An Assessment of the Relationship Between the Beck Anxiety Inventory and Stress Hormones Among Intern Doctors in the Emergency Department

Abstract

Objective: We aimed to investigate the anxiety effect of working conditions on intern doctors in emergency department (ED), the severity of this effect according to the Beck Anxiety Inventory (BAI), and the hormonal factors involved in the etiology of anxiety. Methods: A prospective analysis was conducted on a group of 74 intern doctors who completed training in the ED between May and October 2017. Participants were asked to complete the BAI form and have their blood samples taken at 07:00 a.m. during both the first and last night shifts. The blood samples have been utilized in the study of Adrenocorticotropic Hormone (ACTH), Atrial Natriuretic Peptide (ANP) and Cholecystokinin (CCK), hormones that have been found to have a strong correlation with stress levels. A comparison of hormone levels and BAI scores was conducted before and after the internship to assess any changes. Results: The sample size for the study consisted of seventy-four interns, of which 47.3% (n=35) were identified as male. The average age was 25 +/- 2 years. No significant difference was detected in ACTH levels before and after the internship (p = 0.087), although the end-of-internship BAI score and ANP and CCK levels were found to be significantly higher in the entire group (p=0.001, p=0.001, p=0.048; respectively). While the post-internship BAI score and ANP levels were significantly higher in males (p=0.001, p=0.015, respectively), no significant difference was detected in the ACTH and CCK levels before and after the internship (p=0.128, p=0.077, respectively). While post-internship BAI score, ACTH and ANP levels were found to be significantly higher in female (p=0.001, p=0.026, p=0.001; respectively); No significant difference was detected in CCK levels (p = 0.155). Conclusion: Emergency departments are places where stress and anxiety are intensely experienced. The post-internship hormone levels reveal a predominantly anxiolytic pattern (with no notable alteration in ACTH levels but a rise in ANP), while the elevated BAI score can be attributed to the subjective nature of this assessment tool. Identifying the hormones that increase or decrease in response to stress and conducting further research on treatment may be one method of coping with stress.