Exposure to workplace violence and threats and risk of depression: a prospective study

Several studies have examined the health consequences of workplace threats and violence, however, due to methodological issues the epidemiological evidence is limited. The purpose of this study was to examine the prospective association between self-labelled exposure to work-related threats and violence and the risk of depression, measured by a standardized psychiatric interview and new prescriptions of anti-depressive medication.

Employees were recruited from the Danish PRISME cohort established in 2007 where 4489 Danish public employees answered a postal questionnaire with follow-ups in 2009 and 2011. In all three waves, depression was diagnosed by clinical interviews with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). In addition, we ascertained prescription of anti-depressive medication from a national register. Using logistic regression and Cox proportional hazard models, we estimated the association between exposure to threats and violence at baseline and SCAN depression and prescription of anti-depressive medication during two years of follow-up.

Self-labelled exposure to work-related threats and violence was associated with a risk of SCAN diagnosed depression two years later, odds ratios (OR) 2.20 [95% confidence interval (CI) 1.13-4.28] and OR 2.11 (95% CI 1.05-4.24), respectively, with indication of a dose-response. Self-labelled exposure to work-related threats and violence was associated with prescription of anti-depressive medication in a two-year period, hazard ratios (HR) 2.55 (95% CI 1.47-4.40) and HR 1.47 (95% CI 0.70-3.06), respectively.

Exposure to work-related threats or violence is associated with an increased risk of depression two years later, measured with a psychiatric interview and register data on prescribed antidepressants.