Revisiting the work alienation concept and its link to mental health: a systematic review

Background

Mental health disorders affect a significant proportion of working-age adults. Although adverse working conditions are well-known risk factors, existing models are limited in their ability to fully capture the impact in contemporary labor situations. Work alienation has recently regained importance in contemporary organizational research, although it remains underexamined in public mental health research. This study aims at consolidating existing evidence on how the construct of alienation is defined and measured in contemporary research, exploring the relationship between work alienation and mental health.

Methods

A search was performed across PubMed, MEDLINE, Embase, Web of Science, JSTOR and Wiley Online Library for studies published between 2005 and 2025 following PRISMA guidelines. Eligible studies were observational, quantitative research exploring the relationship between work alienation and mental health outcomes in working-age adults.

Results

Ten studies met inclusion criteria, corresponding to 6,368 participants. Despite the use of 11 alienation measurement tools and heterogenous conceptualization, findings are highly consistent. Higher work alienation was significantly associated with adverse mental health outcomes in all studies, including depression, burnout, anxiety, job stress, emotional exhaustion, and alcohol use. We also identified multiple factors associated with higher levels of work alienation, related to leadership style, working conditions, occupational role, perceived justice in the workplace, exhaustion, and lower learning opportunities.

Conclusions

The association between work alienation and poor mental health outcomes was robust across occupational groups and studies, suggesting that alienation is a relevant, yet overlooked dimension of contemporary work. Despite consistent evidence, its interpretation is constrained by conceptual heterogeneity and the systematic underrepresentation of precarious occupational groups.

Key messages

• Based on a systematic review, we show that the association between work alienation and poor mental health is robust across occupational groups and studies.

• The evidence about the work alienation-mental health link is constrained by (i) conceptual heterogeneity of the alienation concept; (ii) the limited evidence regarding precarious occupational groups.