Aims: Exposure to workplace bullying is associated with an increased risk of mental health conditions, yet it is debated whether the association is causal. This study aims to address this by examining whether onset of workplace bullying is associated with initiating treatment with psychotropic medication, here used as a proxy measure for onset of common mental disorders.Methods: We used two longitudinal datasets from Sweden and Denmark (mean age: 47.4, women: 52.8%), combined with national registry data on psychotropic medication purchases. Using a target trial approach, the study population (N = 25 309) consisted of employees free of workplace bullying and psychotropic medication use at baseline. We used Cox proportional hazards regression (adjusted for sociodemographic variables, depressive symptoms and psychosocial work characteristics) to assess the association between onset of exposure to workplace bullying and incident treatment with psychotropic medication during 2 years.Results: In total, 1490 individuals (5.9%) experienced onset of workplace bullying. Bullying onset was associated with incident treatment with any psychotropic medication (HR: 1.42, 95% CI 1.15–1.77, model adjusted for sociodemographic variables). This association was attenuated in the fully adjusted model (HR: 1.24, 95% CI 0.99–1.53). In analyses focusing on antidepressant treatment, the estimates were stronger (HR: 1.55, 95% CI: 1.15–2.09, fully adjusted model). The results further demonstrated an exposure–response relationship, such that higher frequency of bullying exposure was associated with an increased risk of initiating any psychotropic treatment and antidepressants.Conclusions: Individuals experiencing onset of workplace bullying were at higher risk of starting antidepressant treatment within 2 years. This is the first study showing that onset of workplace bullying can contribute to the development of mental health conditions requiring medical treatment. These results underline the importance of preventive interventions that reduce workplace bullying.

Background: Prior research on health and work-related consequences of workforce restructuring have shown mixed findings. This study seeks to examine if organizational upsizing and downsizing is prospectively associated with sickness absence due to common mental disorders (SA-CMD) and/or with exposure to workplace offensive behaviors (i.e. workplace bullying and workplace violence/threats of violence), and assess if workplace offensive behaviors mediate any association between organizational upsizing/downsizing and SA-CMD.Methods: This study used a prospective design, combining self-reported survey data from the Swedish Longitudinal Occupational Survey of Health and national register data covering the period 2010–2018 on 10 358 employed individuals. Logistic regression with generalized estimating equations was used to examine the associations between organizational upsizing/downsizing, offensive behaviors, and sickness absence due to common mental disorders. To examine the role of offensive behaviors in the association between exposure to upsizing/downsizing and sickness absence due to common mental disorders, mediation analysis was performed.Results: We found that upsizing, but not downsizing, was significantly associated with a higher risk of workplace violence/threats of violence (ORadj: 1.2, 95% CI 1.0-1.3). However, neither upsizing nor downsizing was significantly associated with workplace bullying or with subsequent SA-CMD and the mediation analysis indicated no mediation.Conclusions: Although this study did not find a link between organizational upsizing/downsizing and later sickness absence due to SA-CMD, it suggests that upsizing may be associated with certain types of workplace offensive behaviors. Further research is needed to explore the mechanisms associated with these dynamics.

Background: Growing evidence indicates that a range of psychosocial work characteristics may influence workers’ mental health, with workplace bullying emerging as a particularly harmful factor. However, few studies have examined medically certified mental disorders following exposure to workplace bullying. In addition, evidence of potential sex differences remains inconclusive. Therefore, this study aims to examine if exposure to workplace bullying is associated with an excess risk of mental disorders among men and women in the Swedish workforce.Methods: We linked self-reported questionnaire data from the 2016 Swedish Longitudinal Occupational Survey of Health (N = 13 321, mean age: 51.7 years, women: 57.1%) with data from the Swedish National Patient Registry, covering diagnoses from in- and outpatient specialist care during the period 1997 to 2018. The prospective association between self-reported exposure to workplace bullying and incident mental disorders was examined in sex-stratified logistic regression analyses.Preliminary results: After adjusting for age, marital status, educational attainment, and history of mental disorders, exposure to workplace bullying was associated with subsequent risk of diagnosed mental disorders in men (OR: 2.0, 95% CI: 1.2-3.3), but not in women (OR: 0.9, 95% CI: 0.6-1.5). The same pattern was found when excluding individuals with prior history of mental disorders (men: OR: 2.5, 95% CI: 1.3-5.0; women: 0.8, 95% CI: 0.4-1.7). Interaction analyses supported both additive and multiplicative interaction between sex and exposure to workplace bullying (p < 0.05 for both).Conclusions: Our findings indicate that exposure to workplace bullying may increase the risk of moderate-to-severe mental disorders in men, but not in women, suggesting potential sex differences in response to exposure. The results underscore the importance of continued preventive measures against workplace bullying.

Background The link between workplace bullying and poor mental health is well-known. However, little is known about the prospective and potentially reciprocal association between workplace bullying and mental health-related sickness absence. This 2-year prospective study examined bidirectional associations between exposure to workplace bullying and sickness absence due to common mental disorders (SA-CMD) while controlling for confounding factors from both work and private life.Methods The study was based on propensity score-matched samples (N = 3216 and N = 552) from the Swedish Longitudinal Occupational Survey of Health, using surveys from years 2012, 2014 and 2016. Self-reported exposure to workplace bullying was linked to registry-based information regarding medically certified SA-CMD (≥ 14 consecutive days). The associations were examined by means of Cox proportional hazards regression and via conditional logistic regression analysis. Hazard ratios and odds ratios with 95% confidence intervals were estimated.Results Exposure to workplace bullying was associated with an increased risk of incident SA-CMD (HR: 1.3, 95% CI: 1.0–1.8), after accounting for the influence of job demands, decision authority, previous SA-CMD, as well as other sociodemographic covariates. However, we found no statistically significant association between SA-CMD and subsequent workplace bullying (OR 1.2, 95% CI 0.7–1.9).Conclusions The results support an association between self-reported workplace bullying and SA-CMD, independent of other sociodemographic factors and workplace stressors. Preventing workplace bullying could alleviate a share of the individual and societal burden caused by SA globally.

Objective: Associations between debt and suicidal behaviour have been identified, but the research is sparse. Thus, more research is needed to understand the association between economic vulnerability and suicide. The study aimed to generate further knowledge about over-indebted individuals who have attempted suicide at least once. Method: Participants were a Swedish sample comprising 641 over-indebted individuals. The inclusion criteria were that the participants should be indebted and have been subjected to debt collection measures and/or seizure orders by the Swedish Enforcement Authority. Participants answered questionnaires regarding socio-demographic variables, debt size, history of suicide attempt, critical life events, and social contacts, and filled the Hospital Anxiety and Depression Scale (HADS). In the statistical analyses, Chi(2) test for independence and t-test was used, and binary logistic regression to adjust for the confounding effects of the variables on each other. Results: The analysis revealed that nearly one in five (19.3%, N = 123) had attempted suicide at least once. A larger part of the respondents who had a history of suicide attempts reported that they were living alone (OR 2.30 (95% CI 1.34-3.89, p = .002). Many of those living alone were women (chi(2) (1, n = 121) = 4.88, p = 0.03, phi = 0.22). Conclusions: The results of the current study point to the fact that economic vulnerability is an important psychosocial aspect to take into serious consideration concerning mental health and suicide prevention. Longitudinal research is needed to explain, predict and prevent suicide due to over-indebtedness.