Promotion of Wellness and Mental Health Awareness Among Physicians in Training: Perspective of a National, Multispecialty Panel of Residents and Fellows

Daskivich, Timothy J.; Jardine, Dinchen A.; Tseng, Jennifer; Correa, Ricardo; Stagg, Brian C.; Jacob, Kristin M.; Harwood, Jared L.

doi:10.4300/jgme-07-01-42

Cited by 147 publications

(79 citation statements)

References 17 publications

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“…The identified trend may reflect the medical community's increased awareness of depression or developments external to medical education. 91 Future studies should explore specific factors that may explain this trend.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Depression and Depressive Symptoms Among Resident Physicians

Mata

Ramos

Bansal

et al. 2015

JAMA

1,033

764

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IMPORTANCE Physicians in training are at high risk for depression. However, the estimated prevalence of this disorder varies substantially between studies. OBJECTIVE To provide a summary estimate of depression or depressive symptom prevalence among resident physicians. DATA SOURCES AND STUDY SELECTION Systematic search of EMBASE, ERIC, MEDLINE, and PsycINFO for studies with information on the prevalence of depression or depressive symptoms among resident physicians published between January 1963 and September 2015. Studies were eligible for inclusion if they were published in the peer-reviewed literature and used a validated method to assess for depression or depressive symptoms. DATA EXTRACTION AND SYNTHESIS Information on study characteristics and depression or depressive symptom prevalence was extracted independently by 2 trained investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using meta-regression. MAIN OUTCOMES AND MEASURES Point or period prevalence of depression or depressive symptoms as assessed by structured interview or validated questionnaire. RESULTS Data were extracted from 31 cross-sectional studies (9447 individuals) and 23 longitudinal studies (8113 individuals). Three studies used clinical interviews and 51 used self-report instruments. The overall pooled prevalence of depression or depressive symptoms was 28.8% (4969/17 560 individuals, 95% CI, 25.3%-32.5%), with high between-study heterogeneity (Q = 1247, τ2 = 0.39, I2 = 95.8%, P < .001). Prevalence estimates ranged from 20.9% for the 9-item Patient Health Questionnaire with a cutoff of 10 or more (741/3577 individuals, 95% CI, 17.5%-24.7%, Q = 14.4, τ2 = 0.04, I2 = 79.2%) to 43.2% for the 2-item PRIME-MD (1349/2891 individuals, 95% CI, 37.6%-49.0%, Q = 45.6, τ2 = 0.09, I2 = 84.6%). There was an increased prevalence with increasing calendar year (slope = 0.5% increase per year, adjusted for assessment modality; 95% CI, 0.03%-0.9%, P = .04). In a secondary analysis of 7 longitudinal studies, the median absolute increase in depressive symptoms with the onset of residency training was 15.8% (range, 0.3%-26.3%; relative risk, 4.5). No statistically significant differences were observed between cross-sectional vs longitudinal studies, studies of only interns vs only upper-level residents, or studies of nonsurgical vs both nonsurgical and surgical residents. CONCLUSIONS AND RELEVANCE In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among resident physicians was 28.8%, ranging from 20.9% to 43.2% depending on the instrument used, and increased with calendar year. Further research is needed to identify effective strategies for preventing and treating depression among physicians in training.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Depression and Depressive Symptoms Among Resident Physicians

Mata

Ramos

Bansal

et al. 2015

JAMA

1,033

764

View full text Add to dashboard Cite

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“…51 PHYSICIAN DEPRESSION AND SUICIDE problem is among trainees as the ACGME doesn't collect data on resident suicide (M. Miller, personal communication, June 30, 2013). The ACGME recently convened the Council of Review Committee Residents to study resident wellness and mental health following two resident suicides in 2014, 49 but it is not clear what authority will be given to their recommendations. Finally, we don't know a lot about what works with practicing physicians, because little research has been done.…”

Section: Where Do We Go From Here?mentioning

confidence: 99%

Physician Depression and Suicide: A Shared Responsibility

Eckleberry-Hunt

Lick

2015

Teaching and Learning in Medicine

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The purpose of this article is to draw attention to the problem of physician suicide with an emphasis on the role of medical education. Multiple accreditation bodies should be involved to effect a change in physician suicide prevalence. Thirty years have demonstrated that without mandates, large-scale change will not occur. We adapted some of the 2012 National Strategy for Suicide Prevention goals to medical education as a guide.

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“…Using existing literature on well‐being programmes and the Beyond Blue recommendations, our sessions were curated to validate the feelings of those interns who experience medicine as stressful, to promote well‐being, self‐awareness and positive coping strategies and to cultivate a supportive learning and work environment …”

Section: Methodsmentioning

confidence: 99%

“…Doctor well-being is thought to impact professionalism, physical and mental health, career satisfaction, work sustainability and the quality of care delivered to patients. [1][2][3] The tragic loss of Australian young doctors to suicide, the prevalent reports of workplace bullying and harassment in medicine and surgery and the growing body of evidence revealing high rates of psychological distress, burnout and mental illness among doctors all point to the need to promote doctors' well-being and address the cultural factors within medicine that adversely impact doctors' health. [4][5][6][7] The Beyond Blue health report revealed that younger doctors were more adversely affected by poor rates of mental health compared to other health professionals.…”

Section: Introductionmentioning

confidence: 99%