title: Risk of psychiatric and neurological diseases in patients with workplace mobbing experience in Germany: a retrospective database analysis.
abstract: BACKGROUND
  The number of mobbing experiences recorded has increased during recent years and it has now been established as global phenomenon among the working population. The goal of our study was to analyze the incidence of certain neurologic and psychiatric diseases as a consequence of mobbing as compared with a control group and to examine the possible influence of previous diseases that occurred within one year before the first mobbing documentation on the incidence of mobbing.
  
  
  METHODS
  We used a large database (IMS® Disease Analyzer, Germany) to collect data from general practitioners in Germany from 01/2003 until 12/2012. Based on age, gender, and health insurance, patients with experience of mobbing were matched with a control group of patients who had not reported workplace mobbing and who were being treated by the same physicians. At first, diseases that occurred within one year before the bullying experience took place ("index date") were noted and compared to a control group of similar composition in terms of gender, age, and health insurance. Subsequently, the prevalence of depression, anxiety, somatoform disorders, and sleep disorders following experiences of mobbing were determined. After adjustment to take into account the odds of bullying, the ratios of these diseases were assessed using a logistic regression model.
  
  
  RESULTS
  The study population consisted of n=2,625 patients and n=2,625 controls, of which 33% were men. The number of cases of bullying documented rose continuously from 2003 to 2011 and remained high in 2012. Those who would later become victims of mobbing demonstrated a considerably higher prevalence of diseases in general - these diseases were not confined to the neurologic-psychiatric spectrum. Following experiences of bullying, depression, anxiety, somatoform disorders, and sleep disorders were significantly more prevalent than in the control group (for all, p<0.05). Similarly, odds ratios (OR) representing the risk of suffering from diseases were higher in affected patients, with the highest value (4.28) for depression and the lowest value for sleep disorders (OR=2.4).
  
  
  CONCLUSIONS
  Those who will later become the victims of bullying are more prone to suffer from diseases in general, even before this experience of mobbing has occurred, which underlines the importance of supporting (chronically) ill patients to protect them against bullying. Sequelae of mobbing include, in particular, diseases from the neurologic-psychiatric spectrum.
authors.affiliation: IMS Health, Frankfurt, Germany.
authors.forename: Karel
authors.initials: K
authors.lastname: Kostev
authors.affiliation: IMS Health, Frankfurt, Germany.
authors.forename: Juliana
authors.initials: J
authors.lastname: Rex
authors.affiliation: Fresenius University of Applied Sciences, Idstein, Germany.
authors.forename: Lilia
authors.initials: L
authors.lastname: Waehlert
authors.affiliation: Fresenius University of Applied Sciences, Idstein, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Hog
authors.affiliation: FOM University of Applied Sciences, Essen, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Heilmaier
mesh_terms: D000328:Adult; D017677:Age Distribution; D058445:Bullying / Q000523:psychology*; D015897:Comorbidity; D016208:Databases, Factual / Q000706:statistics & numerical data; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000523:psychology*; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D064450:Workplace Violence / Q000523:psychology* / Q000706:statistics & numerical data
keywords: anxiety; depression; mobbing; risk factors