Background – The study was designed to examine whether patients exposed to workplace bullying have clinically evident dysfunction in their musculoskeletal system. Furthermore, we wanted to explore the relationship between clinical findings and self-reported data on mental and musculoskeletal symptoms in the included patients.
Methods – Targets of workplace bullying referred to an occupational outpatient clinic in Norway in the period August 2011 to February 2017 were invited to participate in the study. The included patients had a high degree of post-traumatic stress symptoms; mean score on the IES-R was 42.9, well above the suggested cut-off at 33 points for Posttraumatic stress disorder (PTSD). The patients underwent a clinical program, and a physiotherapist used the Global Physiotherapy Examination 52 (GPE-52), a standardized test battery with 13 sub-domains, and five main domains examining posture, respiration, movement, muscle and skin. Self–report questionnaires were used to assess subjective musculoskeletal (MSI) and psychological symptoms (PI), as well as anxiety and depression (HADS) and post-traumatic stress symptoms (IES-R).
Results – Altogether 144 patients were included in the study, whereof 65 (45%) had an ongoing musculoskeletal disorder (MSD). Mean scores on the physiotherapy examination showed dysfunction in nine of 13 subdomains. The total GPE-52 sum-score was comparable to patients sick-listed with long-lasting MSD, and significantly higher (worse) than in healthy persons. The physical examination indicated that the bullied patients had reduced flexibility and ability to relax, as well as restricted respiration and tense and painful muscles. The total GPE-52 sum-score as well as the main domains Movement and Muscle had significant correlations with all self-reported health variables. The strongest correlations were found between Movement and Muscle, and PI and HADS (r ≥ 0.32).
Conclusions – Patients exposed to workplace bullying had a high degree of clinically evident dysfunction in the musculoskeletal system, comparable to patients with MSD. These findings confirm previous questionnaire studies on physical health in workers exposed to workplace bullying. The extent of the musculoskeletal problems revealed in our study clearly indicates that future health services to these patients should be multi-dimensional and include bodily assessment.