title: 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.
authors.affiliation: Institute of Occupational and Social Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany. Electronic address: Adrian.Loerbroks@uni-duesseldorf.de.
authors.forename: Adrian
authors.initials: A
authors.lastname: Loerbroks
authors.affiliation: Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Weigl
authors.affiliation: Institute of Occupational and Social Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Glaser
authors.affiliation: Institute of Occupational and Social Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Degen
authors.affiliation: Institute of Occupational and Social Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Angerer
mesh_terms: D000328:Adult; D058445:Bullying / Q000523:psychology; D019548:Crime Victims; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D011446:Prospective Studies; D012306:Risk; D017132:Workplace / Q000523:psychology*
keywords: Depression; Epidemiology; Germany; Physicians; Workplace bullying