Abstract
BackgroundLittle data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya’s largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment.MethodsWe sampled 338 residents belonging to 8 different specialties using self administered questionnaires in this cross-sectional survey between October 2019 and February 2020. Questionnaires included: sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure. Bivariate and multivariate linear regression were used to assess for risk factors for depression.ResultsMean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported no to mild depressive symptoms, 12.7% had moderate, and 16.9% had severe depressive symptoms. Most residents had high social support (71.8%) and moderate stress (61.6%). The educational environment was rated as more positive than negative by 46.3% of residents. Bivariate analyses revealed significant correlations between depressive symptoms, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis showed that depression was strongly associated with: fewer hours of sleep (β = − 0.683, p = 0.002), high perceived stress (β = 0.709, p < 0.001) and low perceived social support (β = − 2.19, p < 0.001).ConclusionsOnly 30% of medical residents in our study had moderate and severe depressive symptoms. Most residents in our study reported high levels of social support, and moderate levels of stress. Though their overall appraisal of medical residency experience was positive, mental health support and self-care skills in the training of medical professionals needs prioritization.
Highlights
Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa
Our secondary aims were to understand how depression was associated with factors such as perceived stress, perceived social support, substance use, sociodemographics (an additional file shows the sociodemographic questionnaire in more detail), and the educational environment of residency training
Bivariate associations between depression and other mental health measures Our results showed that depression was significantly associated with perceived stress (r = 0.618), substance use (r = 0.186), social support (r = − 0.443), and educational environment (r = − 0.304)
Summary
Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can lead to substance abuse and suicide. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment. Errors made in medical practice can have serious consequences for patients and their families. Negligent care causes 28% of adverse events, 13.6% of adverse events result in patient death. Adverse events due to negligent care are more likely to result in serious disability to patients [2, 3]. Some of the symptoms experienced due to depression include: depressed mood, loss of pleasure or interest, weight loss, insomnia or hypersomnia, psychomotor agitation or retardation, loss of energy/fatigue, guilty feelings, feeling worthless, difficulty concentrating, and suicidal ideation [4]
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