Lavreysen, OliviaBakusic, JelenaAbatzi, Thalia-AnthiGeerts, AnnelienMateusen, MiesBashkin, OsnatKoscec Bjelajac, AdrijanaDopelt, Kerendu Prel, Jean-BaptistFranic, ZrinkaGuseva Canu, IrinaKiran, SibelMerisalu, EdaPereira, Cristiana CostaRoquelaure, YvesGodderis, Lode2026-02-232026-02-232025-04-23J Affect Disord. 2025 Aug 15:383:240-259. doi: 10.1016/j.jad.2025.04.076. Epub 2025 Apr 230165-0327http://hdl.handle.net/10400.18/10984Objective: Work-related stress (WRS) is associated with the development of various health issues and long-term absence from the workplace. Adequate measurement of WRS is essential to assess its prevalence, risks, and effectiveness of preventive interventions. The aim of this review was to provide an overview of different categories of WRS assessment: 1) self-assessment, 2) external assessment, and 3) biomarkers. Methods: The databases MEDLINE, PsycINFO, EMBASE, CINAHL, and Web of Science have been searched until July 2024 for studies comprising self-assessment or external assessment of WRS, and WRS biomarkers. The self-assessment studies were further evaluated following the COSMIN guidelines. Results: In this review, a total of 15,749 articles were screened. The final analysis included 53 studies on self-assessment of WRS, 33 articles on external assessment of WRS and 167 articles on stress biomarkers. Within self-assessment studies, four instruments were included in the analysis: Job Content Questionnaire, Effort Reward Imbalance Questionnaire, Copenhagen Psychosocial Questionnaire II and the Demand-Control-Support Questionnaire. The studies applying external assessment used job-exposure matrices, work register data, ethnography, digital tools, and external observation. The identified WRS biomarkers were associated with the sympathetic adrenal medullary axis, the hypothalamic pituitary adrenal axis, immune response and inflammation, and haemostatic, metabolic and (epi)genetic biomarkers. Conclusion: The available evidence does not support the claim that there is a singular golden standard for assessing WRS. Inclusion of objective parameters and the interaction with subjective parameters and biological markers has to be studied to receive a broader view of WRS.Highlights: - Currently, there is no golden standard for assessing work-related stress (WRS). - Self-assessment measures of WRS need additional validation studies. - JEMs can offer valuable insights into WRS but the validity needs careful evaluation. - The link between biomarkers and WRS was inconsistent, with high study heterogeneity. - Combining objective, subjective and biological tools may improve understanding of WRS.enBiomarkersExternal AssessmentJob-exposure MatrixQuestionnairesSelf-assessmentWork-related StressAr e Saúde OcupacionalAvaliação do Riscojournal article10.1016/j.jad.2025.04.07640280433