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Introduction
Bullying in the workplace can be characterised as repeated insulting actions, practices and behaviours that interfere job performance of employees and lead the victims to feel upset, threatened and humiliated. The victims themselves perceive being bullied and often are in an underdog position compared with the bully. 1 2 The general assumption is that bullying negatively affects the victims, their workmates and the workplace environment, creating 'toxic' atmospheres. 2 3
While the general characterisation of workplace bullying is more or less shared, there is no common definition as yet. The terminology also varies, and terms such as mobbing, harassment, victimisation, emotional abuse and psychological terror at workplace have been used as synonyms for bullying. 1 Building on earlier work, the definition by Einarsen et al 2 refers to bullying as the result of systematic and enduring negative and intentional acts reflecting interpersonal conflicts in which the victim is in an inferior position and subject to harassment, social exclusion, offending or other negative acts affecting work tasks. Such adverse acts give rise to negative experiences which may undermine self-confidence as well as health and well-being among the victims. 4-7
Bullying at workplace is a relatively common phenomenon, and its prevalence has ranged from 5% to 20% depending on the definition, measurement and the population under study. 6 In the Nordic and other western European countries, the 6-12-month prevalence of workplace bullying varied around 10%. 2 6 8
Bullying is closely related to conflicts in interpersonal relationships at workplace. Such conflicts enhance distress, and as a result mental health among the victims of bullying is likely to be affected. 9 As a subarea of mental health, common mental disorders are widespread in the community and impair normal social functioning but do not meet diagnostic criteria. 10 11 Nevertheless they are suitable for epidemiological studies of the mental consequences of workplace bullying. Common mental disorders typically include feelings of anxiety and depression, 12 and are reported even by a quarter or a third among employees depending on the measurement. 13 14
In previous studies, workplace bullying has been associated with common mental disorders, such as those indicated by the General Health Questionnaire (GHQ). 15 Bullying has also been associated with depressive symptoms 16 and symptoms of post-traumatic...