Effects of procedural justice on prospective antidepressant medication prescription: a longitudinal study on Swedish workers

BMC Public Health. 2020 Apr 15;20(1):488. doi: 10.1186/s12889-020-08560-5.


Background: Procedural justice has been linked to several mental health problems, but most studies have used self-reported data. There exist a need to assess the link between procedural justice and health using outcomes that are not only self-reported. The aim of the current study was to examine whether perceived procedural justice at work is prospectively associated with antidepressant medication prescription.

Methods: Data from 4374 participants from the Swedish Longitudinal Survey of Health (SLOSH) were linked to the Swedish National Prescribed Drug register. Based on their perceived procedural justice at two times (2010 and 2012), participants were divided into four groups: stable low, increasing, decreasing and stable high justice perceptions. Using Cox regression, we studied how the course of stability and change in perceived procedural justice affected the rate of prescription of antidepressant medication over the next 2 years. Participants with missing data and those who had been prescribed antidepressant medication in the period leading up to 2012 were excluded in the main analyses to determine incident morbidity.

Results: The results showed that after adjustment for sex, age, education, socioeconomic position, marital status, and insecure employment a decrease in perceived procedural justice over time was associated with greater receipt of antidepressants compared to people with stable high perceptions of procedural justice (HR 1.76, 95% CI: 1.16 to 2.68). Being female and having insecure employment were also associated with higher hazards of antidepressant prescription.

Conclusions: These findings strengthen the notion that procedural justice at work influences psychological well-being, as well as provide new insights into how procedural justice perceptions may affect mental health.

Keywords: Antidepressant medication; Organizational justice; Prescription medicine; Procedural justice; Register data.

MeSH terms

  • Adult
  • Aged
  • Antidepressive Agents / therapeutic use*
  • Depression / drug therapy
  • Depression / etiology*
  • Depressive Disorder / drug therapy
  • Depressive Disorder / etiology*
  • Drug Prescriptions*
  • Employment
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Health*
  • Middle Aged
  • Prospective Studies
  • Self Report
  • Social Justice / psychology*
  • Sweden
  • Workplace*
  • Young Adult


  • Antidepressive Agents