How a lack of workplace ‘fairness’ can cause depression

New research in Denmark has looked at how a perceived lack of fairness in the workplace can impact on a worker’s well-being. The study suggests a work environment characterised by low ‘organisational justice’ – or fairness – is a risk factor for employees developing depression. Included in the survey were questions on how employers perceived the fairness of the decision-making process in the workplace, and whether managers were unbiased, truthful, kind and considerate.


A new Danish study has investigated the effects of low levels of organisational justice at the workplace on the risk of depression (Grynderup, Mors, Hansen et al, 2013). A total of 4,237 public employees from 378 work units in Denmark were enrolled at baseline in 2007 from the Danish PRISME project, Psychological risk factors in the work environment and biological mechanism for the development of stress, burnout and depression (in Danish).

The study shows that employees working in units or departments with a low degree of perceived fairness in procedures and relationships have a higher risk of developing depression.

The authors conclude that a working environment characterised by a low degree of ‘organisational justice’ is a risk factor for the development of depression. The authors believe this is an important finding that might open up new possibilities for preventing depression, because unjust working conditions can be changed.

Previous research has shown that a management style characterised by a clearly articulated concern for being fair, reinforced through the use of transparent procedures, increases justice at work (Greenberg, 2004).

Psychosocial working conditions and health

The study of organisational justice is a relatively new way of understanding the relationship between psychosocial working conditions and health, well-being and productivity.

The researchers define organisational justice as a concept that encompasses two separate elements – procedural justice and relational justice.

Procedural justice relates to the decision-making process at the workplace. It describes the consistency of decision-making procedures, the accuracy of the information collected to make decisions and the degree to which all affected employees are allowed to voice their opinion and challenge the decisions.

Relational justice describes the degree to which supervisors consider employees’ viewpoints, suppress personal bias and treat employees with kindness, consideration and truthfulness.

Theoretically, prolonged stress might be the causal link between organisational justice and the development of depression. It may also be a factor in other health problems, such as heart disease. Improved fairness at work might help employees cope with mistrust and uncertainty. At an individual level, improving ‘organisational justice’ might also affect an employee’s behaviour, self-esteem and social identity.

This study shows that both aspects of organisational justice – procedural and relational – are associated with the onset of depression. The authors found that working in a work unit with low procedural justice and low relational justice was a good predictor of the onset of depression after two years. The results were statistically significant after controlling for known risk factors for depression.

Measuring organisational justice

To date only a few studies have investigated whether organisational justice is related to the onset of depression (Spell and Arnold, 2007; Ybema and van den Bos, 2010; Ylipaavalniemi et al, 2005).

The latest Danish study distinguishes itself from this previous research by using aggregated workplace measures instead of individual ratings. This method is relatively novel in research on psychosocial working environments and mental health.

Most of the previous studies on the correlation between psychosocial working conditions and the onset of depression use individual self-reported measures of the working conditions. This creates a serious risk of reporting bias, because individual self-reports may be affected by initial symptoms of depression.

This problem is circumvented in the Danish study by the use of aggregated work unit measures with procedural and relational justice measured as the mean scores of all self-reported ratings within the work unit. To eliminate the potential bias caused by initial symptoms of depression, all participants who were diagnosed with depression at baseline in 2007 were excluded. By only including the ‘justice ratings’ of non-depressed participants in the calculation of the mean scores, any reporting bias is avoided.

Data and methods

The study is designed as a two-year cohort study with a baseline measurement in 2007 and follow-up in 2009. The participants filled out a postal survey in 2007 that included the Danish version of the organisational justice questionnaire.

In 2007 and 2009, the researchers screened the participants for depression using the Common Mental Disorder Questionnaire (CMDQ). Participants with symptoms of depression were then invited to participate in a clinical interview to assess depression in accordance with the International Classification of Disease.

The response rates were 45% for the baseline questionnaire and 72% for the follow-up questionnaire. A non-response analysis showed that the response rates did not distort the results.

The effects of the work unit measures of procedural and relational justice on the risk of developing depression in the two-year period from 2007 to 2009 were analysed using logistic regression analysis with robust clusters.

The authors controlled the analysis for potential ‘confounders’ known to be associated with depression at baseline. These factors included age, gender, education, income, living alone, smoking, alcohol consumption and body mass index. It also included a control for previous episodes of depression, a family history of depression, traumatic life events, neurotic behaviour and depressive symptoms.


This study provides evidence that, statistically, low organisational justice, or fairness, at work significantly increases the risk of onset of depression among Danish public employees. The results are in line with previous studies on depression and organisational justice.

However, studies on organisational justice remain scarce, which means this study provides new insights into the relationship between psychosocial working conditions and depression. The results of this research imply that interventions to increase justice at the workplace might help prevent depression among employees.

This latest study is based on a robust study design. First, it took the form of a prospective cohort study based on a large sample of public employees in Denmark. Second, the study uses an aggregated measure of organisational justice that limits reporting bias. Third, the researchers adjusted for a range of potential ‘confounders’, including depression, at baseline.


Grynderup, M. B., Mors, O., Hansen, Å. M. et al (2013), ‘Work-unit measures of organisational justice and risk of depression – a two-year cohort study’, Occupational and Environmental Medicine, Vol. 70, No. 6, pp. 380–385.

Greenberg, J. (2004), ‘Stress fairness to fare no stress: managing workplace stress by promoting organizational justice’, Organisational Dynamics, Vol. 33, 352–365

Spell, C. S. and Arnold, T. (2007), ‘An appraisal perspective of justice, structure, and job control as antecedents of psychological distress’, Journal of Organizational Behaviour, Vol. 28, No. 6, pp. 729–751.

Ybema, J. F. and van den Bos, K. (2010), ‘Effects of organizational justice on depressive symptoms and sickness absence: a longitudinal perspective’, Social Science and Medicine, Vol. 70, No. 10, pp. 1609–1617.

Ylipaavalniemi, J., Kivimäki, M., Elovainio, M. et al (2005), ‘Psychosocial work characteristics and incidence of newly diagnosed depression: A prospective cohort study of three different models’, Social Science and Medicine, Vol. 61, No. 1, pp. 111–122.

Maj Britt Dahl Nielsen, Oxford Research

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