Orthopaedic Surgeon Mental Health During the COVID-19 Pandemic

Abstract

Introduction: This study compares rates of depression, suicidal ideation, and burnout among resident/fellow and attending physicians in orthopaedic surgery to other specialties during height/end of the first wave of the coronavirus disease 2019 (COVID-19) pandemic at our institution. Main outcomes and measures included suicidal ideation, Patient Health Questionnaire for Depression (PHQ-9) scores for depression, and 2 single-item measures for emotional exhaustion and depersonalization. This study provides valuable information regarding orthopaedic surgeon mental health during world crises. Methods: This is a cross-sectional survey-based study of resident, fellow, and attending physicians from 26 specialties during and after the first wave of the COVID-19 pandemic at our institution from April 24, 2020 to May 15, 2020. The survey contained 22 items. This includes consent, demographics and general data, 2 single-item questions of emotional exhaustion and depersonalization, and the PHQ-9. Subjects were eligible if they were a resident/fellow or attending physician at our institution. Results: The response rate for the study was 16.31%. Across all specialties rates were 6.2% depression, 19.6% burnout, and 6.6% suicidal ideation. The results for orthopaedic surgeons are as follows: 0% tentative diagnosis of depression, 3.8% suicidal ideation, and 4% burnout. Anesthesiology had the highest rate of depression (14.3%). Internal medicine and other non-surgical specialties had the highest rate of suicidal ideation (10.2%). Orthopaedic surgeons were significantly more likely to achieve work–life balance and experience less burnout than anesthesiologists and pediatricians. Discussion: Depression, suicidal ideation, and burnout continue to affect physicians across all specialties. These issues are amplified in light of crisis. Job satisfaction and rigorous training may be protective factors that allow orthopaedic surgeons to adapt to novel clinical settings under stress when compared to anesthesiologists and pediatricians. Resilience training and stress management strategies should continue to be investigated to better prepare physicians for world crises.

Suicidal ideation and suicide attempts in healthcare professionals during the COVID-19 pandemic: A systematic review

“…In this line, there are a number of factors associated with higher suicidality such as higher rates of depression (27,32,33,36,37,39,40,55); anxiety (19, 27, 32, 36-39, 52, 55); post-traumatic stress disorder (32, 42); pre-pandemic lifetime mental disorders (24) or previous lifetime suicide attempt; insomnia severity; nightmare frequency; a poorer self-perceived health (32, 33, 36, 47, 60); and burnout (32). In most cases, all these risk factors have increased in impact during the COVID-19 pandemic and, as Mamun and Ullah (65) estimate, approximately 90% of suicides are due to psychological distress in the face of continued exposure to highly stressful situations.…”

“…Major factors associated with increased suicidality include higher rates of depression (27,32,33,36,37,39,40,55); anxiety (19, 27, 32, 36-39, 52, 55); post-traumatic stress disorder (32, 42); pre-pandemic lifetime mental disorders (24) or previous lifetime suicide attempt; insomnia severity; nightmare frequency; poorer subjective health (32, 33, 36, 47, 60); and burnout (32). In addition, other personal factors predisposing to suicidal thoughts include being female (58); having friends or family members infected with COVID-19 (24,32,56); living alone; having poor physical health (32); being single (27,39), divorced, legally separated, or widowed (24); higher alcohol consumption (32, 34); psychotropic drug use (34, 42); and change in vitamin D levels (45). Younger age is considered a risk factor for some participants (32, 35), a protective factor for others (39), and shows no clear age pattern for the rest (35).…”

“…In addition, other personal factors predisposing to suicidal thoughts include being female (58); having friends or family members infected with COVID-19 (24,32,56); living alone; having poor physical health (32); being single (27,39), divorced, legally separated, or widowed (24); higher alcohol consumption (32, 34); psychotropic drug use (34, 42); and change in vitamin D levels (45). Younger age is considered a risk factor for some participants (32, 35), a protective factor for others (39), and shows no clear age pattern for the rest (35). Regarding work-related factors during the pandemic, suicidal ideation was associated with financial concerns (24,32,34), assessing one's working conditions as poor (34) or perceived lack of preparedness of the health care facility (24); having had job functions changed (51); having been isolated or quarantined for COVID-19 (24,56); having been moved to a specific workplace related to COVID-19; being an auxiliary nurse (24) or a nurse (44, 46); reporting high workload (34) or stress (56); feeling perceived discrimination (43, 50) and not feeling support from family (47) or superiors (52); and reporting an increased post-pandemic burden (34).…”

Burnout und Abhängigkeit bei ärztlichem Personal zeitlos und während der COVID-19-Pandemie am Beispiel der Chirurgie und Anästhesie

“…Über alle Fachgebiete hinweg lagen die Raten bei 6,2 % Depressionen, 19,6 % Burnout und 6,6 % Selbstmordgedanken. Die Ergebnisse für orthopädische Chirurgen lauten wie folgt: 0 % vorläufige Depressionsdiagnose, 3,8 % Selbstmordgedanken und 4 % Burnout [ 1 , 25 ]. Bezüglich der Neurochirurgen hat eine kürzlich durchgeführte Studie gezeigt, dass eine hohe Rate an psychischen Störungen während der Pandemie auftrat.…”

“…Die Prävalenz von beruflichem Burnout in der Anästhesiologie liegt zwischen 15 % und 65 % und hat eine kritische Anzahl von gefährdeten Ärzten erreicht, deren eigenes Wohlergehen während einer globalen Pandemie entscheidend ist [ 3 ]. Darüber hinaus wies die Anästhesiologie die höchste Rate an Depressionen während der COVID-19-Pandemie auf [ 1 ].…”