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Why is this article important?
Per the ACGME, depression and suicide rates among physicians is 1.41 times higher than the general population in men and 2.27 times higher in women. This article looks at the increases in depressive symptoms among residents in their intern year. It compares scores between men and women and then looks at the relationship among depressive symptoms and work-family-conflict. It is important to find solutions and modifiable risk factors to improve mental health and wellness among physicians.
What they looked at:
Does depression disproportionately affect female physicians compared with male physicians during the internship year, and does work-family conflict impact the sex difference in depressive symptoms among training physicians?
How they measured things:
Following the 2015-2016 match year, 5150 email addresses of eligible residents were obtained via public database. 3120 (61%) agreed to participate. Qualtrics surveys gathered general demographic data, depressive symptoms via PHQ-9 and conflict between work and family roles through a work and family conflict scale at 2 months prior to intern year and 6 months into intern year.
Statistical analysis via chi-squared tests, t-tests and pearson correlation were used to determine baseline differences between men and women with respect to demographics, history of depression and changes in work-family conflict scores.
What were their outcomes:
Both men and women had a statistically significant increase in depressive symptoms during their internship year (93% increase in men and 115% increase in women). Increases in work family conflict were correlated with increase in depressive scores.
Even after adjusting for work-family conflict the increase in depression scores was still higher in women than among men.
Why do we care about this article?
What does this mean?
This study shows that depressive symptoms increase dramatically during internship year in both men and women, but the increase is greater for women. Work family conflict was shown to have positive correlation with increase in depressive symptoms. If that is the case, if work-family-conflict could be reduced, in theory so could depressive symptoms among residents. Residency training was designed decades ago. At that time applicants were primarily male. While some changes have been made over the years to things such as work hours, overall things are not much different. There needs to be a stronger focus on mental health and wellness when designing the medical education programs of the future.
For further reading on the topic, check out these articles!
Mata DA, Ramos MA, Bansal N, et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015;314(22):2373-2383.
Williams ES, Konrad TR, Scheckler WE, et al. Understanding physicians’ intentions to withdraw from practice: the role of job satisfaction, job stress, mental and physical health. Health Care Manage Rev. 2001;26(1):7-19.
Schernhammer ES, Colditz GA. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry. 2004;161(12):2295-2302.