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The most recent version of this article was published on 1 July 2006

Occup Environ Med. Published Online First: 12 May 2006. doi:10.1136/oem.2005.022269
Copyright © 2006 by the BMJ Publishing Group Ltd.

Paper

Injustice at work and incidence of psychiatric morbidity: the Whitehall II study

Jane Ferrie 1*, Jenny Head 1, Martin J Shipley 1, Jussi Vahtera 2, Michael G Marmot 1 and Mika Kivimaki 2

1 University College London, United Kingdom
2 Finnish Institute of Occupational Health, Finland

* To whom correspondence should be addressed. E-mail: j.ferrie{at}public-health.ucl.ac.uk.

Accepted 24 March 2006


Abstract

Aim: Previous studies of organisational justice and mental health have mostly examined women and have not examined the effect of change in justice. Using a cohort with a large proportion of men we examined effects of change in the treatment of employees by supervisors (the relational component of organisational justice) on minor psychiatric morbidity.

Methods: Data are from the Whitehall II study, a prospective cohort of 10,308 white-collar British civil servants; 3143 women and 6895 men, aged 35-55 at baseline (Phase 1, 1985-88). Employment grade, relational justice, job demands, job control, social support at work, effort-reward imbalance, physical illness and psychiatric morbidity were measured at baseline. Relational justice was assessed again at Phase 2 (1989-90). The outcome was cases of psychiatric morbidity by Phases 2 and 3 (1991-93) among participants case-free at baseline.

Results: In analyses adjusted for age, grade and baseline physical illness, women and men exposed to low relational justice at Phase 1 were at higher risk of psychiatric morbidity by Phases 2 and 3. Adjustment for other psychosocial work characteristics, particularly social support and effort-reward imbalance, partially attenuated these associations. A favourable change in justice between Phase 1 and Phase 2 reduced the immediate risk (Phase 2) of psychiatric morbidity, whilst an adverse change increased the immediate and longer-term risk (Phase 3).

Conclusion: This study shows that unfair treatment by supervisors increases risk of poor mental health. It appears that the employers' duty to ensure employees are treated fairly at work also has benefits for health.

Keywords: GHQ, minor psychiatric morbidity, organisational justice, psychosocial work characteristics, white collar


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