Abstract
Objective
This study describes the characteristics that are associated with depression in residents and also examines resident perception of available mental health support.
Methods
Residents and their program directors from each of 10 specialties across all academic training institutions in Ohio were electronically surveyed over a 2-month period. Generalized logistic regression was used to test for association between risk factors and depression and, among depressed residents, with suicidal thoughts.
Results
Using the PHQ-9, 19% of residents met criteria for at least moderate depression and 31.1% of depressed residents had suicidal thoughts. Over 70% of depressed residents were not receiving treatment, including 70% of depressed residents with suicidal thoughts. Residents who were unaware of wellness programming or did not believe their program director would be supportive of a depressed resident were significantly more likely to be depressed. Residents who believed depression treatment would negatively impact medical licensure were significantly more likely to be depressed. Male program directors and those in their position for fewer than 5 years were significantly more likely to have depressed residents in their program.
Conclusions
A substantial proportion of depressed residents have suicidal thoughts, and most are not receiving treatment. Depressed residents may perceive the availability of support from their program director differently than their non-depressed colleagues, and may perceive greater risk to medical licensure if they seek treatment.
Similar content being viewed by others
References
Mousa OY, Dhamoon MS, Lander S, Dhamoon AS. The MD Blues: under-recognizing depression and anxiety in medical trainees. PLoS ONE. 2016. https://doi.org/10.1371/jounal.pne.0156556.
Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81(4):354–73.
Goebert D, Thompson D, Takeshita J, Beach C, Bryson P, Ephgrave K, et al. Depressive symptoms in medical students and residents: a multischool study. Acad Med. 2009;84(2):236–41.
Mata DA, Ramos MA, Bansal N, Khan R, Guille C, Di Angelantonio E, et al. Prevalence of depressive symptoms among resident physicians. JAMA. 2015;314(22):2373–83. https://doi.org/10.1001/jama.2015.15845.
Rotenstein LS, Ramos MA, Torre M, Segal B, Peluso MJ, Guille C, et al. Prevalence of depression, depression symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA. 2016;316(21):2214–36.
Lindeman S, Laara E, Hakko H, Lonnqvist J. A systematic review on gender-specific suicide mortality in medical doctors. Br J Psychiatry. 1996;168:274–9.
de Oliveira GS, Chang R, Fitzgerald PC, Almeida MD, Castro-Alves LS, Ahmad S, et al. The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees. Anesth Analg. 2013;117(1):182–93.
Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, et al. Rates of medication errors among depressed and burned out residents: prospective cohort study. BMJ. 2008. https://doi.org/10.1136/bmj.39469.763218.BE.
Sen S, Kranzler HR, Krystal JH, Speller H, Chan G, Gelernter J, et al. A prospective cohort study investigating factors associated with depression during medical internship. Arch Gen Psychiatry. 2010;67(6):557–65.
Guille C, Frank E, Zhao Z, Kalbach DA, Nietert PJ, Mata DA, et al. Work-family conflict and the sex difference in depression among training physicians. JAMA Intern Med. 2017;177(12):1766–72.
Tyssen R, Vaglum P, Gronvold NT, Ekeberg O. The impact of job stress and working conditions on mental health problems among junior house officers. A nationwide Norwegian prospective cohort study. Med Educ. 2000;34:374–84.
Guille C, Speller H, Laff R, Epperson CN, Sen S. Utilization and barriers to mental health services among depressed medical interns: a prospective multisite study. JGME. 2010;2:210–4.
Rosen IM, Christie JD, Bellini LM, Asch DA. Health and health care among housestaff in four U.S. internal medicine residency programs. J Gen Intern Med. 2000;15:116–21.
Montgomery AJ, Bradley C, Rochfort A, Panagopoulou E. A review of self-medication in physicians and medical students. Occup Med. 2011;61:490–7.
Christie JD, Rosen IM, Bellini LM, Inglesby TV, Lindsay J, Alper A, et al. Prescription drug use and self-prescription among resident physicians. JAMA. 1998;280:1253–5.
Ey S, Moffit M, Kinzie JM, Brunett PH. Feasibility of a comprehensive wellness and suicide prevention program: a decade of caring for physicians in training and practice. JGME. 2016;8(5):747–53.
Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.
Harri PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.
Hommel G. A comparison of two modified Bonferroni procedures. Biometrika. 1988;75:383–6.
Knudson C. glmm: generalized linear mixed models via Monte Carlo likelihood approximation. R Package Version 1.2.3. 2018. https://CRAN.R-project.org/package=rms.
Harrell FE Jr. Rms: Regression modeling strategies. R package version 5.1-2. https://CRAN.R-project.org/package=rms.
Kendall MG, Stuart A. The advanced theory of statistics, vol. 2. New York: MacMillan; 1979.
Guille C, Zhao Z, Krystal J, Nichols B, Brady K, Sen S. Web-based cognitive behavioral therapy intervention for the prevention of suicidal ideation in medical interns: a randomized clinical trial. JAMA Psychiat. 2015. https://doi.org/10.1001/jamapsychiatry.2015.1880.
Acknowledgments
The authors wish to acknowledge contributions by the following participants in the DEPRESS-Ohio Study Group:
Julie Niedermier
Ryan Mast
Richard Ulrich
Marijo Tamburrino
Rusheeth Thummalapally
Ronne Proch
Erin Dean
Lindsay O’Brien
Melissa Wagner Schuman
Sophianne Morgan
Christine Collins
Funding
Funding was provided by the Columbus Medical Association Foundation and the Ohio Psychiatric Physicians Foundation.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
This study was conducted after acquiring IRB approval at all seven academic training institutions. Surveys were completed after each participant acknowledged informed consent.
Disclosures
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Levy, A.B., Nahhas, R.W., Sampang, S. et al. Characteristics Associated with Depression and Suicidal Thoughts Among Medical Residents: Results from the DEPRESS-Ohio Study. Acad Psychiatry 43, 480–487 (2019). https://doi.org/10.1007/s40596-019-01089-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40596-019-01089-9