Depression affects 29 percent of medical residents, study reports

One quarter to one third of medical residents have depression or symptoms of depression, according to a new study published December 8, 2015 in JAMA. This finding has implications not only for the mental health of physicians, but also for the care their patients will receive, researchers said.

“These findings highlight an important issue in graduate medical education,” the authors wrote, noting that the prevalence of depression in residents is much higher than in the general population. “Because the development of depression has been linked to a higher risk of future depressive episodes and greater long-term morbidity, these findings may affect the long-term health of resident doctors.”

According to the American Foundation for Suicide Prevention, 300 to 400 physicians commit suicide each year—approximately 1 physician per day.

“Depression among residents may also affect patients, given established associations between physician depression and lower-quality care,” the authors added.

In this meta-analysis, researchers reviewed 54 studies published between 1963 and 2015 that looked at the prevalence of depression or depressive symptoms among more than 17,500 resident physicians. The researchers found that prevalence estimates ranged from 21% to 43%, with an overall pooled prevalence of depression or depressive symptoms of 28.8% (4,969/17,560 individuals). Also, depression increased along with the calendar year.

In a secondary analysis of 7 longitudinal studies, depressive symptoms increased after the beginning of residency training. The findings showed no statistically significant differences between interns vs upper-level residents, or nonsurgical vs both nonsurgical and surgical residents.

“The increase in depression is surprising and important, especially in light of reforms that have been implemented over the years with the intent of improving the mental health of residents and the health of patients,” said the study’s senior author Srijan Sen, MD, PhD, Associate Professor of Psychiatry at University of Michigan Medical School, in Ann Arbor, MI.

While many medical schools and teaching hospitals have directly addressed student and trainee mental health in recent years, more needs to be done, the authors noted.

“Our findings provide a more accurate measure of the prevalence of depression in this group, and we hope that they will focus attention on factors that may negatively affect the mental health of young doctors, with the goal of identifying strategies to prevent and treat depression among graduate medical trainees,” said the study’s lead author Douglas A. Mata, MD, MPH, a resident physician in pathology at Brigham and Women's Hospital and clinical fellow at Harvard Medical School, in Boston, MA.

In an accompanying editorial in JAMA, Thomas L. Schwenk, MD, Dean of the University of Nevada School of Medicine in Reno, NV, wrote, “The solutions to this endemic can be classified into 3 categories: provide more and better mental health care to depressed physicians and those in training; limit the trainees’ exposure to the training environment and system that are thought to contribute at least in part to poorer mental health and wellness; and consider the possibility that the medical training system needs more fundamental change."