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233 Threats and violence at the workplace and the risk of developing anxiety symptoms and depression
  1. J F T Thomsen1,
  2. Mikkelsen2,
  3. Kaergaard3,
  4. Kolstad3,
  5. Hansen4,
  6. Bonde2,
  7. Andersen3,
  8. Grynderup3,
  9. Kaerlev5,
  10. Mors6,
  11. Rugulies7
  1. 1Bispebjerg Hospital, Copenhagen, Denmark
  2. 2Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
  3. 3Danish Ramazzini Centre, Herning, Denmark
  4. 4Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  5. 5Centre for National Clinical Databases South, Odense University Hospital, Odense, Denmark
  6. 6Centre for Psychiatric Research, Aarhus University Hospital, Aarhus, Denmark
  7. 7National Research Centre for the Working Environment, Copenhagen, Denmark


Objectives Workplace threats and violence are common within certain professions. In the European countries, 5% of workers report having been subjected to violence. The health consequences are both physical and mental. This study analyses if repeated threats and violence or serious violence may lead to an increased risk of anxiety symptoms and depression.

Methods In 2007 and 2009 we examined 3224 civil servants employed in hospitals, schools, social centres etc. Exposure at baseline was self-reported number of times the last 12 months subjected to threats or non-serious physical violence or to mobility- or life-threatening violence. In 2007 and 2009, anxiety symptoms were scored (range 0–4) with the Symptom Check List and clinical depression with a psychiatric interview (SCAN). Cases of anxiety symptoms (score >2) and clinical depression at baseline were excluded. We used logistic regression analyses with estimates adjusted for potential confounders.

Results In 2007, 1079 (34%) reported that they had been subjected to threats or non-serious physical violence 1–5 times the last year and 170 (5%) more than 5 times. Fifty-nine (2%) had been subjected to mobility- or life-threatening violence. 173 developed symptoms of anxiety and 62 clinical depression. The adjusted odds ratios (ORs) for incident anxiety symptoms because of threats or non-serious violence 1–5 times were 1.69 (95% confidence interval 1.18–2.42) and more than 5 times 2.53 (1.34–4.77). The corresponding ORs for incident clinical depression were 1.32 (0.73–2.38) and 1.85 (0.71–4.83), respectively. There were too few cases among the exposed to analyse for the effect of mobility- or life-threatening violence.

Conclusions Exposure to threats and non-serious violence predicted anxiety symptoms. The risk increased with increasing number of episodes. The same pattern was found for depression though not significant. The results indicate the importance of considering the less serious but more frequent episodes when planning prevention.

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