Complaints about bullying at the workplace are related to fantasies of aggression in psychosomatic patientss.

BACKGROUND: The workplace can be associated with social stressors like vilification, humiliation, and breach of trust. A common emotional response is embitterment and aggressive behavior.

OBJECTIVE: Aim of the study is to investigate the relation between work-related problems, including bullying, and fantasies of aggression.

METHODS: Therapists of a department of behavioral medicine routinely had to fill in a diagnostic checklist whenever they saw signs of embitterment and/or aggression in their patients. The type of aggressive fantasies was categorized in no fantasy, minor harm, serious harm without bodily harm, or bodily harm. Independent of this interview, social workers assessed problems at work (duration of sickness absence, workplace insecurity, bullying at workplace, ability to work, expectation of pension). Patients were also asked to fill in an embitterment questionnaire and the Symptom-Checklist-90. Further sociodemographic and clinical information was taken from the hospital routine documentation.

RESULTS: A total of 3211 patients were admitted to the hospital during the observation period. Therapists saw the indication for an in-depth interview because of aggressive fantasies in 102 (3.2%) patients. Aggressive ideations refer to "minor harm" in 27%, "serious harm" in 37%, and "bodily harm" in 35%of patients, respectively. There is a significant relation between the severity of aggressive ideations and bullying and duration of sick leave. There was also a significant correlation between ideas of aggression and feelings of embitterment.

CONCLUSION: Aggressive ideations are interrelated with psychosomatic distress and workplace problems and feelings of embitterment. This is of importance for prevention and interventions in regard to workplace bullying.