Work related violence and threats and the risk of depression and stress disorders.
OBJECTIVE
To examine the risk of depression and stress related disorders as a function of occupational exposure to violence and threats.


METHODS
Population based nested case-control study.


METHODS
All gainfully employed Danes. Cases and controls: 14 166 hospital inpatients and outpatients, aged 18-65, treated for affective or stress related disorders during 1995-1998 selected from The Danish Psychiatric Central Research Register and 58 060 controls matched for age, sex, and time, drawn from Statistics Denmark's Integrated Database for Labour Market Research.


METHODS
Clinical psychiatric diagnosis (WHO ICD-10) of affective (F30-39) or stress related (F40-48) disorders compared with controls by the occupation held the year before treatment. The occupation held the year before treatment was used as exposure proxy.


RESULTS
Potential exposure to occupational violence is associated with significantly increased relative risks of both disorders in either sex (women: depression RR 1.45 CI 1.27 to 1.65, stress RR 1.32 CI 1.19 to 1.46; men: depression RR 1.48 CI 1.18 to 1.86, stress RR 1.55 CI 1.29 to 1.84). Work related threats are associated with increase in the risk of depression in women (RR 1.48 CI 1.23 to 1.79) and the risk of stress related disorders in men (RR 1.59 CI 1.32 to 1.91). Risks rose with increasing prevalence of violence and threats. The results remain significant and only slightly attenuated after controlling for extent of professional contact with people other than colleagues.


CONCLUSIONS
Employment in occupations involving exposure to work related threats and violence is a risk factor for depression and stress related disorders in both sexes. These findings have implications for health and safety at work policies.
Wieclaw
Joanna
J
Department of Occupational Medicine, Aarhus University Hospital, Norrbrogade 44, building 2C, DK-8000 Aarhus C, Denmark. jwiec@as.aaa.dk
Agerbo
Esben
E
Mortensen
Preben Bo
PB
Burr
Hermann
H
Tüchsen
Finn
F
Bonde
Jens Peter
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology*; D016022:Case-Control Studies; D003718:Denmark / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D016272:Occupational Health; D011446:Prospective Studies; D012307:Risk Factors; D040921:Stress Disorders, Traumatic / Q000453:epidemiology*; D014754:Violence / Q000523:psychology*; D014937:Work