiety, stress, or suicide ideation in Asia: a systematic review. Front Psychol. 2020;11(July). Available from: https://doi.org/10.3389/fpsyg.2020.01336

Chirico A, Lucidi F, Galli F, Giancamilli F, Vitale J, Borghi S, et al. COVID-19 outbreak and physical activity in the Italian population: a cross-sectional analysis of the underlying psychosocial mechanisms. Front Psychol. 2020;11(August):1–13. Available from: https://doi.org/10.3389/fpsyg.2020.02100

Adu MK, Wallace LJ, Lartey KF, Arthur J, Oteng KF, Dwomoh S, et al. Prevalence and correlates of likely major depressive disorder among the adult population in ghana during the covid-19 pandemic. Int J Environ Res Public Health. 2021;18(13):1–19. Available from: https://doi.org/10.3390/%0Aijerph18137106




How to Cite

Zamberi, M. Z., Abdul Razak, M. I. F., Sapawi, A. A., Hamzah, K. Q. A., Dr Rahmat Dapari, Dom, N. C., … Syed Abdul Rahim, S. S. (2023). FACTORS ASSOCIATED WITH DEPRESSION, ANXIETY, AND STRESS AMONG FOOD INDUSTRY WORKERS: A SYSTEMATIC REVIEW: Factors Associated with Depression, Anxiety, and Stress Among Food Industry Workers: A Systematic Review. Malaysian Journal of Public Health Medicine, 23(2), 312–323. https://doi.org/10.37268/mjphm/vol.23/no.2/art.2146