Workplace bullying and depressive symptoms: a prospective study among junior physicians in Germany

Abstract

Objective: The relationship between workplace bullying and depression may be bi-directional. Furthermore, it has been suggested that the depressogenic effect of bullying may only become evident after reasonable periods of follow-up (i.e., >1 year). As prospective evidence remains sparse and inconsistent, we used data from a three-wave prospective study to disentangle this potentially bi-directional relationship.

Methods: In 2004, 621 junior hospital physicians participated in a survey and were followed-up 1.2 years and 2.8 years later. Prospective analyses were restricted to participants with complete data at all assessments (n=507 or 82%). To measure workplace bullying, a description of bullying at work was provided followed by an item inquiring whether the respondent felt she/he had been exposed. Depressive symptoms were assessed by the state scale of the German Spielberger's State-Trait Depression Scales.

Results: Multivariate linear regression suggested that workplace bullying at baseline predicted increased depressive symptoms both after 1 year (b=1.43, p=0.01) and after 3 years of follow-up (b=1.58, p=0.01). Multivariate Poisson regression models revealed that the depressive symptom z-score at baseline was associated with an increased risk of bullying at the 3-year follow-up (relative risk [RR]=1.49, 95% confidence interval [CI]=1.13-1.97). This association was less pronounced after 1 year of follow-up (RR=1.19, 95% CI=0.90-1.59).

Conclusions: Our study suggests bi-directional associations between depressive symptoms and victimization from bullying at the workplace. Future prospective studies are needed to examine underlying biopsychosocial mechanisms.

Keywords: Depression; Epidemiology; Germany; Physicians; Workplace bullying.