Abstract
Depression amongst physicians can lead to poor individual and institutional outcomes. This study examined the prevalence and factors associated with depression and suicidal ideation amongst doctors in Hong Kong. Doctors who graduated from medical school at the University of Hong Kong between 1995 and 2014 were invited to participate in a survey measuring depressive symptoms, suicidal ideation and thoughts of self-harm, lifestyle behaviours, career satisfaction and socio-demographic characteristics. Data collection occurred between January and April 2016. The prevalence of screened-positive depression was 16.0% and 15.3% of respondents reported having suicidal ideation. Amongst those with positive depression screening scores, less than half reported having a diagnosed mood disorder. Sleeping fewer hours was associated with higher depression scores (P < 0.001) and an increased odds of meeting the cut-off for depression (P < 0.001). Factors associated with suicidal ideation included being unmarried (P = 0.012) and sleeping fewer hours (P = 0.022). Hong Kong doctors appear to have high rates of undiagnosed depression, and high levels of depressive symptoms and suicidal ideations. There is a need for greater awareness of the morbidity due to depression and to promote better mental health help-seeking among physicians. Barriers to mental health help-seeking need to be addressed and appropriate resources allocated to reduce suffering.
Highlights
This study found that a significant proportion of Hong Kong (HK) physicians are depressed (16%) and have thoughts of suicide or self-harm (15.3%)
Our findings were higher than those by Siu et al which found 4.9% of HK doctors had suicidal ideations[21]. This could be a result of the wording of the Patient Health Questionnaire-9 (PHQ-9) suicidality item as the question assesses both self-harm and suicidal ideation together which may result in more positive responses as suicidal ideation and self-harm are not differentiated
This study showed that having less sleep increased the odds of suicidal ideations and self-harm behaviour such that sleeping 1 h less increased the odds of suicidal thoughts by 31%
Summary
Medical school graduates from the University of Hong Kong between 1995 and 2014 who had a valid email or mailing address (N = 1607) were invited to participate in this cross-sectional study. Subjects with valid email addressed were contacted by email to complete an online survey in English via SoGo Survey which tracked the responses electronically. Paper questionnaires were subsequently mailed to graduates with available mailing addresses. The survey was voluntary, and response to the survey was taken as implied consent. The institutional review board allowed implied consent as the risk of harm from the survey study was minimal, the population was deemed not vulnerable, and the data collection was fully de-identified and anonymous. Collecting signatures for consent could increase a perceived risk for subject identification and deter potential respondents from completing the survey
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