Monday, July 20, 2020

Psychiatrists Experience Substantial Burnout, APA Survey Finds

Nearly 80% of North American psychiatrists responding to an online survey reported burnout, and 16% reported symptoms consistent with major depression, according to a report in AJP in Advance.

“We believe that these findings have an important workforce policy implication,” wrote Richard Summers, M.D., of the University of Pennsylvania and colleagues. “Because burnout has been associated with a move to part-time status, increased leaves of absence, job change, and early retirement, interventions to decrease burnout are also interventions to enhance the psychiatric workforce.”

The survey was created by the Board of Trustees Workgroup on Psychiatrist Well-Being and Burnout and open from October 30, 2017, through December 10, 2018. The survey included the 16-item Oldenburg Burnout Inventory (OLBI) as well as the Patient Health Questionnaire-9 (PHQ-9), a common depression screening tool. Both APA members and nonmember psychiatrists were invited to participate, and 2,084 psychiatrists responded.

Seventy-eight percent of respondents reported OLBI scores above 35, indicating a positive screen for burnout. In addition, 16% of respondents reported PHQ-9 ≥10, consistent with moderate or severe depression. Of those reporting possible depression, 98% also reported burnout, suggesting a strong overlap of these two problems. However, the workgroup did not find any association between burnout and suicidal ideation after controlling for other depressive symptoms.

After adjusting for mediating factors, the APA workgroup found that women psychiatrists; those reporting a lack of control over their professional schedule; and those working in inpatient, community, or government settings were more likely to report burnout than others. Women psychiatrists and psychiatrists working in nonacademic settings were also more likely to report high PHQ-9 scores, as were residents and early-career psychiatrists.

“Health care organizations can easily identify those at higher risk by screening for burnout and preferentially allocating their scarce resources toward these individuals,” Summers and colleagues wrote. “Health care organizations should also consider devoting resources to interventions focused on decreasing burnout among minority psychiatrists because of their potential increased risk and essential participation in the workforce.”

They added, “An important area of investigation is identifying individual and workplace factors that could predict burnout, depression, and suicide risk among psychiatrists so that preventive interventions can be developed and employed. Potentially important individual and workplace factors include work-home balance, such as family status and caregiver burden for family members, sense of belonging to the physician community, efficiency of the workplace, ease of use of electronic health records, perception of response to medical errors, and other psychiatry-specific factors (for example, out-of-network practice).”

(Image: iStock/Maryna Andriichenko)

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