Work-family conflict and mental health: A systematic review and meta-analysis

Work-family conflict, defined as a type of inter-role conflict where demands from work and family roles are incompatible, is a global public health concern. Cross-sectional studies consistently demonstrate associations between work-family conflict and adverse mental health outcomes. However, longitudinal evidence remains mixed, highlighting the need for a comprehensive synthesis of available data to better understand its long-term impacts.

We performed a systematic review and meta-analysis of longitudinal studies of associations between work-family conflict and mental health outcomes, involving 112,714 participants and 52 studies in the meta-analysis. The review was prospectively registered in PROSPERO (CRD42022325540). We searched PubMed, Web of Science, Scopus, and PsycINFO for English-language articles and SinoMed for Chinese-language articles in February-March 2026. We further performed backward citation searches by screening the reference lists of previously published reviews to ensure the comprehensive inclusion of all eligible studies. Eligible studies were original longitudinal research focusing on adult workers, examining work-to-family and/or family-to-work conflict as exposures related to mental health outcomes. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted for outcomes with three or more comparable studies, converting effect sizes to standardised regression coefficients (β), indicating standard deviation (SD) differences in mental health per 1-SD increase in work-family conflict. We synthesised effect sizes with the most comprehensive confounding adjustments when possible, including sociodemographic, work/family-related factors, and baseline mental health. Work-to-family conflict was associated with depressive symptoms (β = 0.10, 95% confidence interval [0.06, 0.15]; p < 0.001), burnout (β = 0.11, 95% CI [0.01, 0.21]; p = 0.040), and general mental distress (β = 0.13, 95% CI [0.03, 0.24]; p = 0.005), independent of baseline mental health and other confounders. Significant associations were also found for family-to-work conflict with depressive symptoms (β = 0.09, 95% CI [0.04, 0.15]; p = 0.006) and burnout (β = 0.08, 95% CI [0.03, 0.13]; p = 0.013) in studies with similar adjustments. No significant differences emerged based on gender, follow-up length, and geographical location. While evidence of publication bias was identified, sensitivity analyses employing a trim-and-fill method to adjust for this bias yielded broadly similar pooled estimates. A causal relationship cannot be fully established as all identified studies were observational.

These findings provide evidence of the longitudinal association between work-family conflicts and mental health outcomes, underscoring the need for context-specific policies in promoting work-family balance and mental health.