*Corresponding author: Elpidoforos S Soteriades, United Arab Emirates Uni-
versity, College of Medicine and Health Sciences, Institute of Public Health, Al
Ain, UAE, Tel: + 971 037137586; Email: esoteria@uaeu.ac.ae
Citation: Panayiotou EA, Economidou SC, Kaitelidou D, Soteriades ES (2019)
Workplace Harassment and Depression in Mental Health Nurses: A National
Survey from Cyprus. J Community Med Public Health Care 6: 047.
Received: February 28, 2019; Accepted: March 20, 2019; Published: March 27,
2019
Copyright: © 2019 Panayiotou EA, et al. This is an open-access article dis-
tributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.
Introduction
Workplace harassment or mobbing was defned for the frst time
in the 1980’s by Heinz Leymann as “a type of psychological terror
that arises in the form of systematic, directed, unethical communi-
cation and antagonistic behavior by one or more individuals towards
one individual” [1]. These actions take place often (almost every day)
and over a long period of time (at least for six months) and, because
of such a frequency and duration, it results in considerable psychic,
psychosomatic and social misery [2]. Similarly to Leymann, several
researchers such as Ege et al., Zapf et al., and Einarsen et al., char-
acterize the concept of harassment in the workplace with the term
mobbing [3-5]. Furthermore, bullying in the workplace has been char-
acterized as a gradual, often invisible and an intensely individualized
and harmful experience [6].
Over recent decades, several large-scale studies across a range of
industry sectors have identifed the presence of workplace harassment
and its damaging effects on individual employees and organizations
alike [7-10].
In all felds of work, as well as in the healthcare sector there have
been studies reporting on the presence of workplace harassment and/
or mobbing. The health services sector is classifed as one of the work
areas with the highest prevalence of workplace harassment, reaching
up to 9% [11]. In particular, workplace mobbing or bullying is a
signifcant problem confronting the nursing profession. According to
research reports, nurses are at greater risk of being exposed to work-
place harassment compared to other health care professionals [12-15].
Harassment or mobbing is an international problem for nursing
staff as demonstrated by different surveys conducted in Canada, [16]
the United Kingdom, [17-20] the United States, [21-23] Australia,
[15, 24-26] New Zealand, [27] Italy, [28,29] Pakistan, [30] Taiwan,
Panayiotou EA, et al., J Community Med Public Health Care 2019, 6: 047
DOI: 10.24966/CMPH-1978/100047
HSOA Journal of
Community Medicine and Public Health Care
Research Article
Eleni A Panayiotou
1,2
, Sofa C Economidou
3
, Dafni Kaitelidou
2,4
and Elpidoforos S Soteriades
5,6
*
1
Ministry of Health, Mental Health Services, Nicosia, Cyprus
2
Open University of Cyprus, Healthcare Management Program, Nicosia,
Cyprus
3
National and Kapodistrian University of Athens, School of Health Sciences,
Greece
4
United Arab Emirates University, College of Medicine and Health Sciences,
Institute of Public Health, Al Ain, UAE
5
Harvard T.H. Chan School of Public Health, Department of Environmen-
tal Health, Environmental and Occupational Medicine and Epidemiology,
Boston, MA, USA
6
United Arab Emirates University, College of Medicine and Health Sciences,
Institute of Public Health, Al Ain, UAE
Workplace Harassment and
Depression in Mental Health
Nurses: A National Survey from
Cyprus
Abstract
Background: Workplace harassment constitutes a signifcant occu-
pational hazard in many industries including the healthcare sector.
The aim of our study was to evaluate workplace harassment and
explore its potential association with depressive symptoms among
mental health nurses.
Methodology: A national survey among mental health nurses
was conducted in Cyprus using three international validated ques-
tionnaires; namely the Leymann Inventory of Psychological Terror
(LIPT), evaluating “mobbing” in the workplace, the Center for Epide-
miological Studies in Depression (CES-D) Scale, and a specifcally
designed, questionnaire for the collection of the demographic data of
the participants. The data were analyzed with the statistical package
SPSS 20.
Results: Among 402 mental health nurses in Cyprus, 255 com-
pleted the survey (response rate 62.9%) with a slight majority
being women (55.7%). The prevalence of workplace harassment
(mobbing) was 8.2%. In addition, about one in ten nurses (11.0%)
reported depressive symptoms based on the CES-D scale. Using
multi-variable adjusted logistic regression models (adjusted for age,
gender, marital status, educational level, professional ranking, and
years of experience), we found that mental health nurses who re-
ported workplace harassment were 5.2 times more likely to have
depressive symptoms compared to their colleagues who did not
experience workplace harassment.
Conclusion: Workplace harassment as well as depressive symp-
tomatology is quite prevalent among mental health nurses in Cy-
prus. Workplace harassment was also signifcantly associated
with depressive symptoms among mental health nurses. Further
qualitative and quantitative evaluation of the above association is
warranted.
Keywords: Cyprus; Depression; Mobbing; Nurses; Survey; Work-
place harassment