Abstract
Objective: To complete a systematic review of the literature addressing major depression in resident physicians. Methods: In 2013, the authors completed a systematic review of articles addressing major depression in physicians in United States residency programs. The following keywords were used: anxiety, stress, and mood, medical residents or interns, physician residents, graduate medical education, depression, stress or anxiety, and suicide. Results: The prevalence of depression in resident physicians is higher than that of the general population. Many sociodemographic and residency-associated factors have been studied in their relation to resident physician depression. Only physical health, an unhappy childhood, and stress at work were found to have association with depression, while the amount of call, lifestyle, age, income, and season of the year were not associated with depression. Other factors had an equivocal relationship. Depression in resident physicians is associated with medical errors, decreased ability to handle work-related stress, leaves of absence, discontinuation of medical training, disruption in personal lives, and suicide. Intervention with treatment for depression, using a low-cost, confidential, off-campus program, was successful. However, physicians may hesitate to seek treatment for mental illness because of the professional consequences, such as difficulty with medical licensing, hospital privileges, and malpractice insurance. Conclusions: Major depression is common in resident physicians in the United States. It has a negative impact on the lives of the doctors and the patients whom they treat. There appear to be effective ways of assisting residents with major depression available to training programs.
Highlights
Our goal is to describe the current literature addressing major depression in resident physicians in a narrative fashion that will allow the reader to better understand its risk factors
A study was included if it was conducted in the United States, addressed depression in resident physicians, discussed sociodemographic or residency program factors associated with depression, or addressed consequences of depression, including suicide
The abstracts of the reference articles of the final 32 articles were reviewed and those that addressed depression in resident physicians were included in this review, adding 14 more articles for a total of 46 articles for this literature review
Summary
“On the thirteenth day of his internship...Dr K went to a fifth floor hospital lounge where he was observed...pacing for several minutes periodically touching the thicker inner pane of window glass separated from an outer pane by a venetian blind...A few minutes later, when alone in the lounge, he lunged toward the window and dove through both panes to his death 60 feet below.”. —From Suicide and the Stress of Residency Training: A Case Report and Review of the Literature. Our goal is to describe the current literature addressing major depression in resident physicians in a narrative fashion that will allow the reader to better understand its risk factors. This systematic review will address the incidence and prevalence of resident physician depression, sociodemographic and residency program factors associated with depression, the apparent consequences of depression in residents, the approaches to screening treatment that have been studied, and a discussion of possible barriers to the access and receipt of treatment
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