Abstract
Background: Previous studies have suggested that sleep quality is associated with depressive symptoms. However, associations between overall sleep quality and depressive symptoms in Chinese resident physicians remain unclear. Therefore, we aimed to determine whether overall sleep quality is associated with depressive symptoms in Chinese resident physicians.Methods: This cross-sectional study included 1,230 resident physicians. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was applied to estimate the associations between the PSQI and PHQ-9.Results: Among all participants, the prevalence of mild (PHQ-9 ≥ 5) and moderate or severe (PHQ-9 ≥ 10) depressive symptoms were 48.28 and 12.93%, respectively. PSQI score was positively associated with PHQ-9 score before and after adjustments of socio-demographic, behavioral, and psychologic confounding factors (all P < 0.0001). After adjustments, the regression coefficients (standard error) between PSQI scores and PHQ-9 scores were 0.95 (0.04), 0.88 (0.09), and 0.96 (0.05) in all participants, men, and women, respectively. Compared to physicians with good sleep quality (PSQI scores ≤ 5), the adjusted odds ratios (ORs) [95% confidence intervals (CIs)] for mild (PHQ-9 ≥ 5) and moderate or severe (PHQ-9 ≥ 10) depressive symptoms in physicians with poor sleep quality were 7.15 (5.44, 9.46) and 6.17 (4.03, 9.71) in all participants, respectively.Conclusions: Our findings suggest that poor sleep quality was associated with a higher prevalence of depressive symptoms in Chinese resident physicians.
Highlights
As reported in the Global Burden of Disease Study, the number of cases of depression worldwide increased from 172 million in 1990 to 258 million in 2017, representing a 49.86% increase during the study period [1]
Pittsburgh Sleep Quality Index (PSQI) score was positively associated with Patient Health Questionnaire-9 (PHQ-9) score before and after adjustments of socio-demographic, behavioral, and psychologic confounding factors
Our findings suggest that poor sleep quality was associated with a higher prevalence of depressive symptoms in Chinese resident physicians
Summary
As reported in the Global Burden of Disease Study, the number of cases of depression worldwide increased from 172 million in 1990 to 258 million in 2017, representing a 49.86% increase during the study period [1]. In 2015, a meta-analysis suggested that that the overall pooled prevalence of “screening positive” for depression was 20.9% (95% CI: 17.5–24.7%) among studies using the Patient Health Questionnaire-9 (PHQ-9) with cutoff score ≥ 10. The prevalence of depressive symptoms (defined with the SelfRating Depression Scale score ≥ 53) in Chinese physicians has been reported as high as 57.2% [3]. Depression in resident physicians has been associated with poor-quality patient care and increased self-reported medical errors [6, 7]. Previous studies have suggested that sleep quality is associated with depressive symptoms. Associations between overall sleep quality and depressive symptoms in Chinese resident physicians remain unclear. We aimed to determine whether overall sleep quality is associated with depressive symptoms in Chinese resident physicians
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